宫颈癌~(252)Cf近距离腔内放疗中对周围器官的辐射影响评价
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摘要
~(252)Cf近距离放射治疗主要用于宫颈癌的腔内放射治疗,在放射治疗的同时势必对附近器官产生辐射危害,因此评价宫颈癌患者在放疗过程中其他器官的辐射损伤是必要的。本文以某医院~(252)Cf宫颈癌的放射治疗为参考,通过~(252)Cf在空气、水中剂量场分布理论计算和实际检测,对比子宫、直肠、膀胱、卵巢等器官的耐受剂量限值,给出了在宫颈癌治疗过程中,除靶器官子宫会受大剂量照射出现损伤外,直肠、膀胱、卵巢等器官也受较大辐射危害。为了减少宫颈癌患者的辐射损伤,经计算给出了不同源活度情况下的最佳照射时间。
[Background] The ~(252)Cf brachytherapy is mainly used for cervical cancer endovascular radiotherapy. [Purpose] Radiation therapy will inevitably cause radiation damage to nearby organs. Therefore, it is necessary to evaluate the radiation damage of cervical cancer patients during radiotherapy. [Methods] This article is based on the radiation therapy of ~(252)Cf cervical cancer in a hospital, and theoretical calculations and practical tests of dose field distribution in air and water by ~(252)Cf, and compared with the tolerance limits of uterus, rectum, bladder, ovary and other organs. [Results] By comparison, it is concluded that in the process of cervical cancer treatment, organs such as the rectum, bladder and ovary are also affected by large radiation in addition to damage caused by high doses of irradiation. [Conclusion] In order to reduce the radiation damage of cervical cancer patients, the optimal irradiation time under different source activity was calculated.
[Background] The ~(252)Cf brachytherapy is mainly used for cervical cancer endovascular radiotherapy. [Purpose] Radiation therapy will inevitably cause radiation damage to nearby organs. Therefore, it is necessary to evaluate the radiation damage of cervical cancer patients during radiotherapy. [Methods] This article is based on the radiation therapy of ~(252)Cf cervical cancer in a hospital, and theoretical calculations and practical tests of dose field distribution in air and water by ~(252)Cf, and compared with the tolerance limits of uterus, rectum, bladder, ovary and other organs. [Results] By comparison, it is concluded that in the process of cervical cancer treatment, organs such as the rectum, bladder and ovary are also affected by large radiation in addition to damage caused by high doses of irradiation. [Conclusion] In order to reduce the radiation damage of cervical cancer patients, the optimal irradiation time under different source activity was calculated.
引文
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6马桥,刘明哲,刘德明,等.MC法优化设计252Cf中子源辐射屏蔽装置[J].核电子学与探测技术,2016,36(8):791-794.MA Qiao,LIU Mingzhe,LIU Deming,et al.Modification of 252Cf neutron source radiation shielding device based on MC method[J].Nuclear Electronics and Detection Technology,2016,36(8):791-794.
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8贺丹,宋英明,邹树梁,等.基于252Cf源的反应堆结构屏蔽材料屏蔽性能测试装置设计[J].核技术,2015,38(9):090604.DOI:10.11889/j.0253-3219.2015.hjs.38.090604.HE Dan,SONG Yingming,ZOU Shuliang,et al.Design of shielding device for shielding structure of reactor based on 252Cf source[J].Nuclear Techniques,2015,38(9):090604.DOI:10.11889/j.0253-3219.2015.hjs.38.090604.
9邓景珊,朱国胜,周呈方,等.252Cf中子活化核燃料棒235U富集度均匀性检测装置[J].原子能科学技术,2003,37(6):538-542.DENG Jingshan,ZHU Guosheng,ZHOU Chengfang,et al.Detection device of 235U enrichment of 252Cf neutron activated nuclear fuel rods[J].Anotechnology of Atomic Energy,2003,37(6):538-542.
10刘文杰.萃取色层法分离锎-252和锔-248的研究[D].北京:中国原子能科学研究院,2001.LIU Wenjie.Study on the extraction chromatography252Cf and 248Cm[D].Beijing:China Institute of Atomic Energy,2001.
11李星洪.辐射防护基础[M].北京:原子能出版社,1982:176-183.LI Xinghong.Radiation protection foundation[M].Beijing:Atomic Energy Press,1982:176-183.
12 ICRP 2002.Basic anatomical and physiological data for use in radiological protection reference values[R].ICRPPublication 89,ICRP 32(3-4).
13张殿波,荣荥,王旭东,等.宫颈癌中子刀(252锎)放射治疗前后MRI检查的临床价值[J].中国CT和MRT杂志,2009,7(5):61-63.ZHANG Dianbo,RONG Yong,WANG Xudong,et al.Clinical value of MRI examination before and after radiotherapy for cervical neonate knife[J].China CT and MRT Magazine,2009,7(5):61-63.
14张丹枫,赵兰才.辐射防护技术与管理[M].南宁:广西壮族出版社,2003:30-34.ZHANG Danfeng,ZHAO Lancai.Radiation protection technology and management[M].Nanning:Guangxi Zhuang Publishing House,2003:30-34.
