全身皮肤电子束照射急性毒性反应及剂量监测

Acute Toxicities during total skin electron beam bradiation and dose monitoring using TLD

目的分析全身皮肤电子线照射的急性毒性反应，探讨热释光剂量监测的临床意义。材料与方法自１９９５年底利用Ｖａｒｉａｎ－２１００ＣＨＤＴＳｅ－６ＭｅＶ电子束治疗模式治疗４例病人，分别用６ｍｍ和１０ｍｍ有机玻璃散射屏降低电子线能量，提高皮肤表面剂量。用热释光剂量计进行５人次１８个解剖部位的剂量监测，治疗周剂量５００～６００ｃＧｙ，总量３０００ｃＧｙ。结果全身皮肤电子线照射对各期皮肤Ｔ－细胞淋巴瘤均有良好控制效果；急性毒性反应限于皮肤及附属器，病人均能耐受；热释光监测结果与急性毒性反应相符。结论热释光剂量监测对疗中手指、足背屏蔽防护及治疗后头顶、腋下、会阴、足底补量照射有指导意义。对肥胖病人应行大腿内侧补量。

Porpose To analyze acute toxicities during total skin electron beam therapyand evaluate the clinical significance of monitoring measurement dose using TLD . Materials aad Methods Since 1995 , 4 patients were treated with total skin electron beam therapy using Varian - 2100c linear accelerator HDTSE - 6MeV electron beam . A plastic scatter screen, 6mm and 10mm thickness, wsa used to reduce the primary electron energy and increase the skin dose . The dose were measured using TLD on 18 anatomic sites for 5 times . The radiation dose wu 500～ 600cGy per week, and total dose was 3000cGy.Results The CR was found in allpatients with TSEI. The acute toxicities appeared to be limited to the skin and its appendages. All the patients were welltolerated. The results of TLD measurements were accorded with the reaction of acute toxicities . Conclusion The results of the TLDs will give us the information to determine if the delivered dose is within acceptable range. and also have the guiding role to protect some sites during the treatment and to boost dose to some sites after TSEI .