Radiotherapy has commonly been utilised to cure cancer for more than a century. It is counted among the fundamental branches of medicine and represents an effective local or locally-regional method of curing both cancer and some non-cancerous conditions. It utilises ionising radiation which unfortunately eliminates tumour cells along with healthy ones. This is why a wide range of harmful effects of the radiation can be observed on humans. Patients treated with radiotherapy are in some cases monitored with dosimeters so that the intended dose can be compared with what is really absorbed. Nemocnice České Budějovice, a. s. monitors the dose in expected locations of non-homogeneous irradiation using the aforementioned TL dosimeters during the process of rotary irradiation of Mycosis fungoides. Before actually being used in an in vivo dosimetry, these dosimeters must be properly calibrated and have their sensitivity adjusted. Other than that, they are fairly easy to use, do not require much time or money invested and are able to constantly monitor the dose received by a patient treated with rotary irradiation. This diploma thesis discusses the usage of TL dosimeters to measure non-homogeneity of irradiation. It therefore compares the doses received by patients in various parts of the body during irradiation by the TSEI method. These 22 irradiated patients had thorough measurements taken of the doses they received in the so-called black hole region, their axillae and neck while holding their arms up and with arms loosely positioned close to the body. The thesis also suggests the possibility of the dosimeters being used by the integrated emergency service to assist during rescues and demolitions performed in emergency situations when a leak of ionising radiation occurs. Using TL dosimeters would mean more precise measurements of the dose received by the involved personnel in various parts of their body. If a patient is treated with the TSEI method, the dose received is monitored in a reference point, critical areas and areas with residual infiltrations or tumours. Doses measured in critical areas indicate that should the acral parts of limbs be left uncovered, they absorb larger doses than the rest of the body. They thus exceed the intended dose significantly. In the case of fingers, the dose tends to reach as much as 3 Gy. Depending on clinical picture, the attending physician determines whether special covering should be used. This covering reduces the doses received to merely a few tenths of a Gy. There also tends to be a large difference in absorbed doses in axillar areas and the neck, depending on whether the patient's arms are held up or close to the body respectively. Test results indicate that holding arms up or keeping them close to the body on a particular side have always had a profound effect on the dose absorbed by the patient in this particular area. This means that the position of the body greatly influences how much is absorbed in various parts of the body. TL dosimeters are also used in other areas than in vivo dosimetry in radiotherapy. An example of this could be determining the dose received in upper limbs of the workers monitored with thermoluminescent dosimeters in the form of bracelets or rings. They also serve to monitor the external irradiation of persons within the limits of the Czech Republic (TLD network). In radiation therapy, both the doses in skin and body are taken into account when conducting measurements. Depending on the data extracted, it is then possible to assess the course of treatment and ensure safe implementation of ionising radiation. Integrated emergency service teams deployed in cases of radiation emergencies are not considering using TL dosimeters so far, although they could most likely be used to ascertain the exact doses absorbed. Further research would however need to be conducted to either confirm or disprove the benefits of using TLD.
| Identifer | oai:union.ndltd.org:nusl.cz/oai:invenio.nusl.cz:188852 |
| Date | January 2015 |
| Creators | CANDROVÁ, Daniela |
| Source Sets | Czech ETDs |
| Language | Czech |
| Detected Language | English |
| Type | info:eu-repo/semantics/masterThesis |
| Rights | info:eu-repo/semantics/restrictedAccess |
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