15 ICRP 1991.1990 recommendations of the international commission on radiological protection[R].ICRPPublication 60,ICRP 21(1-3).
16 ICRP 2007.The 2007 recommendations of the international commission on radiological protection[R].ICRP Publication 103,ICRP 37(2-4).
2 Morice P,Leary A,Creutzberg C,et al.Endometrial cancer[J].Lancet,2016,387(10023):1094-1108.DOI:10.1016/s0140-6736(15)00130-0.
3杨越波,叶青剑,曾海涛,等.252锎中子后装在宫颈癌术前辅助放疗中的作用[J].中山大学学报(医学科学版),2011,32(5):644-647.DOI:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2011.0122.YANG Yuebo,YE Qingjian,ZENG Haitao,et al.Role of252Cf neutron after loading in preoperative radiotherapy for cervical cancer[J].Journal of Sun Yat-sen University(Medical Sciences),2011,32(5):644-647.DOI:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2011.0122.
4崔彦莉.宫颈癌放疗所致急性放射性直肠炎影响因素[J].分子影像学杂志,2017,40(1):44-47.DOI:10.3969/j.issn.1674-4500.2017.01.13.CUI Yanli.Factors influencing acute radiation proctitis caused by radiotherapy of cervical cancer[J].Journal of Molecular Imaging,2017,40(1):44-47.DOI:10.3969/j.issn.1674-4500.2017.01.13.
5邓君,苏根平,任福利,等.252Cf中子后装治疗室辐射防护的测量与分析[J].中国辐射卫生,2015,24(3):240-242.DOI:10.13491/j.cnki.issn.1004-714x.2015.03.020.DENG Jun,SU Genping,REN Fuli,et al.Measurement and analysis of radiation protection of 252Cf neutron after loading treatment room[J].China Journal of Radiation Health,2015,24(3):240-242.DOI:10.13491/j.cnki.issn.1004-714x.2015.03.020.
6马桥,刘明哲,刘德明,等.MC法优化设计252Cf中子源辐射屏蔽装置[J].核电子学与探测技术,2016,36(8):791-794.MA Qiao,LIU Mingzhe,LIU Deming,et al.Modification of 252Cf neutron source radiation shielding device based on MC method[J].Nuclear Electronics and Detection Technology,2016,36(8):791-794.
7温国义.浅谈核电站用锎-252中子源[J].科技与创新,2017,16(5):5-6.DOI:10.15913/j.cnki.kjycx.2017.16.00.WEN Guoyi.A discussion on 252Cf neutron source for nuclear power station[J].Technology and Innovation,2017,16(5):5-6.DOI:10.15913/j.cnki.kjycx.2017.16.00.
8贺丹,宋英明,邹树梁,等.基于252Cf源的反应堆结构屏蔽材料屏蔽性能测试装置设计[J].核技术,2015,38(9):090604.DOI:10.11889/j.0253-3219.2015.hjs.38.090604.HE Dan,SONG Yingming,ZOU Shuliang,et al.Design of shielding device for shielding structure of reactor based on 252Cf source[J].Nuclear Techniques,2015,38(9):090604.DOI:10.11889/j.0253-3219.2015.hjs.38.090604.
9邓景珊,朱国胜,周呈方,等.252Cf中子活化核燃料棒235U富集度均匀性检测装置[J].原子能科学技术,2003,37(6):538-542.DENG Jingshan,ZHU Guosheng,ZHOU Chengfang,et al.Detection device of 235U enrichment of 252Cf neutron activated nuclear fuel rods[J].Anotechnology of Atomic Energy,2003,37(6):538-542.
10刘文杰.萃取色层法分离锎-252和锔-248的研究[D].北京:中国原子能科学研究院,2001.LIU Wenjie.Study on the extraction chromatography252Cf and 248Cm[D].Beijing:China Institute of Atomic Energy,2001.
11李星洪.辐射防护基础[M].北京:原子能出版社,1982:176-183.LI Xinghong.Radiation protection foundation[M].Beijing:Atomic Energy Press,1982:176-183.
12 ICRP 2002.Basic anatomical and physiological data for use in radiological protection reference values[R].ICRPPublication 89,ICRP 32(3-4).
13张殿波,荣荥,王旭东,等.宫颈癌中子刀(252锎)放射治疗前后MRI检查的临床价值[J].中国CT和MRT杂志,2009,7(5):61-63.ZHANG Dianbo,RONG Yong,WANG Xudong,et al.Clinical value of MRI examination before and after radiotherapy for cervical neonate knife[J].China CT and MRT Magazine,2009,7(5):61-63.
14张丹枫,赵兰才.辐射防护技术与管理[M].南宁:广西壮族出版社,2003:30-34.ZHANG Danfeng,ZHAO Lancai.Radiation protection technology and management[M].Nanning:Guangxi Zhuang Publishing House,2003:30-34.
15 ICRP 1991.1990 recommendations of the international commission on radiological protection[R].ICRPPublication 60,ICRP 21(1-3).
16 ICRP 2007.The 2007 recommendations of the international commission on radiological protection[R].ICRP Publication 103,ICRP 37(2-4).