Mide Kanserli Hastalarda Radyoterapi Sırasında Dalak Dozimetrisi ve Doz/Hacim Oranı

Yıl 2022, Cilt: 8 Sayı: 3, 68 - 79, 31.12.2022

Nülifer Kılıç Durankuş , Mert Saynak , Necdet Süt , Mustafa Doğan Mustafa Cem Uzal Zafer Koçak

Öz

Amaç: Dalak, doğuştan ve edinsel bağışıklık sistemi açısından önemli bir role sahiptir. Dalak, genellikle konturları olmayan ve abdominal radyoterapi vakalarında ihmal edilebilme ihtimali olan bir organdır. Bu nedenle dalak dozimetrisi nadiren çalışılmıştır. Bu çalışmada mide kanserli hastalarda dalak radyasyon dozunu ve dalak hacmi kaybı ile ilişkisini araştırmayı amaçladık.
Yöntemler: Veriler, kanserin evreleri, tedavi planı, dalak şekillendirme ve dozimetri, 3 boyutlu bilgisayarlı tomografi (3D CT) gibi klinik ve demografik faktörlerden oluşmaktadır. Tedavi öncesi ve tedavi sonrası fazdaki dalak hacimleri karşılaştırılmıştır.
Bulgular: Medyan V20 değeri 65.5 (0.0-100.0) idi. Radyoterapi öncesi ve sonrası medyan dalak hacimleri sırasıyla 185.1 (71.4-488.0)cm3 ve 138.2 (59.0-429.0) cm3 olarak ölçüldü. Bu hacim kaybının istatistiksel olarak anlamlı olduğu bulundu (p = 0,001).
Sonuç: Üst karın malignitesi, özellikle mide kanseri olan hastaları, hipospleniye bağlı olabilecek enfeksiyonlardan korumak için RT sırasında dikkatli bir şekilde taranmalıdır. Ayrıca, üst abdominal malignitesi olan hastalarda RT'nin dalak hacmi ve dalak fonksiyonu üzerindeki etkilerini netleştirmek için ileriye dönük ve daha geniş örneklemli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Abdominal Radyoterapi, Kanser, Mide, Dalak

Kaynakça

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