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유방암환자의 전유방절제술 후 표준치료기법과 세기조절 방사선치료기법에 관한 비교연구

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Alternative Title
Comparison study for intensity modulated radiation therapy and standard therapy with the breast cancer patients who received modified radical mastectomy
Abstract
Purpose: To tried to find better plan between intensity modulated radiation therapy plan and the standard plan from the breast cancer patients who took a modified radical mastectomy. When the planning target volume include chest wall, supraclavicular nodes, and internal mammary nodes, a significant volume of the heart and the ipsilateral lung may received high radiation doses, which may result in late complications. The value of intensity modulated radiation therapy to avoid the heart and ipsilateral lung dose was studied.
Materials and methods: Chest wall, supraclavicular nodes, and internal mammary nodes, and normal tissues were contoured for 10 patients previously treated with the radiation therapy after the modified radical mastectomy for the breast cancer. With eleven- beam, intensity modulated radiation therapy plans were developed and compared with standard plans. Conformity index, homogeneity index and doses to normal tissues were compared.
Results: Intensity modulated radiation therapy plans were significantly improved homogeneity (1.11 vs. 2.47), conformity (0.99 vs. 0.54), volum of the heart receiving more than 30 Gy (V30-heart) (4.6% vs. 16.96%), and volume of lung receiving more than 20 Gy (V20-lung) (22% vs. 27%) in left breast cancer patients. And intensity modulated radiation therapy plans were improved homogeneity (1.11 vs.3.35), conformity (0.99 vs. 0.5), and volume of lung receiving more than 20 Gy (V20-lung) (27% vs. 28%) in right breast cancer patients also.
Conclusions: Intensity modulated radiation therapy plan was better for the breast cancer patients with the modified radical mastectomy. The heart and the ipsilateral lung volume receiving high doses were decreased, except the low dose regions.
Author(s)
고혜진
Issued Date
2012
Awarded Date
2012. 8
Type
Dissertation
URI
http://dcoll.jejunu.ac.kr/jsp/common/DcLoOrgPer.jsp?sItemId=000000006027
Alternative Author(s)
Ko, Hye Jin
Affiliation
제주대학교
Department
산업대학원 에너지공학과
Advisor
박재우
Table Of Contents
List of Figures .iii
List of Tables v
Summaryvi
I. 서론 . 8

1. 연구의 필요성 8
2. 연구의 목적 10
II. 이론적 배경 . 11
1. 유방. 11
1) 유방의 위치 및 구조 . 11
2) 유방의 기능 . 11
2. 유방암 12
1) 유방암의 정의 . 12
2) 유방암의 종류 . 12
3) 관련통계 . 14
3. 유방암의 치료방법 . 14
1) 수술 14
2) 약물요법 . 16
(1) 항호르몬요법 . 17
(2) 항암화학요법 . 17
(3) 표적치료 17
3) 방사선치료 . 18
4. 방사선치료의 과정 . 19
1) 모의치료 . 19
2) 치료계획 . 19
3) 방사선치료 . 23
5. 유방암의 치료의 부작용 . 25
1) 수술로 인한 부작용 25
2) 항암화학요법의 부작용 25
3) 호르몬치료의 부작용 26
4) 방사선치료의 부작용 26
6. 치료 후 재발 및 전이 . 27
1) 유방절제술 후 국소 재발 27
2) 유방보존술 후 국소 재발 27
3) 전이성 재발 . 28
7. 유방암의 치료성적 . 28
III. 대상 및 방법 . 29

1. 연구 대상 29
2. 연구 방법 30
1) Stuctures contouring 30
2) Planning methods -Standard plan vs. IMRT plan . 30
(1) Standard planning method . 31
(2) IMRT Plan-Optimization 32
3) Plan comparison 33
4) Plan verification . 33
IV. 결과 및 고찰 . 36
1. Plan verifications . 37
2. Isodose curve in Standard plan vs. IMRT plan . 43
3. Comparison parameter . 43
4. Feasibility in clinically . 44
5. Evaluations 44
V. 결론 46
VI. 참고문헌 47
VII. 사사 . 51
Degree
Master
Publisher
제주대학교 산업대학원
Citation
고혜진. (2012). 유방암환자의 전유방절제술 후 표준치료기법과 세기조절 방사선치료기법에 관한 비교연구
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Graduate School of Industry > Nuclear and Energy Engineering
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