InfluÃncia do posicionamento da paciente na modificaÃÃo da dose em ÃrgÃos crÃticos na braquiterapia de alta taxa de dose em cÃncer de colo uterino

AUTOR(ES)

Jonathan Azevedo Melo

DATA DE PUBLICAÇÃO

2008

RESUMO

High dose rate brachytherapy is a medical procedure which uses radioisotopes with dose rate over 0.2 Gy/min. This kind of treatment is commonly used on uterine cancer in more advanced stages of the disease. The brachytherapy of high dose have substituted the low dose rate modality because it is a treatment performed at clinic and without the need for anaesthesia. The main limiting factor of brachytherapy for cervix cancer treatment is its potential risks of actinic sequels for adjacent normal organs, such as bladder, rectum, and sigmoid colon. It is well known that a change in patient positioning on exam table leads to modifications on positions of internal organs. The major distance among these organs from the irradiated region can lead to obtainment of a minor dose and, consequently, a less possibility of health consequences to the patients. Nowadays, there is not scientific literature about a recommendation of patient positioning on decubitus to treatment of these patients. In this context, the aim of this research was to identify the influence of these positioning by comparison of doses in bladder, rectum and sigmoid of patients in dorsal decubitus with the legs in lithotomy (elevated) and with the legs extended, as well as to identify the positioning that make possible the minor dose on these organs and to establish a systematic protocol for use in radiotherapy services. The results presented here show a significant reduction of dose in the bladder of such patients with the extended legs position, despite the increase of dose for the sigmoid region, what can be reduced by the time of radioactive source stop. The dose to the rectum was not influenced by the position of patientâs treatment. Thus, propose treat patients with the legs extended.

ASSUNTO(S)

cervix cancer planejamento dosimÃtrico posicionamento da paciente hdr tecnologias energÃticas e nucleares (proten) dosimetric planning hdr tecnologias energÃticas e nucleares (proten) ÃrgÃos crÃticos braquiterapia patient positioning engenharia nuclear cÃncer de colo uterino brachytherapy critical organs

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