The method of total body irradiation of the patient

 

(57) Abstract:

The invention relates to medicine, more specifically to radiology, and may find application in radiation therapy of cancer patients. The method consists in the rotation of the source of ionizing radiation at a speed determined by the ratio of the measured and the desired absorbed dose, while the measured absorbed dose is set by rotating the radiation source around a phantom simulating the size of the patient, with a speed of 1 deg/sec, the Patient is placed at a distance L = A/2 ctg below isocenter of rotation, where A is the patient's height, cm; - half of the angle of rotation of the source. Over the patient uses the ionizing radiation absorber of variable thickness

< / BR>
where RIO is the distance between the ionizing radiation source and the isocenter of rotation, cm; x is the distance from the center of the patient on the longitudinal axis to intersect its plane, which define a thickness, cm; linear attenuation coefficient of the filter material. The present invention allows to evenly distribute the absorbed dose in the body of the patient in any treatment room with a rotating source of radiation. table 1.

The invention relates to medicine, more specifically to radiology, the second therapy is a commonly used method of treatment for common malignant processes a large number of locations. The main physico-technical task total exposure is getting in the patient's body uniform distribution of the absorbed dose.

Current methods of total body irradiation person ionizing radiation based on the use of fixed radiation sources and large distances from the radiation source to patient (4 - 5 m), which makes it possible to obtain the radiation field, commensurate with the growth of the patient. or special moving with a constant speed past the source of the truck with the patient.

There is a method of total exposure with the use of a stationary emitter located with a horizontal beam of radiation using large distances (4-5 m) and the alignment of the joints to create a uniform dose distribution in the body [Ilyin, N. In. and others, ed. St. N 1769418 A 61 N 5/10 "Method of formation of the dose distribution along the body when the total irradiation", A 61 6/00].

Way connected with the use of horizontal directional source of the beam of ionizing radiation, the location of the patient at a great distance (4,75 m) from source to achieve uniform size field exposure equal to the odd variable thickness of the patient's body compensated by the special absorbers. The disadvantages of this method are the need for treatment of large areas of non-standard sizes, lateral irradiation of the patient, giving an uneven distribution of doses up to 15-20%, the inability to irradiate patients large in stature, and small dose due to large distances from the source. The latter is quite uncomfortable for the patient due to the duration of the procedure and reduces the throughput of the treatment room.

Closest to the proposed method is a method of total irradiation using a fixed set of emitter with a vertical beam and moving the medical table trolley with the patient to reach a beam of radiation of the whole body [The Radiotherapy of Malignant Disease, Springer-Ver., 1985, p. 362]. This method consists in using a special truck to rail move, which fit the patient. This cart is moving with a constant speed under the vertical beam of ionizing radiation from a stationary source such that the beam covers the entire body. Irradiation is carried out from two sides by turning the patient's body. This method allows you to provide the necessary uniformity of the races is a special device - trolleys on rails course in the treatment room does not allow you to use the latest for other types of radiation therapy, such as standard methods of radiation therapy. The method allows to obtain the distribution of the absorbed dose on the patient's body with the non-uniformity of +/-5%.

Thus, known methods of total exposure are necessary the use of special treatment rooms with a source of ionizing radiation for a total exposure of patients, and significantly larger than for conventional radiation therapy. This hardly allows for total exposure in the standard areas for radiation therapy, thereby reducing the possibility of radiation therapy, or designing treatment facilities with a source of ionizing radiation is specially only for total exposure, which is economically disadvantageous.

The technical result of the present invention is to implement suitable for widespread clinical use of total exposure due to the use of the rotation of the source of ionizing radiation.

This result is achieved by the fact that irradiation of the patient's body, placed on lacebug radiation, rotate around the isocenter of rotation, placed at a distance

< / BR>
below isocenter of rotation, where A is the height of the patient, cm, the half angle of rotation of the radiation source, a pre-determined speed of rotation of the source of ionizing radiation in relation to the measured data and the required absorbed dose, while the measured absorbed dose is set by rotating the radiation source around a phantom simulating the size of the patient, with a speed of 1 deg/s, and over the patient have the ionizing radiation absorber of variable thickness D, which is determined by the formula

,

where RIO is the distance between the ionizing radiation source and the isocenter of rotation, cm;

X - the distance from the center of the patient on the longitudinal axis to intersect its plane, which define a thickness, cm;

linear attenuation coefficient of the material of the filter.

Known methods of rolling rotary irradiation of a number of locations with the removal of the target point in the isocenter of rotation [The Radiotherapy of Malignant Disease, Springer-Ver., 1985, p. 20]. However, these methods solve the problem of the concentration of the absorbed dose only in the selected target point and can't solve the problem of total body irradiation of the patient.

