TWM417136U - Measuring device for skin surface dose of radiation therapy - Google Patents

Description

M417136M417136

五、新型說明： 【新型所屬之技術領域】 本創作係一種放射治療表面劑量有關的劑量量測裝置，更詳而 言之，是一種適用於放射治療皮膚表面劑量模擬的量測裝置。 【先前技術】 按’惡性腫瘤為國人常見的癌症，包括頭頸癌、口腔癌、肺癌、 肝癌、乳癌、子宮頸癌、結腸直腸癌、攝護腺癌等，過去癌症的主 要治療方式多以手術為主’並輔以化學與放射治療。隨著放射治療 技術的進步，例如三度空間順形治療（3D Conformal Radiotherapy, 3D CRT)、強度調控放射治療（Intensity Modulated Radiotherapy， IMRT)與導航式螺旋刀放射治療(Tomotherapy)的應用，利用多重、 複雜的照野射束設計，並結合次照野的強度調控，能給予腫瘤乾積 (Target Volume)足夠的劑量照射，並有效減低治療過程鄰近正常組 織及危及器官之劑量。放射治療除了可提高腫瘤控制率（Tum〇r Control Probability，TCP)與降低正常組織併發症之機率（N〇rmalV. New description: [New technical field] This creation is a dose measuring device for radiation therapy surface dose. More specifically, it is a measuring device suitable for radiation treatment of skin surface dose simulation. [Prior Art] According to 'malignant tumors, common cancers of the country, including head and neck cancer, oral cancer, lung cancer, liver cancer, breast cancer, cervical cancer, colorectal cancer, prostate cancer, etc., the main treatment of cancer in the past is mostly surgery Mainly supplemented by chemotherapy and radiation therapy. With the advancement of radiotherapy technology, such as the application of 3D Conformal Radiotherapy (3D CRT), Intensity Modulated Radiotherapy (IMRT) and navigational toroidal therapy, the use of multiple The complex field beam design, combined with the intensity control of the secondary field, can give sufficient dose of the target volume of the tumor, and effectively reduce the dose of the adjacent normal tissue and the organs at risk. In addition to improving the tumor control rate (Tum〇r Control Probability, TCP) and reducing the risk of normal tissue complications (N〇rmal)

Tissue Complication Probability，NTCP) ’ 可提高癌症治療效益 並減輕因放射線照射所產生的副作用，進而改善病患之生活品質， 放射治療在癌症的治療上扮演越來越重要的角色。 雖然先進的放射治療技術能顯著降低立即或延遲的副作用，但 在放射治療期間，因照射引起的急性皮膚輻射效應卻仍然無法有效 克服，例如照射部位之皮膚經過高劑量的放射線照射後，會導致急 性的皮膚輻射效應和後續的延遲效應。依據ICRp 85號報告，照射 2 mj 劑量小於10 Gy，皮膚將發生不等程度的紅斑(Erytherma) 脫毛(Epilation)或永久性脫毛；皮膚劑量介於10〜20 Gy間，皮膚 發生乾性脫屑（Desquamation)、溼性脫屑或延遲性皮膚壞死 (Delayed Skin Necrosis);皮膚劑量大於20 Gy，將造成皮膚潰瘍 (Ulceration)與壞死。由初期皮膚上皮細胞發炎而有紅腫癢痛之現 象’至治療中後期的皮膚累積劑量增加，會產生中度至重度的皮膚 發炎反應’造成皮膚基底細胞層被破壞，使得皮膚表層受損，嚴重 時甚至會造成皮膚組織壞死，此狀況常嚴重影響病患之生活品質。 另一方面，放射治療過程常引起的口腔黏膜炎也會造成吞嚥困 難、疼痛’甚至因舌部味覺組織受傷而喪失味覺等現象；此外，由 於腸胃道上皮組織的高輻射敏感度，亦可能影響病患的營養素吸收 ，況。由上述狀況將導致體重顯著下降，而當體重減輕過多時使得 病患明顯變痩，亦將造成體表外形輪廓的改變。因病患所接受的放 射治療其治療計畫是根據治療前的電腦斷層影像為基礎進行設計， 當治療過程巾發生體表外形輪雜變時，將影響放在病患體内 與皮膚表賴量分布’而與原先設計的治療賴不符。另外，以頭 頸癌頸部淋巴引流的區域為例，此區域位於兩邊頸部皮膚的内側， 此部位通常域射賴射的高繼純，#病患體重減輕變瘦時會 使得照射雜雜表皮膚更往_，朝向原先高劑量之乾區移動， 導致體表皮_量增加的疑慮及後續可能的皮膚延遲反應。 目前臨床上常使用的劑量驗證量測卫具包括游離腔（Ion Chamber)、熱發光(The__escent D〇simeter，孔_量計、Tissue Complication Probability (NTCP) ’ can improve the therapeutic efficacy of cancer and reduce the side effects caused by radiation exposure, thereby improving the quality of life of patients. Radiation therapy plays an increasingly important role in the treatment of cancer. Although advanced radiotherapy techniques can significantly reduce immediate or delayed side effects, the effects of acute skin radiation caused by exposure during radiotherapy are still not effectively overcome, for example, after exposure to high doses of radiation from the skin of the site. Acute skin radiation effects and subsequent delayed effects. According to ICRp No. 85, when the dose of 2 mj is less than 10 Gy, the skin will undergo unequal erythema (Epiltherma) or permanent hair removal; the skin dose will be between 10 and 20 Gy, and the skin will be dry desquamation ( Desquamation), wet desquamation or Delayed Skin Necrosis; skin doses greater than 20 Gy will cause skin ulceration and necrosis. From the initial skin epithelial cells inflammation and redness and itching pain 'to increase the cumulative dose of skin in the middle and late stages of treatment, will produce a moderate to severe skin inflammation reaction' caused by the destruction of the skin basal cell layer, causing damage to the skin surface, serious It can even cause skin tissue necrosis, which often seriously affects the quality of life of patients. On the other hand, oral mucositis often caused by radiation therapy can also cause dysphagia, pain, and even loss of taste due to injury to the tongue's taste tissue; in addition, due to the high radiation sensitivity of the gastrointestinal epithelial tissue, it may also affect The nutrient absorption of the patient, condition. From the above conditions, the body weight will be significantly decreased, and when the weight loss is excessive, the patient will become significantly paralyzed, which will also cause a change in the contour of the body surface. The treatment plan for radiation therapy received by the patient is based on the computerized tomographic image before treatment. When the treatment process towel occurs on the surface of the body, the effect is placed on the patient and the skin. The amount distribution 'is not in line with the original design treatment. In addition, taking the area of lymphatic drainage of the neck and neck of the head and neck cancer as an example, this area is located on the inner side of the skin on both sides of the neck. This part is usually high-purity, and the patient's weight loss becomes thinner. Moving toward the _, the original high-dose dry area, causing doubts about the increase in the body's epidermis and subsequent possible delayed skin reactions. The currently used dose-testing measuring devices commonly used in clinical practice include the Ion Chamber and the thermal luminescence (The__escent D〇simeter).

M417136 膠片型劑量計(RadiochromicFilm)、凝膠體劑量計(Gel Dosimeien1 為主，為解決上述臨床治療之疑慮，本創作提供一放射治療劑量量 測裝置’可實際模擬病患的體表輪廓與外形改變時皮膚表面劑量的 大小。 【新型内容】 故’本創作係一種放射治療皮膚表面劑量量測裝置，適用於放 射治療時，因病患於治療期間體重下降，而使病患因體表外形輪廓 改變，照射部位的皮膚因組織内縮而趨向治療計劃的高劑量區時， 使得皮膚有輻射傷害效應增加之現象。 以頭頸癌病患放射治療為例，為真實呈現臨床上頭頸癌病患外 形輪廓（尤其是頸部）改變，對於表面劑量的影響，本創作乃是使用 臨床上常用直徑30公分(柱高18公分）的圓柱型固態假體(Cheese Phantom)或擬人固態假體（Rand〇 phant〇m)進行劑量量測。於此假 體外表面鋪上堆疊薄片式人體組織等效物質，其厚度可依照使用的 薄片數目與厚度變化，提供〇. 1〜5.0公分的體表模擬厚度，用以模 擬病患外形輪廓改變時量測不同輪廓下皮膚表面劑量之變化，量測 的方法敘述如下： 於至少一薄片的人體組織等效填充物外表面不同位置處，分別 貼以至少—個劑量量測物質（如：熱發光晶體或感光膠片），隨後將 貼有劑量量測物質的堆疊薄片式人體組織填充物，緊密貼附於固態 假體的外表面，模擬病患於放射治療後，因身體外型輪廓改變，照 射部位的皮膚因組織内縮而趨向治療計劃的高劑量區時的劑量量 4 M417136 【實施方式】M417136 Film type dosimeter (RadiochromicFilm), gel dosimeter (Gel Dosimeien1 based, in order to solve the above clinical treatment concerns, this creation provides a radiation therapy dose measuring device' can actually simulate the patient's body contour and shape The size of the skin surface dose when changing. [New content] Therefore, this creation is a radiation therapy skin surface dose measuring device, which is suitable for radiation therapy, because the patient loses weight during treatment, and the patient has a body surface appearance. When the contour changes, the skin of the irradiated part tends to increase the radiation damage effect of the skin due to tissue shrinkage and tends to the high dose area of the treatment plan. Taking the radiation therapy of the head and neck cancer patient as an example, the clinical manifestation of the head and neck cancer patients is true. The contour (especially the neck) changes, the effect on the surface dose, the creation is the use of clinically common 30 cm diameter (column height 18 cm) cylindrical solid prosthesis (Cheese Phantom) or anthropomorphic solid prosthesis (Rand 〇phant〇m) dose measurement. The surface of the artificial body is stacked with a stack of thin-film human tissue equivalents. According to the number and thickness of the sheets used, a surface simulated thickness of 〜 1 to 5.0 cm is provided to simulate changes in the skin surface dose under different contours when the patient's contour is changed. The measurement method is described as follows: At least one sheet of human tissue equivalent to the outer surface of the filler is attached with at least one dose measuring substance (such as a thermoluminescent crystal or a photographic film), and then a stacked sheet human body to which a dose measuring substance is attached The tissue filler is closely attached to the outer surface of the solid prosthesis, simulating the dose of the skin after the radiation treatment, due to changes in the contour of the body, and the skin of the irradiated site tends to the high dose area of the treatment plan due to tissue retraction. 4 M417136 [Embodiment]

本創作的目的紐供-減職_44崎置，[圖係為本 創作之單層量測裝置立體示意圖，第二圖係為本創作之單層量測裝置 剖面狀態示意圖，第三齡為本辦之單層量_置赠性性質料 曲狀立體示意圖，由以上第―、二、三圖可知本創作包括至少一片人 體組織等轉充物（i 〇)，該人體組__絲可於最外層貼附至 少一個輻射量測物質（i i )，該人體組織等效填充物為—軟性物質， 可適當彎曲以緊密貼於固態假體外表面。第四圖係為本創作之堆疊薄 片式量測裝置立_意圖，第五圖料本創作之堆疊薄片式量測裝置 剖面狀態示意圖，第六_為本創作之堆疊糾式量測裝置作彎曲狀 立體示意®，由社第四、五、六圖可知本創作可使駐少一片填充 物形成堆_式人·鱗效填絲（i Q )，該人馳織等效填充The purpose of this creation is to provide a new-supply-reduction _44 崎, [Figure is a three-dimensional schematic diagram of the single-layer measurement device of the creation, the second picture is a schematic diagram of the profile state of the single-layer measurement device of the creation, the third age is The single-layer quantity of the office _ the three-dimensional schematic diagram of the material property of the gift, from the above pictures of the first, second and third, the creation includes at least one body tissue (i 〇), the body group __ silk At least one radiation measuring substance (ii) is attached to the outermost layer, and the human tissue equivalent filling is a soft substance which can be appropriately bent to be closely attached to the surface of the solid foreign body. The fourth figure is a schematic diagram of the profile state of the stacked sheet type measuring device of the present creation, and the fifth figure is a schematic diagram of the profile state of the stacked sheet type measuring device, and the sixth is to bend the stacking correcting measuring device of the present invention. The three-dimensional schematic®, according to the fourth, fifth and sixth figures of the Society, can be used to create a pile of _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

物可因堆疊的填充物的數量而呈現不同厚度，且該堆疊薄片式人體組 織等效填充物的最外層貼附至少—個輕射量測物質（丄i)，該堆疊薄 片式人體_等效填絲為-軟性㈣，可適當_以緊密貼於固態 假體外表心該@1態假體可為_姻態假體（i 2)或擬人固態假 體（1 3 )’如第七、八圖所示，為至少一片堆叠薄片式人體組織等效 填充物（1 ό )’於堆疊料式人體組鱗效填充物最外層貼附至少一 鋪射量職質（11)，以緊密貼於n柱狐·體（i 2)或擬人 固態假體（1 3 )外表面，可實際模擬病患的體表輪賴外形改變時 皮膚表面劑量的大小，為一簡便的劑量量測裝置。 5 M417136The object may exhibit different thicknesses due to the number of stacked fillers, and the outermost layer of the stacked sheet-type human tissue equivalent filler is attached with at least one light-emitting measuring substance (丄i), the stacked sheet type human body_etc. The effect of the filler wire is - soft (four), which can be appropriately _ to be closely attached to the solid body of the external body. The @1 state prosthesis can be a _ marriage prosthesis (i 2) or anthropomorphic solid prosthesis (1 3 ) as the seventh As shown in the eight figure, at least one stacked sheet of human tissue equivalent filler (1 ό ) is attached to at least one spreading amount of the outermost layer of the stacked body type squama filler (11), so as to be close Attached to the outer surface of the n-pillar fox body (i 2) or the anthropomorphic solid prosthesis (1 3 ), it can actually simulate the size of the skin surface dose when the patient's body surface changes, which is a simple dose measuring device. . 5 M417136

本創作用來進行照射之儀器為Elekta Synergy®醫用直線加速 器，其能量及輸出劑量校正依據AAPM TG-21(A Protocol for the Determination of Absorbed Dose from High Energy Photon andThe instrument used for the illumination was an Elekta Synergy® medical linear accelerator whose energy and output dose were corrected according to AAPM TG-21 (A Protocol for the Determination of Absorbed Dose from High Energy Photon and

Electrons Beams)報告進行，本創作中所使用的射束為6MV光子射 束’利用原子能委員會核能研究所校正後的Farmer型游離腔（I〇n chamber)放入固態水假體(Sol id Water Phantom)中，設定深度d=l. 5 公分’照野大小為10x10公分2 ’經溫壓修正後，將1MU劑量輸出校 正成lcGy的吸收劑量。本創作用來進行劑量量測的物質有兩種：熱 發光晶體或膠片。 為達成本創作的功效與目的，本創作採用之技術手段，於進行 劑量量測前，必須先進行以下五項實驗以建置系統，分別為熱發光 晶體劑量校正曲線、膠片劑量校正曲線、固態假體電腦斷層影像擷 取、建立四角度(Box)模擬治療計劃與建立IMRT治療計劃，並以實 施例1.敘述之；而針對本創作的應用與實施，則於實施例2與3敘 述之。分述如下： 實施例1 : ⑴熱發光晶體劑量校正曲線 使用ElektaSynergy*直線加速器6MV光子射束，分別照射不同劑 量20cGy、40cGy、60cGy、80cGy、120cGy、160cGy、200cGy。利用 固態假體分別堆疊於熱發光劑量計之上下，以提供增建及適當的回 散射劑量’每次分別放置四顆TLD於固態假體中，設置方法為 SSD(Source-to-Source Distance)=100公分、照野大小ι〇χι〇公分2、 6 M417136 補充丨 dmax=1.5公分，並取其平均值以減少實驗誤差。分析2〇cGy至200cGy 之劑量區間内，發現熱發光y晶體訊號產生與所照射之輻射劑量經一 次線性迴歸得R2=〇. 9941，參閱附件一所示。 (2)膠片劑量校正曲線 本創作可使用各種膠片進行劑量量測，以新一代高靈敏度Electrons Beams) report, the beam used in this creation is a 6 MV photon beam. A solid water prosthesis (Sol id Water Phantom) is placed in the Farm-type free cavity (I〇n chamber) corrected by the Nuclear Energy Research Institute. In the setting depth d=l. 5 cm 'the size of the field is 10x10 cm 2' After the temperature and pressure correction, the 1MU dose output is corrected to the absorbed dose of lcGy. There are two types of substances used in this creation for dose measurement: thermoluminescent crystals or film. In order to achieve the efficacy and purpose of this creation, the technical means used in this creation, before the dose measurement, must first carry out the following five experiments to build the system, respectively, the thermoluminescent crystal dose calibration curve, film dose calibration curve, solid state The prosthetic computed tomography image capture, the establishment of a four-dimensional (Box) simulation treatment plan and the establishment of an IMRT treatment plan, and described in Example 1. The application and implementation of the present application are described in Examples 2 and 3. . The description is as follows: Example 1: (1) Thermoluminescent crystal dose calibration curve Using an Elekta Synergy* linear accelerator 6 MV photon beam, different doses of 20 cGy, 40 cGy, 60 cGy, 80 cGy, 120 cGy, 160 cGy, and 200 cGy were respectively irradiated. Solid-state prostheses are stacked on top of the thermal luminescence dosimeter to provide additional and appropriate backscatter doses. Each time four TLDs are placed in the solid-state prosthesis, the method is SSD (Source-to-Source Distance). =100 cm, field size ι〇χι〇 cm 2, 6 M417136 Supplement 丨dmax=1.5 cm, and take the average to reduce the experimental error. In the dose range from 2〇cGy to 200cGy, it was found that the thermoluminescence y crystal signal was generated by linear regression with the irradiated radiation dose by R2=〇. 9941, as shown in Annex 1. (2) Film dose calibration curve This creation can use various films for dose measurement, with a new generation of high sensitivity.

GafChromic EBT2(8xlO 吋2)膠片為例，任意剪裁 GafChromic EBT2 適當尺寸(通常為2x2公分2)，剪裁的底片需與原始膠片標誌相同方 向’避免掃描方向不同而影響分析的準確度。本創作將膠片裁剪為2 x2公分2大小’置放於固態假體中，利用固態假體分別堆疊於膠片之 上下，以提供增建及適當的回散射劑量，設置方法為SSD=100公分、 照野大小10x10公分2、dmax=l. 5公分。因GafChromic EBT2膠片在 照射後7至14天間呈現穩定狀況，因此，本創作採照射完畢後放置 至少7天，待其化學作用完畢後再以掃描器計讀其光密度值以減少 誤差產生。分別照射不同劑量20cGy、40cGy、60cGy、lOOcGy、150cGy、 200cGy、250cGy ' 300cGy、350cGy、400cGy。分析 20cGy 至棚cGy 劑量區間之膠片淨光密度值（Net Optical Density, Net OD)作為 校正曲線（Calibration Curve)，也稱 HD 曲線（HD Curve)，得到 校正曲線以四次廻歸後得r2=〇. 9984，參閱附件二所示。 (3)假體電腦斷層影像擷取 擁取影像方面’使用電腦斷層掃描模擬定位機(Siemens s〇mat〇m Emotion，Concord，CA，USA)進行掃描，掃描設定條件為：15〇fflAs、 130kV、切面厚度為3毫米。在假體外表面依序鋪上不同厚度（〇 ι~5. 〇 7 M417136 ¢.672 1^ ......... “ 曰補充 公分)之人體組織等效填充物’以开>成堆疊薄片式組織等效填充 物來模擬病患外形輪廓改變’分別掃描0 cm (沒有使用人截組織等 效填充物)及適當厚度人體組織等效填充物之影像合計5組，所有影 像藉由鉛線(Guide Wire)之定位座標來決定假體表面之輪廓以及劑 量評估的所在位置，參閱附件三所示。 (4)四角度(Box)模擬治療計劃 在假體接近體表處與適當厚度人體等效組織填充物間，模擬臨 床上頭頸癌頸部區域照射之方式，繪製一半圓型的腫瘤靶區，其外 圈輪廓與假體表面距離0. 5公分。分別以兩種不同照射技術來設計 治療計畫。首先是使用四角度技術(B〇x Technique)，使用4個不同 角度之射束，分別為0。、90。、180。、及270。進行照射，並以假體 中心為參考點，每次給予2〇〇cGy之劑量，參閱附件四所示。 (5)IMRT治療計刻 同前所述，在假體接近體表處與適當厚度人體等效組織填充物 間，模擬臨床上頭頸癌頸部區域照射之方式，繪製一相同的半圓型 的腫瘤靶區，其外圈輪廓與假體表面距離〇 5公分，並設計一強度 調控放射鱗（脈τ)賴，共用七個不同角度且相互錯開之射束， 射束角度分別為 150。、125。、80。、0。、280。、235。、210。，以達到 劑量均勻之目的，參閱附件五所示。 實施例2.不同厚度人想组織等效物質於固態假艘外表面劑量量測 本創作使用Elekta Synergy直線加速器，選擇6 MV之光子能 量從冶療計畫之等劑量曲線分佈，找出感興趣的點(p〇int 〇f 8For example, GafChromic EBT2 (8xlO 吋2) film can be cut at any size (usually 2x2 cm 2). The cut film should be in the same direction as the original film mark. This creation cuts the film into 2 x 2 cm 2 size 'placed in a solid prosthesis, using solid prosthesis stacked on top of the film to provide additional construction and appropriate backscatter dose. The setting method is SSD=100 cm, Photo field size 10x10 cm 2, dmax = l. 5 cm. Since the GafChromic EBT2 film is stable between 7 and 14 days after the irradiation, the creation is placed for at least 7 days after the irradiation is completed, and after the chemical reaction is completed, the optical density value is read by the scanner to reduce the error. Different doses of 20cGy, 40cGy, 60cGy, lOOcGy, 150cGy, 200cGy, 250cGy '300cGy, 350cGy, 400cGy were respectively irradiated. The Net Optical Density (Net OD) of the 20cGy to the shed cGy dose interval was analyzed as the Calibration Curve, also known as the HD Curve. The calibration curve was obtained after four rounds of return. 〇. 9984, see annex II. (3) Prosthetic computed tomography image capture image capture using a computerized tomography simulator (Siemens s〇mat〇m Emotion, Concord, CA, USA), the scan setting conditions are: 15〇fflAs, 130kV The cut surface has a thickness of 3 mm. The outer surface of the pseudo-exterior surface is sequentially coated with different thicknesses (〇ι~5. 〇7 M417136 ¢.672 1^ ......... " 曰 supplemental cents) of human tissue equivalent filling 'to open> A stack of sheet-like tissue equivalent fillers to simulate a patient's contour change's scan of 0 cm (without human-section tissue equivalent filler) and appropriate thickness of human tissue equivalent filler image total 5 groups, all images The contour of the lead wire is used to determine the contour of the prosthesis surface and the location of the dose assessment, as shown in Annex 3. (4) Four-angle (Box) simulated treatment plan at the prosthesis close to the body surface 5 cm. The difference between the outer ring contour and the surface of the prosthesis is 0. 5 cm, respectively, between the appropriate thickness of the body equivalent tissue filling, simulating the way of the neck area of the head and neck cancer. Irradiation techniques are used to design treatment plans. The first is to use four angle techniques (B〇x Technique) to use four different angle beams, 0, 90, 180, and 270. The center of the body is the reference point, each time giving 2〇〇cG The dose of y is shown in Annex 4. (5) IMRT treatment is calculated as described above, and the neck area of the head and neck cancer is simulated between the prosthesis close to the body surface and the appropriate thickness of the human equivalent tissue filler. In a way, a similar semi-circular tumor target area is drawn, and the outer ring contour is at a distance of 5 cm from the surface of the prosthesis, and a beam of intensity-regulated radiation scale (pulse τ) is designed to share seven different angles and mutually staggered beams. The beam angles are 150, 125, 80, 0, 280, 235, 210. For the purpose of uniform dosage, see Annex 5. Example 2. People of different thickness want to organize Equivalent Substance on Solid Surface Docking Surface Dose Measurement This creation uses the Elekta Synergy linear accelerator to select the photon energy of 6 MV from the isodose curve distribution of the treatment plan to find the point of interest (p〇int 〇f 8

Interesting，POT)，使用一個以上（最多不超過 質（熱發S晶體或膠片）.（1 1 )貼附於不同厚度人體組織等效物質 的堆疊式薄片（1〇)的最外層上，並以對稱方式將輪射量測物質 貼於適當幾何位置。此貼有劑量量測物質（i i)的堆疊薄片式人 體組織等效物質Π 〇)為一軟性物質，可適當彎曲以緊密貼於固 態假體（圓柱型固態假體（1 2)或擬人固態假體（丄3乃外表面， 为別里測堆疊薄片不同厚度時最外層劑量的變化，可實際模擬病串 的體表輪廓與外形改變時皮膚表關量的大小，分析此表面劑量作 為臨床參考之數據，圓柱型固態假體之外表面劑量量測方式描述如 下： 在佈點方面，可選擇假體表面四個不同位置作為劑量量測點， 分別為Gantry: 60。、90。、270。、300。，選定位置後，斷層影像示 意如附件六，在假體表面緊密蘭不同厚度並貼有购細物質（熱 發光晶體M-IGGH或則EBT2) ( 1 1 )之人體_較物質（工 〇 )’照射後更換另一厚度之人體組織等效物質（i 〇 ),以同樣的 實驗條件進行照射，依此類推，因此會量測到五個不同厚度體表輪 廓之表面劑量··分別為〇公分(不加人體組織等效物質時)與〇卜5 〇 公分的各種厚度的人體組織等效物質共計五組數據，同樣方式進行 欠以求取平均值，觀察以同樣照射條件下，不同厚度的體表輪 廊所量_的表_量是否有差異，並比較熱發光晶體與膠片兩者 數據之差異，詳細數據如下表所示： 9 U〇· β. 2 l^j£ 丄月曰k充1’ 不同人體組織等效物質厚度於圓柱型固態假體之外表面射量量測 相對表面劑量Interesting, POT), use more than one (maximum quality (hot hair S crystal or film). (1 1 ) attached to the outermost layer of stacked sheets (1〇) of different thickness of human tissue equivalents, and The shot measuring substance is attached to the appropriate geometric position in a symmetrical manner. The stacked sheet type human tissue equivalent substance (Π) which is attached with the dose measuring substance (ii) is a soft substance which can be appropriately bent to be closely attached to the solid state. Prosthesis (cylindrical solid prosthesis (1 2) or anthropomorphic solid prosthesis (丄3 is the outer surface, the variation of the outermost dose when different thicknesses of stacked sheets are measured, can actually simulate the contour and shape of the body surface of the diseased string The amount of skin surface change when changing, the surface dose is analyzed as the clinical reference data, and the surface dose measurement method of the cylindrical solid prosthesis is described as follows: In the aspect of the arrangement, four different positions of the prosthesis surface can be selected as the dose amount. The measuring points are: Gantry: 60., 90., 270., 300. After the selected position, the tomographic image is shown in Annex VI. The surface of the prosthesis is compact and different in thickness and has a fine substance (hot hair). The crystal M-IGGH or EBT2) (1 1 ) is replaced with another thickness of human tissue equivalent substance (i 〇) after irradiation, and irradiated under the same experimental conditions, and so on. Therefore, the surface doses of the contours of five different thicknesses are measured. · Five groups of human tissue equivalents of various thicknesses of 〇 centimeters (when no human tissue equivalents are added) and 〇 5 5 〇 centimeters The data is averaged in the same way to obtain an average value. Observe whether there is a difference in the amount of the surface of the body surface of the different thicknesses under the same irradiation conditions, and compare the difference between the data of the thermoluminescent crystal and the film. The detailed data are shown in the following table: 9 U〇·β. 2 l^j£ 丄月曰k充1' Different body tissue equivalent material thickness is measured on the surface of the cylindrical solid prosthesis.

Bolus Thickness TLD-100H Box EBT2 Box TLD-100H IMRT EBT2 IMRT 0公分 108.83 109. 64 145. 76 123. 27 0. 3公分 111.78 114.35 141.54 124.19 0. 5公分 107. 75 107.76 136.92 118.61 1. 0公分 104.66 105. 44 141.38 113.74 1. 5cm 107.33 108.13 139.44 113.38 實施例3·不同人體組織等效物質厚度於擬人固態假體外表面劑量董測 在佈點方面，根據臨床之觀察，以一般皮膚反應較明顯的區塊 作為參考，故在擬人固態假體(Anthr〇p〇m〇rphic Rand〇* Phant0m) 的上頸部（Upper Neck)及中頸部（Middle Neck)作為量測點，^ 上述原則為基準，故本創作之量測位置分別是以影像原點切面往腳 端方向3. 5公分以及6. 5公分的體表位置，左右兩邊各找兩個量測 點，總共量測四點，重複前項步驟，選定位置後，在假體表面貼附 不同厚度並貼有輕射量測物質（熱發光晶體TUH_或勝片 (11)之人體組織等效物質（i 〇 )，照射後更換另一厚度之人體 組織等_ ( i G )，以_實驗條件進行照射依此類推因 此會量測到五個不同厚度體表輪廟之表面劑量：分別為〇公分（不 加人體組麟效师時）與G.卜5. Q公分的各種厚朗 效物質共計五組數據，雜方私 、，織等 同檨，U麵平均值，觀察以 異、、射條件下，列厚度_表輪廓所量_的表 =，並比請侧峨姆咖 疋否* 斷層影像谢跑， 够J ^ *Jr -y- 補无: Κ». 6. 2 年月日 ^ ^人體组織等效物f厚度於擬人®態健絲©劑量量測Bolus Thickness TLD-100H Box EBT2 Box TLD-100H IMRT EBT2 IMRT 0 cm 108.83 109. 64 145. 76 123. 27 0. 3 cm 111.78 114.35 141.54 124.19 0. 5 cm 107. 75 107.76 136.92 118.61 1. 0 cm 104.66 105 44 141.38 113.74 1. 5cm 107.33 108.13 139.44 113.38 Example 3·Equivalent body thickness of different human tissues in the surface of human anthropomorphic pseudo-foreign surface. In the aspect of the distribution, according to the clinical observation, the block with obvious skin reaction is obvious. For reference, the upper neck (Upper Neck) and the middle neck (Middle Neck) of the anthropomorphic solid prosthesis (Anthr〇p〇m〇rphic Rand〇* Phant0m) are used as the measurement points. The measurement position of this creation is the body surface position of the image origin cut surface to the foot end 3. 5 cm and 6.5 cm, and two measurement points are found on the left and right sides. The total measurement is four points, and the previous steps are repeated. After the selected position, the surface of the prosthesis is attached with different thicknesses and attached with a light-emitting measuring substance (thermographic material TUH_ or winning piece (11) of human tissue equivalent substance (i 〇), and another thickness is replaced after irradiation. Human body Weaving _ ( i G ), illuminating with _ experimental conditions, and so on, will measure the surface dose of five different thickness body rounds: 〇 centimeters (when no human body group is used) and G .5. The various thick and effective materials of Q cents have a total of five sets of data, the squares are private, the weave is equivalent to the mean, the U-surface average, and the observation is based on the difference between the thickness and the thickness of the table. =, and than the side of the 峨 峨 疋 疋 * * * * 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断 断Dynamic wire © dose measurement

Bolus Thickness ----- 相對表面香丨晋 TLD-100H IMRT ----- EBT2 IMRT Ocm公分 162. 51 158.71 0.3公分 164.72 159.19 0.5公分 164.75 155.94 1.0公分 179.73 165.44 1.5公分 187.18 170.44 【圖式簡單說明】 第-圖係林創作之單層制裝置立體示意圖。 第一圖係為本創作之單層量測裝置剖面狀態示意圖。 第三圖係為本創作之單層量測裝置以軟性性質作彎曲狀立體示意圖。 第四圖係為本創作之堆疊薄片式量測裝置立體示意圖。 第五圖係為本創作之堆疊薄片式量測裝置剖面狀態示意圖。 第六圖係為本創作之堆疊薄片式量測裝置作彎曲狀立體示意圖。 第七圖係為本創作之量測裝置貼附於圓柱型假體擺放位置示意圖。 第八圖係為本創作之量測裝置貼附於擬人假體擺放位置示意圖。 【主要元件符號說明】 1 0人體組織等效填充物 1 1輻射量測物質 12圓柱型固態假體 1 3擬人固態假體Bolus Thickness ----- Relative surface 丨 丨 TLD-100H IMRT ----- EBT2 IMRT Ocm cent 162. 51 158.71 0.3 cm 164.72 159.19 0.5 cm 164.75 155.94 1.0 cm 179.73 165.44 1.5 cm 187.18 170.44 [Simple description 】 The first picture shows a three-dimensional schematic diagram of a single-layer device. The first picture is a schematic diagram of the profile state of the single-layer measuring device of the present creation. The third figure is a three-dimensional schematic diagram of the single-layer measuring device of the present invention in a curved shape with soft properties. The fourth figure is a three-dimensional schematic diagram of the stacked sheet type measuring device of the present invention. The fifth figure is a schematic diagram of the profile state of the stacked sheet type measuring device of the present invention. The sixth figure is a curved perspective view of the stacked sheet type measuring device of the present invention. The seventh figure is a schematic view of the position of the measuring device attached to the cylindrical prosthesis. The eighth figure is a schematic diagram of the position of the artificial measuring device attached to the artificial prosthesis. [Description of main component symbols] 1 0 equivalent packing of human tissue 1 1 radiation measuring substance 12 cylindrical solid prosthesis 1 3 anthropomorphic solid prosthesis

