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Advisor(s)
Abstract(s)
Introdução: As técnicas de irradiação têm sido desenvolvidas de acordo com o progresso das novas tecnologias com o intuito de aumentar a eficiência da irradiação nos volumes alvo e diminuir a toxicidade da radiação ionizante nos tecidos saudáveis. Este trabalho tem como objetivo avaliar a qualidade de cálculos
dosimétricos realizados para a irradiação da neoplasia da próstata, em 32 doentes tratados com RapidArc, na Unidade de Radioncologia de Santarém (URS). Materiais e Métodos: Foram realizadas planimetrias para 32 doentes com duas fases de tratamento. A avaliação da qualidade foi baseada na utilização de variáveis dosimétricas existentes na literatura científica internacional, para os volumes alvo e órgãos de risco. Nas planimetrias foram utilizadas imagens tomográficas de transmissão, em sistema de planeamento Eclipse® - VMS (versão 13.5). A metodologia foi baseada nas recomendações existentes (ICRU 50/62/83, RTOG) e para os OAR usadas tabelas QUANTEC e EMAMI. Resultados: Foram encontradas evidências estatísticas para os valores de referência e diferenças significativas em: dose máxima, dose média, dose mínima do PTV2, índices dosimétricos, doses limites do reto, bexiga e dose média no bulbo peniano, com exceção de todas as variáveis associadas às cabeças do fémur. Porém, não há diferenças estatísticas nas variáveis associadas às unidades monitor por arco, exceto entre o 1º e 3º arco da fase 2 de tratamento. Conclusão: A qualidade dos cálculos dosimétricos é bastante satisfatória. Pressupõe uma metodologia de execução de acordo com as recomendações internacionais conhecidas. A avaliação de mais parâmetros deve ser realizada para complementar o impacto na sobrevida e qualidade de vida dos doentes.
ABSTRACT - Introduction: The irradiation techniques have been developed with the progress of the new technologies in order to increase the irradiation efficiency in the target volumes and reduce the impact of ionizing radiation toxicity on soft tissues. The aim of this study was to evaluate the quality of dosimetric calculations performed in 32 patient’s prostate cancer with RapidArc, at the Unidade de Radioncologia de Santarém (URS). Materials and Methods: The dosimetric calculations were performed for 32 patients with 2 phases of treatment. Quality assessment was based on the use of dosimetric variables existing in the guidelines, for the target volumes and OAR. CT images were used in dosimetric calculations, using the Eclipse® - VMS planning system (v.13.5). The methodology used was based on ICRU 50/62/83, RTOG reports, QUANTEC, and EMAMI tables. Results: Statistical evidence was found for the reference values and significant differences in most variables: maximum dose, mean dose, minimum dose, dosimetric index of PTV2, mean dose, penile bulb, limit doses of the rectum, bladder, with the exception of all variables associated with the bilateral femoral heads. However, there are no statistical differences in the variables associated with the monitor units per arc, except between the 1st and 3rd arc in the second treatment phases. Conclusion: It is possible to conclude that the quality of the dosimetric calculations is quite satisfactory. It assumes the use of an execution methodology in accordance with known internationals recommendations. The evaluation of more parameters should be performed to complement and understand the impact of survival and quality of life in patients.
ABSTRACT - Introduction: The irradiation techniques have been developed with the progress of the new technologies in order to increase the irradiation efficiency in the target volumes and reduce the impact of ionizing radiation toxicity on soft tissues. The aim of this study was to evaluate the quality of dosimetric calculations performed in 32 patient’s prostate cancer with RapidArc, at the Unidade de Radioncologia de Santarém (URS). Materials and Methods: The dosimetric calculations were performed for 32 patients with 2 phases of treatment. Quality assessment was based on the use of dosimetric variables existing in the guidelines, for the target volumes and OAR. CT images were used in dosimetric calculations, using the Eclipse® - VMS planning system (v.13.5). The methodology used was based on ICRU 50/62/83, RTOG reports, QUANTEC, and EMAMI tables. Results: Statistical evidence was found for the reference values and significant differences in most variables: maximum dose, mean dose, minimum dose, dosimetric index of PTV2, mean dose, penile bulb, limit doses of the rectum, bladder, with the exception of all variables associated with the bilateral femoral heads. However, there are no statistical differences in the variables associated with the monitor units per arc, except between the 1st and 3rd arc in the second treatment phases. Conclusion: It is possible to conclude that the quality of the dosimetric calculations is quite satisfactory. It assumes the use of an execution methodology in accordance with known internationals recommendations. The evaluation of more parameters should be performed to complement and understand the impact of survival and quality of life in patients.
Description
Mestrado em Radiações Aplicadas às Tecnologias da Saúde. - Área de especialização: Terapia com Radiações
Keywords
Cancro da próstata Cálculo dosimétrico RapidArc Avaliação da qualidade Prostate cancer Dosimetric calculation Quality assessment
Citation
Fernandes PJ. Avaliação da qualidade de cálculos dosimétricos em doentes com cancro da próstata submetidos a RapidArc [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2020.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa