放射肿瘤简介_SUH_1导论.pptVIP

前列腺癌近距离照射组织间近距离照射 GammaKnife 放射外科 GammaKnife 放射外科 LINAC 放射外科 Cyberknife 放射外科 术中放射治疗 * * 可以用两种观点理解X-rays，一、X线可被视作一种带有电磁能量的波， X-线、无线电波、雷达、热辐射、可见光都属于电磁辐射，具有相同的运动速度（光速），但是具有不同的波长和频率，X-线和γ线的特点是波长短/能量高，位于波谱的末端，X-rays产生于原子核外。伽马线产生于原子核内，另外一种考虑是X射线可被考虑为光子流。Photon = packet of energy. * First use of ions heavier than helium used for therapy were in 1977 at Laurence Berkley labs. Clinical trials done in Japan. Since theyhave a larger diameter and bending radius these machines are three times larger. * ring cyclotron at PSI accelerate protons up to 590 MeV. Protons of energy ____ are used clinically… Describe how protons and other heavy ions are accelerated. * IJRBP, 2004 * Direct Action: A secondary electron resulting from the absorption of an x-ray interacts with DNA to produce the effetc. Indirect action: the secondary electron interacts with water (for example; usually water b/c 80% of a cell is water) to produce a hydroxyl radical (OH-) which in turn goes to effect the DNA. Radiation can cause breaks in DNA that may lead to cell killing. 2/3 of the effect is due to the INDIRECT action. Goal is to deliver precisely measured dose of RT to a defined volume with minimal damage to surrounding healthy tissue. * Potentally lethal damage – if post irradiation conditions are suboptimal for growth then the cells do not have to attempt the complex process of mitosis with damaged chromosomes (not very practical for daily RT; for ex, bathing cells in a salt solution to delay mitosis). * UCSF Experience: 1987 – 1st US GK 1989-1991 – homemade LINAC based software 1991 – UCSF builds GK Radiation unit 201 cobalt 60 sources Patient couch control console – outside the room treatment planning computer system – outside the room individual collimator helmets (four different sizes) provides secondary collimation of the beam; 4, 8, 14, or 18mm tungsten collimators used to create specific diameter fields at the focus point any of the201 channels can be replaced by an occlusive p