Printentry rotation and placing it at a distance L

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below isocenter of rotation, where A is the height of the patient, cm, the half angle of rotation of the source, allows for total body irradiation patients of any height in a standard office for radiation therapy with rotary source of ionizing radiation. The distance L is found by calculation and depends on the growth of the patient and the start and end angles of the rotation.

The definition of the speed of rotation of the source of ionizing radiation is produced in relation to the measured data and the required absorbed doses and measured absorbed dose is determined by rotation of the radiation source around a phantom simulating the size of the patient, with a speed of 1 deg/sec

The location on the patient to ionizing radiation absorber of variable thickness D determined by the formula

< / BR>
where RIO is the distance between the ionizing radiation source and the isocenter of rotation, cm; X is the distance from the center of the patient on the longitudinal axis to intersect its plane, which define a thickness, cm; linear attenuation coefficient of the material of the filter, makes uniform distribution of ionizing radiation within the patient's body and, consequently, the most uniform distribution of the absorbed dosette in the following.

For carrying out of sessions of radiation therapy, the patient is placed on the treatment table standard rotary source of ionizing radiation, for example ROCUS-M, in position on the back" so that the longitudinal axis of the patient's body is located in the plane of rotation of the source. The table with the patient set below the source to isocenter distance L, depending on the growth of the patient and calculated by the formula

,

where A is the patient's height, cm; - half of the angle of rotation of the source.

Start and end angles of rotation of the radiation source is selected typically +/-60othen , for example, when the patient's height in 2 m it is necessary to set the distance from the isocenter to the patient 57.7 see

A patient is set to ionizing radiation absorber of thickness D, which is determined by the formula

< / BR>
where RIO is the distance between the ionizing radiation source and the isocenter of rotation, cm; X is the distance from the center of the patient on the longitudinal axis to intersect its plane, which define a thickness, cm; linear attenuation coefficient of the material of the filter.

The absorber is made of polyethylene (density =0.95 g/cm) and the thickness calculated by the formula given you the patient A= 2 m and the previously selected L=57,7 cm, RIO=75 cm will receive the thickness of the absorber, cm

< / BR>
To determine the speed of rotation before a session of radiation therapy on the patient's place installed a water phantom size HH mm3. The water is poured to a level equal to the anterior-posterior size of the patient, the sensor dosimeter is set in the centre of the phantom on the half of the anterior-posterior size. Then, a rotation of the source with speed =1 deg/sec Measured absorbed dose at the time of the source from the initial to the final angle of rotation. For the previously selected patient growth of 2 m and anterior-posterior size of 23 cm for the source ROCUS-M absorbed dose was 0.044 Gr.

If half of a given absorbed dose is 0.05 G, = 0.044/0.05=0.88 deg/s

The results of measurements of the absorbed dose distribution on the patient's body is shown in the table.

As can be seen from the table, phantom measurements showed that the uneven distribution of the absorbed dose does not exceed +/- 3%.

After determining the desired speed of rotation, the patient is placed on a previously defined distance from the isocenter of rotation and radiation therapy. When this is released half the required dose n is camping.

The proposed method is compared with the known has a number of advantages:

1) allows for total body irradiation of the patient in any standard location for radiation therapy with a rotating gamma system, while others are known to require premises of large size or special equipment in the form of a buffet-truck;

2) allows for total irradiation with uniform distribution of the absorbed dose +1/-3%, while the known methods create uniformity of not more than +1/-5%.

The method developed at the Central research x-ray radiological Institute of the RF Ministry of health and was clinically tested in 8 patients with lung cancer and 4 with brain tumors. In all cases, a positive result was achieved in the stabilization process.

The method of total body irradiation of the patient is placed on the treatment table, a source of ionizing radiation, wherein the patient is placed in the plane of rotation of the source of ionizing radiation, rotating around the isocenter of rotation, placed at a distance

< / BR>
below isocenter rotation,

where a is the patient's height, cm;

- half of the angle of rotatio relation measured and the required absorbed dose thus the measured absorbed dose is set by rotating the radiation source around a phantom simulating the size of the patient, with a speed of 1 deg/s, and over the patient have the ionizing radiation absorber of variable thickness D, which is determined by the formula

< / BR>
where RIO is the distance between the ionizing radiation source and the isocenter of rotation, cm;

X - the distance from the center of the patient on the longitudinal axis to intersect its plane, which define a thickness, cm;

linear attenuation coefficient of the filter material.

 

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