臺灣博碩士論文加值系統

在舌癌的放射治療中會使用腔內固定器(intro-oral block)將舌頭固定並且提高舌頭表面的劑量。但不同材質的固定器會造成不同的劑量分佈，所以在本實驗中使用四種不同材質之腔內固定器，分別在左右對照（Bilateral beam）治療計畫、四照野（4 fields）治療計畫以及強度調空放射治療（Intensity Modulation Radiation Therapy，IMRT）治療計畫等三個治療計畫中使用不同材質之腔內固定器測量其單次治療之劑量分布。
本實驗主要的測量工具為EBT 底片，將照射過的EBT 底片使用軟體FILMQA做分析得到結果。結果顯示當在舌癌的放射治療中時使用高密度的腔內固定器不僅可以提高舌頭表面的劑量也可以降低周圍組織所接受的劑量。

Radiation therapy in the tongue cancer patient by using intro-oral block will use to fix the tongue and raise the tongue surface dose. However, the intro-oral block of different materials will cause different dose distribution, so in this experiment we using four different materials to fix the tongue .The intro-oral blocks will be used in three different treatment plans respectively, the Bilateral beam treatment plan, 4 fields treatment planning and Intensity Modulation Radiation Therapy ( IMRT) treatment planning. Finally, we measure the dose distribution with four different materials of intro-oral blocks.
In this study, we use the EBT film to measure the dose, and also use the FILMQA to do the analysis of the EBT film. The results show that when we use high-density intro-oral block to treat the tongue cancer patient, it will not only increase the surface dose of the tongue may also reduce the dose to the nearby normal tissues.

目錄
中文摘要……………………………………………………Ⅰ
Abstract….…………………………………………………Ⅱ
目錄…………………………………………………………Ⅲ
圖目錄………………………………………………………Ⅵ
表目錄………………………………………………………Ⅸ
第一章 前言……………………………………………...1
1.1 研究動機..…………………………………………………………. 1
1.2 實驗目的..…………………………………………………………. 2
第二章 文獻回顧…………………………………….......3
2.1 口腔癌簡介..………………………………………………………..3
2.1.1口腔癌定義..……………………………………………………3
2.1.2口腔癌之分期..…………………………………………………4
2.1.3口腔癌之治療與預後..…………………………………………5
2.2 Radiochromic film(輻射變色底片) 之特性..……………………...7
2.3 Radiochromic film（輻射變色底片）之臨床應用…………………7
第三章 材料與方法………………………………………9
3.1 實驗架構…………………………………………………………....9
3.2 實驗設備…………………………………………………………..11
3.2.1 底片劑量系統……………………………………..………...11
3.2.2 醫用直線加速器（Varian 21EX）……………………........14
3.2.3 固態水假………………..…………………………………...15
3.2.4 光學平臺式彩色掃描機（Epson 1680）……………...........16
3.2.5 自製壓克力假體體………………………………….............17
3.2.6 腔內固定器軟體(Intro- Oral Blocks)…….…………………18
3.2.7 Eclips 治療計畫系統……………………..………...............19
3.2.8 FILMQA……………………………………..………............20
3.3 實驗方法…………………………………………….…………….21
3.3.1 前期研究……………………………………….……............21
3.3.2 後期實驗……………………………………….……….…...22
第四章 結果…………………………………………….………..27
4.1 EBT film劑量校準以及驗證………………………….……….…27
4.2 四種固定器使用在不同治療計畫中測量之後得到之劑量分布結果……………………………………………………….29
4.2.1 左右對照治療計畫之劑量分布……………………..……...29
4.2.2 四照野治療計畫之劑量分 ...................................................39
4.2.3 強度調控放射治療治療計畫之劑量分布 .……………..…48
第五章 討論……………………………………………..58
5.1 總計量比較……………………………………………………….58
5.1.1 不同腔內固定器在左右對照技術完中整療程之劑量差異..58
5.1.2 不同腔內固定器在四照野技術中完整療程之劑量差異…..61
5.1.3 不同腔內固定器在強度調控放射治療技術中完整療程之劑量差異………………………………………….64
5.1.4 總劑量比較…………………………………………………..66
5.2 不同材質之固定器造成劑量分佈不同的原因……..…....48
5.3 腔內固定器之臨床應用…………………...…………………69
第六章 結論……………………………………………..70
第七章 未來展望………………………………………..71
第八章 參考文獻………………………………………..72

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