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Tesi etd-11172020-132848


Tipo di tesi
Tesi di specializzazione (3 anni)
Autore
GILIO, MARIA ANTONIETTA
URN
etd-11172020-132848
Titolo
Dosimetric evaluation of head and neck radiotherapy treatments
Dipartimento
FISICA
Corso di studi
FISICA MEDICA
Relatori
relatore Dott.ssa Quattrocchi, Mariagrazia
correlatore Dott.ssa Giuliano, Alessia
Parole chiave
  • GafChromic
  • Head and Neck
  • In Vivo Dosimetry
  • OAR
  • phantom
  • TLD
  • TomoTherapy
  • VMAT
Data inizio appello
16/12/2020
Consultabilità
Completa
Riassunto
Head and neck cancers could interest every part of otolaryngoiatric districts, which have a very complex anatomy with many healthy organs at risk. A radiotherapy treatment does not only improve survival outcomes but also preserve organ functions. Among all the possible dynamic IMRT techniques, Helical TomoTherapy and Volumetric Modulated Arc Therapy are the most diffuse. A good IMRT treatment plan has to meet simultaneously several needs: the isodose lines for high-dose have to be tailored to the planning treatment volume, where the dose distribution has to be homogeneous while has to be constrained in other sensitive regions. Therefore the accelerators must work in more stressful operating conditions: this implies potential mechanical errors and dose errors during the delivery. To minimize these errors, IMRT delivery quality assurance measurements for each patient are essential and are usually performed using phantoms in water-equivalent materials and with very simple geometric shapes. To take into account the anatomy and the radiation attenuation properties of different human body components, an anthropomorphic phantom has to be used. Moreover, since the outcome of a radiation treatment depends greatly also on the level of collaboration of the patient, in vivo dosimetry turns out to be essential to record the dose actually received by the patient in a single fraction or overall the treatment procedure. In vivo dosimetry has been carried out in patients with cardiovascular implantable electronic devices that have to be treated when the CIED was inside or very close to the target volume. All these aspects concerning a head and neck cancer radiotherapy treatment have been addressed in this thesis.
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