유방암 방사선치료 시 반대편 유방의 피부선량 감소를 위한 볼루스 효과
Bolus Effect to Reduce Skin Dose of the Contralateral Breast During Breast Cancer Radiation Therapy
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초록
본 연구는 유방암 방사선치료 시 반대편 유방의 피부선량을 경감시키기 위해 Radon phantom을 이용하여 조직등가물질인 볼루스 5 mm, 10 mm를 적용해 종속조사면 병합치료방법(FIF)과 쐐기접선조사(Wedge 15, 30)그리고세기조절방사선치료계획(IMRT)을 이용하여 선량비교평가를 시행하고자 하였으며, 치료처방으로 50.4 Gy로 시행하였다. 선량비교평가 방법으로 광자극발광선량계를 이용하여 치료 부위 반대편 유방의 8곳에 부착하여 각각의 치료계획별로 선량을 측정하였다. 연구에 이용된 광자극발광선량계 중 재현성은 3% 이내인 25개를 사용하였다. 연구결과, FIF 치료계획에서는 볼루스 없이 측정된 결과 대비 5 mm와 10 mm 평균 감소율은 각각 37.23 cGy와 41.77 cGy이었으며, Wedge 15°를 이용한 치료계획에서 평균 감소율은 각각 70.69 cGy, 87.57 cGy였다. 또한 IMRT에서는 각각 67.37 cGy와 83.17 cGy의 감소율을 보여주었다. 볼루스를 이용한 결과는 모든 치료계획에서 볼루스의 두께가 증가할수록 선량 감소폭이 커지는 결과를 보여주었다.
Abstract
The aim of this study was to evaluate the dose comparison using Radon phantom with 5 mm and 10 mm tissue equivalent materials, FIF, Wedge(15, 30 angle) and IMRT, to reduce the skin dose of the contralateral breast during breast cancer radiation therapy(Total dose: 50.4Gy). The dose was measured for each treatment plan by attaching to the 8 point of the contralateral breast of the treated region using a optical-stimulated luminance dosimeter(OSLD) as a comparative dose evaluation method. Of the OSLD used in the study, 10 were used with reproducibility within 3%. As a result, the average reduction rates of 5 mm and 10 mm in the FIF treatment plan were 37.23 cGy and 41.77 cGy, respectively, and the average reduction rates in the treatment plan using Wedge 15° were 70.69 cGy and 87.57 cGy, respectively. The IMRT showed a reduction of 67.37 cGy and 83.17 cGy, respectively. The results of using bolus showed that as the thickness of the bolus increased in all treatments, the dose reduction increased. We concluded that mastectomy as well as general radiotherapy for breast cancer would be very effective for patients who are more likely to be exposed to scattered radiation due to a more demanding or complex treatment plan.
참고문헌 (10)
- "National Cancer Information Center"[URL]
- Jone DB, "Cancer in the contralateral breast after radiotherapy for breast cancer", The New England Journal of Medicine, 326, pp.781~785 (1992)
- Terence M. Williams, "Contralateral breast dose after whole breast irradiation. An analysis by treatment technique", Int. J. Radiation Oncology Biol. Phys, 82(5), pp.2079~2085 (2012)
- Starkschall G, "Surface dose for megavoltage photon beams outside the treatment field", Med. Phys, 10, pp.906~910 (1983)
- Ajay KB, "Intensity modulated radiation therapy (IMRT) reduces the dose to contralateral breast when compared to conventional tangential fields for primary breast irradiation", Breast Cancer Research and Treatment, 96, pp.41~46 (2007)
- Su Chul Han, "Changes of Optically Stimulated Luminescence Dosimeter Sensitivity with High Dose", Medical Physics, 27, pp.98~104 (2016)
- 라정은, "유리선량계의 선량 특성에 관한 연구", 방사선방어학회지, 31(4), pp.181~186 (2006), 대한방사선방어학회
- Chougule A, "Radiation dose to contra lateral breast during treatment of breast malignancy by radiotherapy", Journal of Cancer Research and Therapeutics, 3(1), pp.8~11 (2007)
- Yuan-Chyuan Lo, "Intensity modulation for breast treatment using static multi-leaf collimators", Int J Radiat Oncol Biol Phys, 46, pp.187~194 (2000)
- Beckham WA, "Is multibeam IMRT better than standard treatment for patients with left-side breast cancer", Int J Radiat Oncol Biol Phys, 69, pp.918~924 (2007)