浅层X射线治疗患者靶外组织受照剂量测量的实验研究

职业与健康 ›› 2025, Vol. 41 ›› Issue (22): 3068-3073.

浅层X射线治疗患者靶外组织受照剂量测量的实验研究

于润秋¹, 姜雯雯^1,2, 马永忠^1,2, 冯泽臣¹, 白斌¹

1.北京市疾病预防控制中心,北京 100013;
2.首都医科大学,北京 100069

收稿日期:2025-07-07 修回日期:2025-09-04 发布日期:2025-12-15
通信作者: 马永忠,主任医师,E-mail：myz0905@126.com
作者简介:于润秋,女,技师,主要从事辐射剂量监测与放射防护工作。
基金资助:
首都卫生发展科研专项项目（首发2024-2G-30119）; 北京市高层次公共卫生技术人才建设项目（学科带头人-01-20）

Experimental study on the measurement of radiation dose to non-target tissues of patients in superficial x-ray therapy

YU Runqiu¹, JIANG Wenwen^1,2, MA Yongzhong^1,2, FENG Zechen¹, BAI Bin¹

1. Beijing Center for Disease Control and Prevention,Beijing 100013,China;
2. Capital Medical University,Beijing 100069,China

Received:2025-07-07 Revised:2025-09-04 Published:2025-12-15
Contact: MA Yongzhong,Chief physician,E-mail：myz0905@126.com

摘要/Abstract

摘要： 目的对浅层X射线治疗（superficial X-ray therapy,SFXT）靶外组织的受照剂量进行实验测量,掌握典型照射条件下患者病灶靶外组织器官的受照剂量,为患者靶外组织器官辐射危害风险的评估和靶外放射防护提供实验依据和指导。方法以一台SRT-100型浅层X射线治疗系统为辐射源,结合ATOM 702型仿真人体模型测量体表关注部位的受照剂量。事先在仿真人体模型眼晶状体、甲状腺、乳腺、胸腹部和性腺部位体表设置15个测量点,每个点布放热释光探测器（thermoluminescent detector,TLD）,现场使用直径Φ=10 cm的限束器在100 kV、8 mA治疗照射条件下模拟胸部病灶治疗状态累积照射32 Gy,使用TLD Cube型热释光剂量仪测读,对仿真模体躯干体表左右两侧靶外受照剂量采用曼惠特尼检验,以P<0.05为差异有统计学意义。结果模体表面无屏蔽防护条件下,左右两侧甲状腺受照剂量分别为404.26和527.74 mGy,左右两侧乳腺受照剂量分别为512.62 和446.74 mGy,胸部乳沟体表受照剂量为494.71 mGy。左右两侧眼晶状体受照剂量分别为22.09和27.44 mGy,左右两侧性腺部位受照剂量分别为1.86和1.45 mGy。以照射野的中线为对称轴,躯干体表左右两侧各27个位点受照剂量范围分别为0.31~512.62 mGy和0.32~527.74 mGy,平均值分别为161.86和120.01 mGy。模体表面在0.35 mm Pb屏蔽条件下,相应部位受照剂量降低90%以上。结论浅层X射线治疗过程中体表靶外组织受照剂量和其与照射野中心的距离及靶外屏蔽防护状况密切相关,应规范浅层X射线治疗与靶外防护操作流程,最大限度降低患者靶外组织的受照风险。

关键词: 浅层X射线治疗, 靶外组织, 受照剂量, 放射防护

Abstract: Objective To experimentally measure the radiation dose of non-target tissues of patients in superficial X-ray therapy(SFXT),and to understand the dose received by tissues outside the target and organs under typical SFXT conditions,so as to provide experimental basis and guidance for evaluation of radiation hazard risk and protection of non-target tissues of patients. Method A SRT-100 superficial X-ray therapy system was used as the radiation source,and the surface doses corresponding to interested points of an ATOM 702 anthropomorphic phantom were measured.Fifteen measurement points were set on the surface of the phantom at locations corresponding to the eye lens,thyroid,breast,chest,abdomen and gonads,and each point was equipped with a thermoluminescent detector(TLD).A field size of Φ=10 cm was determined to simulate chest treatment conditions at 100 kV and 8 mA,with a cumulative dose of 32 Gy.The TLD Cube thermoluminescent dosimeter reader was used to measure the doses.The Mann-Whitney U test was used to determine the non-target radiation dose on the left and right sides of the simulated torso body surface,with P<0.05 considered statistically significant. Results Under unshielded conditions,the doses received by the left and right thyroid were 404.26 and 527.74 mGy,respectively.The doses received by the left and right breast were 512.62 and 446.74 mGy,respectively. The dose at the chest midline was 494.71 mGy. The doses received by the left and right eye lens were 22.09 and 27.44 mGy,respectively,and the doses received by the left and right gonads were 1.86 and 1.45 mGy,respectively.With the central axis of the irradiation field as the symmetry axis,the dose ranges at 27 points on the left and right sides of the torso surface were 0.31-512.62 mGy and 0.32-527.74 mGy,with average doses of 161.86 and 120.01 mGy,respectively.When the phantom surface was shielded with 0.35 mm Pb,the doses at the corresponding locations were reduced by over 90%. Conclusion The dose received by non-target tissues during superficial X-ray therapy is closely related to the distance from the irradiation field and the shielding conditions.It is essential to standardize the operational procedures for superficial X-ray therapy and non-target tissue protection to minimize the radiation risk to non-target organs of patients.

Key words: Superficial X-ray therapy, Non-target tissue, Radiation dose, Radiation protection

中图分类号:

R144

于润秋, 姜雯雯, 马永忠, 冯泽臣, 白斌. 浅层X射线治疗患者靶外组织受照剂量测量的实验研究. [J]职业与健康, 2025, 41(22): 3068-3073.

YU Runqiu, JIANG Wenwen, MA Yongzhong, FENG Zechen, BAI Bin. Experimental study on the measurement of radiation dose to non-target tissues of patients in superficial x-ray therapy. [J]OCCUPATION AND HEALTH, 2025, 41(22): 3068-3073.

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