Title Radioterapijske metode u liječenju raka pluća
Title (english) RADIOTHERAPY METHODS IN TREATMENT OF LUNG CANCER
Author Domagoj Babić
Mentor Tihana Boraska Jelavić (mentor)
Committee member Tihana Boraska Jelavić (član povjerenstva)
Committee member Tatjana Matijaš (predsjednik povjerenstva)
Committee member Sanja Lovrić Kojundžić (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2019-07-01, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Abstract Prema podatcima SZO-a rak pluća je danas najčešća maligna bolest na svijetu. Iako se za nju zna već dugo, svoj vrhunac doživljava upravo zadnjih desetljeća, proporcionalno rastu upotrebe najprije duhanskih proizvoda, potom azbesta, kroma i drugih kancerogenih tvari. Histološki gledano riječ je o širokoj skupini bolesti, koja ima mnogo podvrsta, te svaka od njih zahtjeva specifičan oblik terapije.
Jedna od najprovjerenijih metoda u liječenju raka pluća je radioterapija. Njene indikacije su predoperativna primjena (neoadjuvantna konkomitantna kemoradioterapija), postoperativna primjena kod selekcioniranih bolesnika, primarno liječenje sa ili bez pridružene kemoterapije, palijacija simptomatske bolesti te kod sitnostaničnog karcinoma profilaktička kranijalna iradijacija.
Planiranje radioterapije počinje snimanjem na određenom simulatoru (CT, MRI, PET-CT). Od inicijalne dvodimenzionalne simulacije na klasičnom RTG uređaju prešlo se na CT-om vođenu simulaciju koja je danas potpomognuta i dodatnom dimenzijom. Dimenzija vremena zajedno sa CT-om čini savršenu 4D tehniku koja minimizira utjecaj respiracijskog kretanja tumora i omogućuje lakše ocrtavanje istog. Nakon provedene simulacije bitno je napraviti dobar plan zračenja koji zahtjeva razgraničenje tumorskog tkiva od zdravog, a zatim usmjeriti radijacijske snopove pod pravim kutem i odgovarajućim intenzitetom kako bi što veća koncentracija zračenja završila na pravom mjestu.
Vrhunac čitavog procesa događa se na linearnom akceleratoru gdje se taj plan provodi u praksi. Veliki broj prepreka zahtijevao je i veliki broj načina na koji se doza isporučuje, tako da su stvorene različite metode koje zaobilaze artefakte i oštećenja zdravih tkiva. Uvođenjem IMRT tehnike doza biva u većoj mjeri isporučena tumoru, ali planiranje i terapija traju duže. Najveći zaokret u radioterapiji pluća bilo je uvođenje SBRT metode, koja svojim načinom primjene radioterapije i kombinacije sa 4D simulacijom najbolju kurativnu metodu liječenja bolesnika s ranim tumorima
Abstract (english) According to data from WHO, lung cancer is today the most common malignant disease in the world. Although it has been known for a long time, its peak has been experiencing just for last couple of decades, proportionally increasing the use of tobacco products, then asbestos, chromium and other carcinogenic substances. Histologically speaking, it is a wide group of diseases that have many subtypes and each of them requires a specific form of therapy.
One of the most common methods for treating lung cancer is radiotherapy. Its indications are preoperative use (neoadjuvant concomitant chemoradiotherapy), postoperative use for selected patients, primary treatment with or without associated chemotherapy, palliation of symptomatic disease, and for NSCLC prophylactic cranial irradiation.
Radiotherapy planning process starts with the scaned CT images on a particular simulator (CT, MRI, PET-CT). From the initial two-dimensional simulation on a classic RTG device, it has been transformed to three-dimensional CT simulation that is now backed by another additional dimension. The time dimension along with the CT makes perfect 4D technique that minimizes the effect of the respiratory motion of the tumor and makes it easier to delineate the tissue. After the simulation is done, it is important to make a good radiation plan that requires demarcation of the tumor from the healthy tissue, then direct the radiation beams at the right angle and the adequate intensity to get the highest concentration of radiation in the right place.
The culmination of the whole process takes place on a linear accelerator where this plan is implemented in practice. A large number of obstacles also required a large number of ways to deliver the dosage, thus creating a variety of methods that overlook the artifacts and damage to healthy tissues. By introducing the IMRT technique, the dosage is delivered in greater amount to the tumor, but planning and therapy last longer. The biggest turnaround in radiotherapy of lung cancer was the introduction of SBRT method, which by its mode of radiotherapy and combination with 4D simulation represents the best curative method of treating patients with early stage tumors.
Keywords
radioterapijske metode
rak pluća
pacijent (ključne riječi unio urednik)
Keywords (english)
radiotherapy methods
lung cancer
patient (ključne riječi unio urednik)
Language croatian
URN:NBN urn:nbn:hr:176:282416
Study programme Title: Radiologic Technology (university/undergraduate) Study programme type: university Study level: undergraduate Academic / professional title: sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) radiološke tehnologije (sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) radiološke tehnologije)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-06-19 13:03:21