【附件說明】 附件一係為本創作實施例之熱發光劑量計劑量校正曲線圖。 係為本創作實施例之GafChromic EBT2夥片劑量校正曲線圖。 附件三係為本創作實施例之總厚度為1· 5公分人體組織填充物貼於 圓柱型固態假體外表面之電腦斷層切面影像示意圖。 附件四係為本創作實施例之圓柱型固態假體使用四角度(Β〇χ)模擬治 療計劃射束示意圖。 附件五係為本創作實施例之圓柱型固態假體之IMRT射束示意圖。 附件六係為本創作實施例之堆疊薄片式人體等效組織填充物貼附於 圓柱型固態假體示意圖。 附件七俾為本創作實施例之堆疊薄片式人體等效組織填充物貼附於 擬人固態假體示意圖。 12[Description of Attachment] Attachment 1 is a graph of the dose calibration curve of the thermal luminescence dosimeter of the present embodiment. This is the GafChromic EBT2 tablet volume calibration curve for the present example. Attachment 3 is a schematic diagram of a computerized tomographic section of a cylindrical solid body surface with a total thickness of 1.5 cm of human tissue filler attached to the present embodiment. Annex IV is a schematic diagram of a four-angle (Β〇χ) simulated treatment plan beam for a cylindrical solid prosthesis of the presently-created embodiment. Annex V is a schematic diagram of the IMRT beam of the cylindrical solid prosthesis of the present embodiment. Attachment 6 is a schematic view of the stacked sheet type human equivalent tissue filler attached to the cylindrical solid body prosthesis of the present embodiment. Attachment VII is a schematic view of the stacked human body equivalent tissue filler of the present embodiment attached to the anthropomorphic solid prosthesis. 12

Claims (1)

M417136M417136 六、申請專利範圍： 1· 一種放射治療皮膚表面劑量量測裝置，包括：一假體；一人體組織 等效填充物，貼於該假體上。 2.如申請專利範圍第1項所述之放射治療皮膚表面劑量量測裝置’其 中，該人體組織等效填充物為至少一片薄片堆疊而成，總片數不超過 5〇片，總厚度為0.1〜5.0公分。 3·如申請專利範圍第1項所述之放射治療皮膚表面劑量量測裝置，其 g 中，該人體組織等效填充物最外層貼附至少一個輻射量測物質，該輻射 量測物質總數不超過250個。 4·如申請專利範圍第1項所述之放射治療皮膚表面劑量量測裝置’其 中，該人體組織等效填充物最外層貼附至少一個熱發光晶體，該熱發光 晶體總數不超過250個。 5.如申請專利範圍第1項所述之放射治療皮膚表面劑量量測裝置，其Sixth, the scope of application for patents: 1. A radiation treatment skin surface dose measuring device, comprising: a prosthesis; a human body equivalent filler, attached to the prosthesis. 2. The radiotherapy skin surface dose measuring device according to claim 1, wherein the human tissue equivalent filler is formed by stacking at least one sheet, and the total number of sheets is not more than 5 pieces, and the total thickness is 0.1 to 5.0 cm. 3. The radiation treatment skin surface dose measuring device according to claim 1, wherein the outermost layer of the human tissue equivalent filler is attached with at least one radiation measuring substance, and the total amount of the radiation measuring substance is not More than 250. 4. The radiotherapy skin surface dose measuring device according to claim 1, wherein the outermost layer of the human tissue equivalent filler is attached with at least one thermoluminescent crystal, and the total number of the thermoluminescent crystals is not more than 250. 5. The radiation treatment skin surface dose measuring device according to claim 1, wherein 中’該人體組織等效填充物最外層貼附至少一個膠片.，該膠片總數不超 過250片。 6·如申請專利範圍第1項所述之放射治療皮^表面劑量量測裝置，其 中’該假體為一圓柱型固態假體、橢圓柱型固態假體、擬人頭部固態假 體、擬人胸腔固態假體、擬人腹腔固態假體、擬人全身固態假體。 13At least one film is attached to the outermost layer of the human body equivalent filler. The total number of the film is no more than 250 pieces. 6. The radiotherapy skin surface dose measuring device according to claim 1, wherein the prosthesis is a cylindrical solid prosthesis, an elliptical cylindrical solid prosthesis, a human head solid prosthesis, anthropomorphic Thoracic solid prosthesis, anthropomorphic abdominal solid prosthesis, anthropomorphic solid prosthesis. 13