北京市放射治疗设备应用现状和质量控制情况分析

The analysis of application status of radiation therapy devices and quality control condition in Beijing

目的了解北京市放射治疗设备应用和机房防护状况,分析放射治疗设备应用中存在的问题和质量控制开展情况。方法结合放射治疗设备的放射卫生防护性能检测工作,对目前全市使用中的放射治疗设备的类型、设备状态、机房防护状况及配置的质量控制设备等相关资料进行调查统计。结果北京市现有25家医院(不含部队医院)开展放射治疗工作,共有放射治疗设备49台,其中医用电子直线加速器35台,60Co远距离治疗机5台,后装γ源近距离治疗机5台,术中放射治疗机2台,γ刀1台,X射线治疗机1台,每台设备均设有独立机房,机房防护水平均能达到国家标准的要求,25家医院均配置了模拟定位机和绝对剂量测量的剂量仪与物理师人员。结论北京市放射治疗设备虽然数量较多,但各医院间放射治疗设备配备的数量和档次相差较大,部分医院设备老化,使用年限较长,故障率高,不能满足现代精确放射治疗发展的需要;49台设备机房的防护状况均能达到国家标准的要求,放射工作人员的年个人剂量当量低于全市医疗放射工作人员的平均水平;25家医院的物理师数量、物理师水平和配备的质量控制设备也有相当大的差距,大部分医院仅能做最基本的绝对剂量测量,并有部分医院放射治疗设备绝对剂量偏差过大,在放射治疗的技术比以往大大提高的今天,必须有一个完整的质量控制措施和程序,并配备相应的质量控制设备以保证放射治疗的精确执行。

Objective To explore the application status of radiation therapy devices and machine-room protection condition in Beijing, and to analyze the issues existing in those applications and the current conditions of quality control （ Qc）. Methods During the detection of radiation health prevention capacity in radiation therapy devices, all information including their types and status, machine-room protection conditions and their QC equipments were also collected and analysed. Results There were 25 hospitals in Beijing （ not including military hospitals） conducting radiation therapy which had 49 radiation therapy machines. Among them, there were 35 medical electron lineal accelerators, 5 6~Co tele-therapy machines, 5 after-loading ＂,/therapy machines, 2 intra-operative radiation therapy machines, l~/knife and 1 X-ray therapy machine. Each machine placed in a separate room and its protection condition met the requirement of national standard. All hospitals had simulators, dosimeters and physicists. Conclusion [n spite of the fact that there were total 49 machines in 25 hospitals, the number and grade of the machines between hospitals were much different. Some machines with high failure rate were too old to meet the demands of modern accurate radiation therapy. Although all the machine-rooms reached national protection standard, the annual personal dose equivalent of the radiation staff was in a lower level. The number and skills of the physicists, as well as outfitted quality control equipments among these 25 hospitals were very disparate. What most of the hospitals can do was only basic absolute dose measurement, sometimes the measurements had big deviation. Since the modern radiation therapy technique is improved rapidly, we must establish a whole quality control measures and procedures, together with correspondent quality control equipment, in order to guarantee precise performance of radiation therapy.