초록
목 적 : 폐의 우측후사방향 선량전달시, Carbon Side Rail과 환자 고정기구인 Vac-lok이 미치는 영향을 보고자 한다. 대상 및 방법 : Vac-lok의 오른쪽 부분을 10, 20, 30 mm 두께로 제작하였다. 측정은 유리선량계를 이용하여 측정하였고, 측정점은 팬텀 우측 폐의 center Point를 기준으로 좌, 우, 하, 상 방향 각각 A, B, C, D Point로 설정 하였다. 각 point에 유리선량계를 삽입한 후 couch의 Side Rail을 외측(Out)으로 뺀 후 vac-lok을 놓지 않은 no vac-lok, 그리고 10, 20, 30 mm의 vac-lok 위에 팬텀을 세팅하였다. 중심점에 6 MV 광자선을 조사야 $10{\times}10cm^2$, SAD 100 cm, 겐트리 각도 $225^{\circ}$로 하여 300 MU/min 선량률과 100 MU 조사선량을 전달하였다. 측정은 5회씩 실시하였고, 마찬가지로 Side Rail을 내측(In)으로 넣은 후 각 point에 대해서도 같은 조건으로 5 회씩 측정하여 평균값을 산출하였다. 결 과 : side rail에 따라서는 중심점, A, B, C, D Point 각각 -11.8 %, -12.3 %, -4.1 %, -12.3 %, -7.3 %의 선량 감소를 보였다. Side-Rail-Out에서 10 mm vac-lok의 경우 약 -0.9 %가 감소되었고, 20 mm vac-lok 사용 시 약 -2.0 %, 30 mm vac-lock 사용 시 약 -3.0 %가 감소되었다. Side-Rail-In에서 10 mm vac-lok의 경우 약 -1.0 %가 감소되었고, 20 mm vac-lok 사용 시 약 -2.1 %, 30 mm vac-lok 사용 시 약 -3.0 %가 감소되었다. Side-Rail-In 상태의 no vac-lok 선량 값을 기준으로 Side-Rail-Out 상태의 10, 20, 30 mm vac-lok을 사용할 때, side rail에 대한 선량 감소에 더하여 중심점에서는 약 -0.9 %, -1.8 % -2.4 %, A point에서는 -0.5 %, -1.6 %, -2.1 %, B point에서는 약 -0.9 %, -2.0 %, -3.2 %, C Point에서는 -1.0 %, -2.1 %, -3.1 %, D point에서는 약 -1.0 %, -1.6 %, -3.1 %의 추가적인 선량 감소를 나타냈다. 결 론 : 폐를 비롯한 우측후사방향 방사선 치료 시 side rail에 대해 주의를 기울이고, vac-lok 제작 시 vaclok 두께에 대해 관심을 갖는다면 더 나은 치료 효과를 기대해 볼 수 있으리라 사료된다.
Purpose : To evaluate the effect of carbon couch side rail and vacuum immobilization device in case of lung RPO irradiation. Materials and Methods : The 10, 20, 30 mm thickness of vac-lok's right side were obtained. To measure of doses, glass dosimeters were used and measured reference point is left lung center at the phantom. A, B, C, and D points are left, right, down, and up directions based on the center point. In the state of Side-Rail-Out, place the without vac-lok, with the thickness of 10, 20, and 30 mm vac-lok. After the glass dosimeters was inserted in center, A, B, C, and D points, 100 MU of 6 MV X-ray were irradiated to the referenced center point in the condition of $10{\times}10cm^2$ field size, SAD 100 cm, gantry angle 225, 300 MU/min dose rate. Five measurements were made for each point. In the state of Side-Rail-In, five measurement were made for each point under the same conditions. The average is measured on each of the five Side-Rail-Out and Side-Rail-In measurements. Results : In the presence of side rail, the dose reduction ratio was -11.8 %, -12.3 %, -4.1 %, -12.3 %, -7.3 % for each A, B, C, and D points. In the state of Side-Rail-Out, the dose reduction ratio for the using 10 mm thickness of vac-lok was -0.9 % than without vac-lok. The dose reduction ratio for the using 20 mm thickness of vac-lok was -2.0 %, for the using 30 mm thickness of the vac-lok was -3.0 % than without vac-lok. In the state of Side-Rail-In, the dose reduction ratio for the using 10 mm thickness of vac-lok was -1.0 % than without vac-lok. The dose reduction ratio for the using 20 mm vac-lok was -2.1 %, for the using 30 mm vac-lok was -3.0 % than without vac-lok. Based on the value of no vac-lok dose in the Side-Rail-In state, The dose reduction ratios for the using 10 mm, 20 mm and 30 mm thickness of vac-loks In the Side-Rail-Out that the center point were -12.7 %, -13.7 %, -14.2 % and -12.8 %, -13.8 %, -14.5 % respectively at point A. The dose reduction ratios for the same conditions to the B point were -4.9 %, -6.1 %, -7.1 % and -13.4 %, -14.4 %, -15.5 % respectively at point C. The dose reduction ratios for the same conditions to the D point were -8.4 %, -9.0 %, -10.4 % respectively. Conclusion : The attenuation was caused by presence of side rails and thickness of vac-lok. Pay attention to these attenuation factors, making it a more effective radiation therapy.