Rojas López, José A. (2019) Dosimetría in vivo con el uso de OSL nanodot en radioterapia con intensidad modulada / In vivo dosimetry with the use of OSL nanodot in intensity modulated radiotherapy. Maestría en Física Médica, Universidad Nacional de Cuyo, Instituto Balseiro.
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Resumen en español
El mayor grado de conformidad de la distribución de la dosis en los volumenes objetivo (planning target volume, PTV) y la reducción de dosis en los órganos de riesgo (organat risk, OAR) en la técnica de radioterapia de intensidad modulada (IMRT) con filtros compensadores (6 MV), conlleva un mayor grado de susceptibilidad debido a las incertidumbres espaciales inter e intra-fraccion. La dosimetría in vivo ha mostrado ser adecuada para la verificación y mejora en la precisión de la dosis dispensada. En particular, la dosimetría intracavitaria es la única que mide directamente la dosis en el PTV o en OAR. El objetivo de este trabajo consiste en realizar la dosimetría in vivo intracavitaria usando dosimetros OSL nanoDot en IMRT con ltros compensadores. Se realizo la dosimetría in vivo intracavitaria en 56 pacientes (dos dosmetros por paciente, 112 mediciones) en tratamientos de IMRT con patologías: de recto (9), de cuello uterino (6), de próstata (22), de cabeza-cuello (18) y tumor retroperitoneal (1). En todos los casos se comparo la respuesta del OSL nanoDot con el sistema de planificación de tratamiento (TPS) MIRS v.5.1 (NUCLEMED S.A., Argentina) que cuenta con un algoritmo semi-empírico integrador de scatter. Los casos se clasificaron como PTV y OARs (en zonas de alto gradiente y de dosis bajas). Por medio del límite de confianza denido por Palta et al. [1], fue posible obtener los niveles de acción (NA) para los casos estudiados. En los casos de PTV, el recto y cuello uterino tienen NA del 7% y en cabeza-cuello el 9 %. Estos valores concordaron con reportes internacionales en los que se sugiere un NA del 7% para dosimetría en IMRT. En los casos de OAR, el recto (en tratamientos de próstata) y cabeza-cuello tuvieron NA del 27% y 12 %, respetivamente. En los 10 casos estudiados en la zona de dosis bajas fuera del campo, se mostraron subestimaciones por parte del TPS MIRS de hasta el 87.7 %. Esto sugiere ampliar la investigación en virtud de los factores asociados a los efectos biológicos, ya que muchas veces los TPS tienen limitaciones para calcular la dosis en estas zonas, especialmente con el advenimiento de nuevas tecnologías, las cuales pueden causar dosis mayores fuera de los bordes de campo.
Resumen en inglés
The degree of complexity of the dose distribution at the target volumes (PTV) and the dose reduction at organs at risk (OAR) in intensity modulated radiotherapy technique (IMRT) with compensator filters (6 MV), entails a greater degree of susceptibility due to inter and intra-fractional spatial uncertainties. In vivo dosimetry has shown to be appropiate for verification and improvement in the accurate measurement of imparted dose. In particular, intracavitary dosimetry is the only technique that directly measures the dose at PTV or OAR. The objective of this work is to perform intracavitary in vivo dosimetry using OSL nanoDot dosimeters in IMRT with compensator filters. In vivo intracavitary dosimetry was carried out in 56 patients (two dosimeters per patient, 112 measurements) in IMRT treatments with following pathologies: rectum (9), cervix (6), prostate (22), head-and-neck (18) and retroperitoneal tumor (1). In all cases, the response of the OSL nanoDot was compared with the calculated doses of treatment planication system (TPS) MIRS v.5.1 (NUCLEMED S.A., Argentina) which has a semi-empirical algorithm scatter integrator. Cases were classied as PTV and OARs (in high dose gradient and low dose regions). It was possible to obtain the action levels (AL) for the studied cases through the confidence limit dened by Palta et al. [1]. For cases as PTV, rectum and cervix, the AL was 7% and 9% for head-and-neck. These values were consistent with international reports suggesting an AL of 7% for IMRT dosimetry. By the other hand, such as OAR, AL were 27% and 12% for rectum and head-and-neck, respectively. Higher AL in prostate treatments was associated to the presence of the detector in a high dose gradient region. At the low dose out-of-the-treatment eld region, dosimetric underestimation by the TPS MIRS was up to 87.7%. This suggests to continue the research in virtue of related factors with biological effects, since many times TPS has limitations to calculate dose in these regions, especially with the advent of new technologies such as IGRT, IMRT, VMAT, among others.
| Tipo de objeto: | Tesis (Maestría en Física Médica) |
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| Palabras Clave: | Dosimetry; Dosimetría; Radiotherapy; Radioterapia; [Intensity modulated radiotherapy; Radioterapia de intensidad modulada; Optically stimulated luminescence; Luminiscencia estimulada ópticamente; Intracavitary in vivo dosimetry; Dosimetría in vivo intracavitaria; Uncertainty; Incertidumbre; Low dose; Baja dosis; Level of action; Nivel de acción] |
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| Materias: | Medicina > Radioterapia |
| Divisiones: | FUESMEN |
| Código ID: | 892 |
| Depositado Por: | Tamara Cárcamo |
| Depositado En: | 09 Abr 2021 10:56 |
| Última Modificación: | 12 Abr 2021 12:00 |
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