The Journal of Korean Society for Radiation Therapy (대한방사선치료학회지)

Korean Society for Radiation Therapy (대한방사선치료학회)
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The effect of patient position on dose in radiation therapy of liver cancer

환자 자세가 간의 방사선 치료 시 선량에 미치는 영향

  • Jung, Won Seok (Department of Radiation Oncology, Kyunghee College Hospital) ;
  • Kim, Ju Ho (Department of Radiation Oncology, Yonsei Cancer Center) ;
  • Kim, Young Jae (Department of Radiological Technology, Daegu Health College) ;
  • Shin, Ryung Mi (Department of Radiation Oncology, Kyunghee College Hospital) ;
  • Oh, Jeong Hun (Department of Radiation Oncology, Kyunghee College Hospital) ;
  • Jeong, Geon A (Department of Radiation Oncology, Kyunghee College Hospital) ;
  • Jo, Jun Young (Department of Radiation Oncology, Kyunghee College Hospital) ;
  • Kim, Gi Chul (Department of Radiation Oncology, Kyunghee College Hospital) ;
  • Choi, Tae Kyu (Department of Radiation Oncology, Kyunghee College Hospital)
  • 정원석 (경희의료원 방사선종양학과) ;
  • 김주호 (연세암센터 방사선종양학과) ;
  • 김영재 (대구보건대학교 방사선과) ;
  • 신령미 (경희의료원 방사선종양학과) ;
  • 오정훈 (경희의료원 방사선종양학과) ;
  • 정건아 (경희의료원 방사선종양학과) ;
  • 조준영 (경희의료원 방사선종양학과) ;
  • 김기철 (경희의료원 방사선종양학과) ;
  • 최태규 (경희의료원 방사선종양학과)
  • Received : 2014.03.21
  • Accepted : 2014.04.30
  • Published : 2014.06.30
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Abstract

Purpose : To analyze tumor's movement and volume change from changing position in order to minimize movement caused by breathing. Materials and Methods : We conducted survey of 14 patients with HCC(Hepatocellular carcinoma). Patient immobilization device was made in two ways(Supine position, prone position) and from image acquisition, tumor's movement, volume and dose are analyzed. Results : The mean movement of target(LR, Left-right) in supine position and prone position was $2.76{\pm}1.25mm$, $2.21{\pm}0.93mm$. AP(Anterior-posterior) and SI(Superior-inferior) was $4.02{\pm}1.63mm$, $11.56{\pm}3.08mm$, $3.36{\pm}1.17mm$, $7.45{\pm}1.96mm$. Treatment volume was decreased and normal liver volume was increased in prone position. Conclusion : We could reduce the margin of the treatment volume by minimizing the movement of liver caused by breathing. Especially in prone position, it is considered to be able to decrease the movement of the liver and increase normal liver volume.

목 적 : 간암 치료 시 호흡으로 인한 움직임을 최소화하기 위해 환자 체위 변화에서 종양의 움직임과 용적 변화를 분석하고자 하였다. 대상 및 방법 : 간 세포암종(Hepatocellular Carcinoma) 환자 14명의 환자를 대상으로 시행하였다. 바로 누운 자세(Supine position)와 엎드린 자세(Prone position)에서 2가지 방법으로 환자 고정기구를 제작하고 영상을 획득하여 간 종양의 움직임과 용적 그리고 선량을 분석하였다. 결 과 : 바로 누운 자세(Supine position)와 엎드린 자세(Prone position) 에서 표적의 왼쪽-오른쪽(LR, Left-right) 움직임은 평균 $2.76{\pm}1.25mm$, $2.21{\pm}0.93mm$이고, 앞-뒤(AP, Anterior-posterior)와 상하(SI. Superior-inferior) 방향의 움직임은 각각 $4.02{\pm}1.63mm$, $11.56{\pm}3.08mm$, $3.36{\pm}1.17mm$, $7.45{\pm}1.96mm$이었다. 이를 이용한 엎드린 자세(Prone position)에서 치료 용적(Treatment volume)은 감소하였고, 이에 따라 정상간 용적은 증가 하였다. 결 론 : 호흡에 의한 간의 움직임을 최소화함으로써 치료 용적(Treatment volume)의 경계여유를 감소시킬 수 있었다. 즉 환자 자세 변화 특히 엎드린(Prone) 자세는 간의 움직임을 감소 시켜주고 정상 간의 용적을 증가 시킬 수 있을 것으로 사료된다.

Keywords

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