RESUMO
Intraoperative radiation therapy (IORT) is a treatment modality whereby a large single dose of radiation is delivered to a surgically open, exposed cancer site. Typically, a beam of megavoltage electrons is directed at an exposed tumor or tumor bed through a specially designed applicator system. In the last few years, IORT facilities have proliferated around the world. The IORT technique and the applicator systems used at these facilities vary greatly in sophistication and design philosophy. The IORT beam characteristics vary for different designs of applicator systems. It is necessary to document the existing techniques of IORT, to detail the dosimetry data required for accurate delivery of the prescribed dose, and to have a uniform method of dose specification for cooperative clinical trials. The specific charge to the task group includes the following: (a) identify the multidisciplinary IORT team, (b) outline special considerations that must be addressed by an IORT program, (c) review currently available IORT techniques, (d) describe dosimetric measurements necessary for accurate delivery of prescribed dose, (e) describe dosimetric measurements necessary in documenting doses to the surrounding normal tissues, (f) recommend quality assurance procedures for IORT, (g) review methods of treatment documentation and verification, and (h) recommend methods of dose specification and recording for cooperative clinical trials.
Assuntos
Elétrons/uso terapêutico , Neoplasias/radioterapia , Terapia Combinada , Hospitais Especializados , Humanos , Período Intraoperatório , Neoplasias/cirurgia , Aceleradores de Partículas , Equipe de Assistência ao Paciente , Qualidade da Assistência à Saúde , Dosagem Radioterapêutica , Radioterapia de Alta EnergiaRESUMO
Routine weekly calibration of a Siemens Mevatron 20 linear accelerator with 3-, 5-, 7-, 10-, 12-, 15-, and 18-MeV electron energies demonstrated fluctuations in dose/monitor unit for the electron beam on the order of 3%-6%. Evaluations and study of the problem demonstrated that the electron chamber, which is open to atmosphere, was undergoing significant temperature changes during the course of a treatment day. The inability of the chamber to compensate for these changes in temperature and pressure led to the addition of a compensating circuit by the manufacturer. The results of the addition of this circuit were evaluated for several extended periods throughout the year, and it was found that the changes in dose/monitor were reduced to approximately +/- 0.5%.