DOI QR코드

DOI QR Code

전신방사선치료시 산란체의 두께에 따른 선량측정

The Study of Dosimetry according to the Thickness of Beam Spoiler on Total Body Irradiation

  • 김영재 (대구보건대학교 방사선과) ;
  • 전병규 (대구보건대학교 방사선과) ;
  • 이재식 (혜전대학교 임상병리과) ;
  • 정재은 (대구보건대학교 방사선과)
  • Kim, Youngjae (Dept. of Radiologic Technology, Daegu Health College) ;
  • Jeon, Byeongkyou (Dept. of Radiologic Technology, Daegu Health College) ;
  • Lee, Jaesik (Department of Clinical Laboratory Science, Hyejeon College) ;
  • Jung, Jaeeun (Dept. of Radiologic Technology, Daegu Health College)
  • 투고 : 2014.07.01
  • 심사 : 2014.08.26
  • 발행 : 2014.08.30

초록

방사선을 이용한 백혈병의 전신방사선 치료는 환자의 골수에 건강한 골수세포를 이식하는 골수이식(bone marrow transplantation) 시행 전, 골수의 재구성을 위한 준비단계로 전신에 외부 방사선을 조사(external beam therapy)하여 유해한 세포를 죽이거나 면역체계의 억제를 목적으로 시행된다. 전신방사선 치료를 시행할 경우 환자의 표면선량을 증가하기 위해 사용되는 산란판(spoiler)을 사용하게 되는데 산란판을 사용할 때의 표면선량은 환자와의 거리에 따라 달라지고, 두께에 따라 달라지게 된다. 이에 본 논문에서는 산란판의 두께에 따른 표면선량의 변화를 알아보았다. 아크릴로 된 산란판을 0.5 cm부터 3.0 cm 까지 0.5 cm 간격으로 제작하여 각각 측정한 결과 2.0 cm를 기준으로 두께에 따라 약 0.5% 정도의 표면선량의 증가를 관찰 할 수 있었다. 이를 토대로 임상에 직접 적용하기에는 제한적일 수 있으나 임상실험과 치료받은 환자의 예후 등을 조사하여 임상에 적용한다면 각기 다른 표면선량을 요구하는 환자들에게 산란판의 두께변화 만으로도 적절한 표면선량을 부여하는 방법이 될 것으로 생각된다.

The therapy of total body irradiation on leukemia carries out to kill harmful bacteria or suppression of immune system by external beam therapy, which is a preparatory stage to reconstitute bone marrow before a pre-treatment of bone marrow transplantation to patients with health bone marrow cells. In case of this kind of radiation therapy, the spoiler use to increase surface dose of patient which varies depending on distance and thickness between patient and spoiler. In this study, the change was investigated the surface dose according to thickness of spoiler. The 0.5% increase of surface dose was observed with each 2.0 cm when the spioler in acrylic was prepared from 0.5 cm to 3.0 cm at intervals of 0.5 cm was evaluated. Based on this result, it suggests that this kind of application will be somewhat limited on clinical trials directly but proper surface dose can be useful method when is applied on patients of treatment prognosis who are required each different surface dose.

키워드

참고문헌

  1. S. J. Kim, D. G. Han, and H. J. Baek, Comparison of Total Body Irradiation (TBI) or Non-TBI as conditioning Regimen for Stem Cell Transplanation (SCT) in Pediatric Leukemia patient, Korean Journal of Pediatrics, Vol.53, No.4, pp.538-547, 2010. https://doi.org/10.3345/kjp.2010.53.4.538
  2. Korean Network for Organ Sharing, Korea Centers for Disease Control and Prevention, Annual Report of the transplant 2012, 2013
  3. S. H. Kim and I. Y. Yu, Identification of symtoms by treatment phases in children with leukemia, The graduate school of nursing Yonsei University, 2009.
  4. Kim SJ, Han DG, Baek HJ et al. Comparison of Total Body Irradiation (TBI) or Non-TBI as conditioning Regimen for Stem Cell Transplanation (SCT) in Pediatric Leukemia patient, Korean Jounal of Pediatrics, Vol. 53, No. 4, pp.538-547, 2010. https://doi.org/10.3345/kjp.2010.53.4.538
  5. Jeong-Keun Lee, Seong-Joo Jang, Young-Ill Jang, Medical Radiation Exposure in Children CT and Dose Reduction, Jurnals of Korea Contents Association. Vol.14, No.1, pp.356-363, 2014. https://doi.org/10.5392/JKCA.2014.14.01.356
  6. Faiz M. Khan, The Physics Of Radiation Therapy-Fourth Edition, Lippincott Williams & Wilkins Pub, 2003.
  7. Jonghwan Choi, Jongsik Kim, Jimin Choi, Analysis of Surface Dose Refer to Distance between Beam Spoiler and Patient in Total Body Irradiation, JKSR, Vol.19, No.1, 2007.
  8. Kassaee A, Xiao Y, Block p, et al. Dose near the surface during total body irradiation with 15 MV X-ray, Int J Cancer No.96, pp.125-130, 2001.
  9. Philip AP, David GP. Principles and practice of pediatric oncology. 3rd ed. Philadelphia : JB Lippincott Co, pp.1-9, 1997.
  10. Fernbach DJ. Natural history of acute leukemia. In : Sutow WW, Vietti TJ, Fernbach DJ, editors. Clinical pediatric hematology. 2nd ed. Saint Louis : CV Mosby Co, pp.291-333, 1977.
  11. Ah Young Jung, Medical radiation exposure in children and dose reduction, J Korean Med Assoc, Vol.54, No.12, pp.1277-1283, 2011. https://doi.org/10.5124/jkma.2011.54.12.1277
  12. National Council on Radiation Protection and Measurements. Ionizing radiation exposure of the population of the United States. Bethesda (MD): National Council on Radiation Protec-tion & Measurements; 2009.
  13. Silverman FN. The skeletal lesion in leukemia. Clinical and roentgenographic observations in 103 infants and children, with a review of the literature. AJR, No.59, pp.819-44, 1948.
  14. Thomas LB, Forkner CE, Frei E, Besse BE, Stabenau JR. The skeletal lesions of acute leukemia. Cancer, No.14, pp.608-21, 1961.
  15. Dong-Yeon Lee, Seongjin Ko, Sesik Kang, et al, Dose Evaluation of Childhood Leukemia in Total Body Irradiation, JKSR, Vol.7, No.4, 2013. https://doi.org/10.7742/jksr.2013.7.4.259
  16. Dong-Yeon Lee, Chang-Soo Kim, Dong-Hyen Kim et al. Total Body Irradiation of Childhood Leukemia dose Evaluation due to Changes in the Thickness of the Tissue Compensators, Journals of Korea Contents Association, Vol.14, No.4, 2014. https://doi.org/10.5392/JKCA.2014.14.04.249