학술논문
Dosimetric Comparison for Rectal Cancer Radiation Therapy Techniques
이용수 11
- 영문명
- 발행기관
- 한국방사선학회
- 저자명
- 양정윤 신준영 강성은 김영재 이승철
- 간행물 정보
- 『한국방사선학회 학술대회 논문집』한국방사선학회 2017년 추계종합학술대회논문집, 52~52쪽, 전체 1쪽
- 주제분류
- 공학 > 기타공학
- 파일형태
- 발행일자
- 2017.11.10
0원
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국문 초록
대장암 중 직장암의 경우 전 세계적으로 매우 높은 발생빈도로 발병하고 수많은 환자들이 발생하고 있다. 암의 치료에는 외과적 수술, 항암요법, 방사선요법이 대표적이며 방사선 요법은 최근 치료기술의 발달로 3차원 입체조형치료, 세기조절방사선치료, 토모테라피 치료로 발전되어 있다. 본 논문에서는 이와같은 치료기법을 치료계획을 각각 수립하여 직장암 환자에 대한 최적의 치료법을 비교하고자 한다.
직장암의 확정을 받은 환자 10명을 대상으로 CT 모의치료를 시행 한 후 3차원 영상 얻었다. 이 영상을 바탕으로 종양조직과 정상조직(소장, 방광, 넙다리머리뼈)의 용적을 구분하였다. 처방선량을 치료계획용적에 50.4Gy를 부여하여 종양 및 정상조직의 흡수선량을 상호 비교하였다.
직장암 환자의 치료기법 간 종양 및 정상조직의 선량분포의 변화를 살펴본 결과 다음과 같은 결론을 얻을 수 있었다.
치료계획용적(PTV)에 대한 평균선량은 각각 50.7 ± 0.7Gy , 50.9 ± 0.6Gy, 50.9 ± 1.1Gy이었다. 치료계획 용적에 대한 평균선량에서는 모든 치료계획들이 소장은 Tomotherapy, Linac-IMRT, 3D-CRT 순으로 흡수선량이 적었다. 방광에 흡수되는 평균선량은 Tomotherapy, Linac-IMRT, 3D-CRT에서 각각 22.1 ± 1.4 Gy, 22.8 ± 1.8 Gy, 44.9 ± 2.3 Gy로 나타났다. 우측 넙다리머리뼈(Right Femoral Head)에 대한 평균 흡수 선량은 Tomotherapy인 경우 17.6 ± 2.1Gy, Linac-IMRT는 22.1 ± 1.9 Gy, 3D-CRT는 35.2 ± 2.2Gy이었으며 좌측 넙다리머리뼈(Left Femoral Head)는 Tomotherapy인 경우 17.5 ± 1.8Gy, Linac-IMRT는 22.3 ± 2.3Gy, 3D-CRT는 35.0 ± 2.6Gy로 나타났다.
방사선치료는 정상장기에는 선량을 최소화하고, 종양조직의 억제율을 높이기 위해 최대의 선량을 부여하는 것을 목적으로 한다. PTV의 경우 처방선량은 Tomotherapy를 이용한 IMRT가 가장 양호한 결과를 보였으며 그 뒤를 Linac based IMRT, 3D-CRT 순(처방선량 50.4Gy에 대해 Tomotherapy 49.8 ± 1.3 Gy, Linac-IMRT 49.1 ± 1.0Gy, 3D-CRT 48.5 ± 1.4Gy)이었다. 정상조직의 흡수선량을 선량을 분석해보면 Tomotherapy와 Linac-IMRT가 3D-CRT에 비해 소장, 방광, 넙다리머리뼈에서 평균 흡수선량이 낮아 정상조직의 방어율이 높다는 것을 알 수 있었다. 본 실험의 결과 Tomotherapy, Linac-IMRT, 3D-CRT 모두 종양에 적절한 치료가능비를 보였다. 단순한 선량을 비교해 보면 Tomotherapy가 가장 효율적이었으며 3D-CRT가 가장 낮았다. 3가지 치료법 모두 효율적이었으므로 환자의 상태와 여건을 고려하여 적절한 치료법을 적용하는 것이 좋을 것으로 사료된다.
영문 초록
목차
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