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Treatment of Bronchogenic Carcinoma
RAČÁKOVÁ, Jana
My bachelor thesis deals with the issue of lung cancer and its treatment with radiotherapy. I have chose this topic to get a better overview of methods and how the disease is treated by radiotherapy. At the very beginning there is a short characteristic of lung cancer. Lung carcinoma is one of the most common causes of death from malignant tumor. By this disease are usually affected men between 40-70 years but even women are no exception. The patient is endangered by both, intensive growth of the tumor and metastasis to surrounding organs. Main cause is smoking thus heavy smokers have much greater likelihood to be affected by the tumor. The first part of the work is practical. There is described and discussed the issue of lung cancer and its treatment options. I also describe the possibility of lung cancer diagnosing and overview of TNM classification (T is the size of the tumor, N is the involvement of regional lymph nodes and M is called distant metastases). Then, only marginally, I mention surgical and chemotherapy treatment. More attention is given to treatment by radiotherapy and fractionation regimens and potential side effects. The very first objective of the thesis was presentation of irradiation techniques of lung cancer from history into the present. Those techniques were mentioned at the beginning of the practical part, to illustrate how the techniques are being developed so as to allow much better quality of healthcare to a patient and to make the work of a radiologist assistant easier. I also presented the algorithm of lung cancer treatment at oncology department of Nemocnice České Budějovice, a.s. where I describe the treatment of a patient gradually form the diagnosis until the first irradiation. The second, and the main, objective of my thesis was to create a series of patients treated at the oncology department of Nemocnice České Budějovice, a.s. and to compare the setting of irradiation position using the verification software. The file of 67 patients with the lung cancer diagnosis was made at oncology dept. of Nemocnice České Budějovice, a.s. in the period of March 2012 to March 2013. According to my hypothesis the verification system is an essential part of radiation treatment. My results also confirm the fact. By creating verification images it is possible in most cases to prevent potential mistakes (exceeding the maximum tolerated deviations) when adjusting the irradiation position of a patient. By making a control image of a patient per week it is possible, for a radiologist assistant, to balance the any excess deviation and then the patient is not necessarily irradiated with the surrounding , healthy, organs. Unfortunately the verification system does not allow 100% accuracy (derivations in all directions and angles are always in tolerance, but we are very close to this goal. In order to achieve higher quality in treating patients with this method there are two option. The first on is to use IGRT-image (Guided Radiation Therapy) which is an image guided radiotherapy, that allows more precise control of the patient before each fraction and also improves the orientation of the target volume and critical organs before each fraction, or during it. It means improving of the verification system but because of high cost it is not used in Nemocnice České Budějovice, a.s. The second option how to improve the healthcare service is using the technique of breath gating radiotherapy, which is a technique that allows to irradiate the patient only in a certain phase of a breath cycle. This technique means to apply substantially higher dose to the target volume with greater accuracy.
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Role of the treatment verification system and verification generally in modern radiotherapy
TÁBORSKÁ, Hana
Radiotherapy is a complex process which involves the verification system, often underestimated by the user. The verification system can be used not only for the planning process of the patient{\crq}s exposure, but also for its setting and even for the setting of the irradiation device itself. Additionally, the verification system can set correctly the dose applied. The consistent verification both from the side of the radiological assistant and from the side of the software used is very important with respect to the patient safety, especially at present day, when new irradiation technologies are introduced and high curative doses are applied. Even a small mistake can cause fatal consequences. For this reason the verification system particularly operates independently without external interventions. It is the database based on the client/server information technology. In my bachelor thesis I should describe the classification, significance and necessity of the usage of the verification system and the verification procedures in the modern radiotherapy. The part of my bachelor thesis is also the statistical processing of offsets in the patient{\crq}s positions using the portal imaging and the accuracy of the dose applied using in-vivo dosimetry.
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