Basit öğe kaydını göster

dc.contributor.advisorCengiz, Mustafa
dc.contributor.authorDalgıç, Eylem
dc.date.accessioned2023-05-04T12:50:29Z
dc.date.issued2023
dc.date.submitted2023-04-10
dc.identifier.urihttps://hdl.handle.net/11655/33154
dc.description.abstractIn thoracic irradiations, the coronary arteries (CA) are involuntarily exposed to radiation and subsequent cardiovascular toxicities may occur. To avoid this, the importance of accurately creating the safety margins (SM) of CA and determining the doses they receive has been recognized in recent years. Therefore, in the first part of study; Using electrocardiography-gated intravenous contrast-enhanced computed tomography (CT), CA (left coronary artery; LCA, left anterior descending artery; LAD, circumflex artery; Cx, right coronary artery; RCA) were divided into sections over cardiac CTs obtained from patients without cancer, SM were obtained by measuring their diameter and displacement (d). In the second part of the study; Using calculated this SM, the new treatment plans (NTP) resulting from the inclusion of LAD contour in the optimization (Op) treatment plans of previously treated lung cancer (LC) and left breast cancer (LBC) patients, were compared with the standard treatment plans (STP). While the maximum d of LCA, LAD1 and RCA2 were in the radial, the maximum d of Cx2 and LAD2 were in the craniocaudal direction, no generalization could be made in other parts. SM (mm), sagittal, transversal and vertical axes; In breath-hold planning CTs, LAD1 (upper section) 10, 6, 4; LAD2 (middle section) 2, 2, 5; LAD3 (lower section) 4, 8, 6; In planning CTs with internal target volume or free breath; LAD1 9, 5, 4; LAD2 2, 1, 4; LAD3 is 3, 7, 5 were found. In NTP; While no significant difference can be observed in the doses received by the targets and other critical organs, LAD V15 Gy, heart mean dose in LC cases, LAD V15 Gy, heart V25 Gy, heart V10 Gy in LBC cases, decreased significantly. Hence, it was concluded that LAD should be included in the Op by giving SM.tr_TR
dc.description.abstractIn thoracic irradiations, the coronary arteries (CA) are involuntarily exposed to radiation and subsequent cardiovascular toxicities may occur. To avoid this, the importance of accurately creating the safety margins (SM) of CA and determining the doses they receive has been recognized in recent years. Therefore, in the first part of study; Using electrocardiography-gated intravenous contrast-enhanced computed tomography (CT), CA (left coronary artery; LCA, left anterior descending artery; LAD, circumflex artery; Cx, right coronary artery; RCA) were divided into sections over cardiac CTs obtained from patients without cancer, SM were obtained by measuring their diameter and displacement (d). In the second part of the study; Using calculated this SM, the new treatment plans (NTP) resulting from the inclusion of LAD contour in the optimization (Op) treatment plans of previously treated lung cancer (LC) and left breast cancer (LBC) patients, were compared with the standard treatment plans (STP). While the maximum d of LCA, LAD1 and RCA2 were in the radial, the maximum d of Cx2 and LAD2 were in the craniocaudal direction, no generalization could be made in other parts. SM (mm), sagittal, transversal and vertical axes; In breath-hold planning CTs, LAD1 (upper section) 10, 6, 4; LAD2 (middle section) 2, 2, 5; LAD3 (lower section) 4, 8, 6; In planning CTs with internal target volume or free breath; LAD1 9, 5, 4; LAD2 2, 1, 4; LAD3 is 3, 7, 5 were found. In NTP; While no significant difference can be observed in the doses received by the targets and other critical organs, LAD V15 Gy, heart mean dose in LC cases, LAD V15 Gy, heart V25 Gy, heart V10 Gy in LBC cases, decreased significantly. Hence, it was concluded that LAD should be included in the Op by giving SM.tr_TR
dc.language.isoturtr_TR
dc.publisherKanser Enstitüsütr_TR
dc.rightsinfo:eu-repo/semantics/openAccesstr_TR
dc.subjectinternal risk hacmitr_TR
dc.subjecttorasik radyoterapitr_TR
dc.subjectkoroner arter hareketitr_TR
dc.subjectrisk altındaki organlartr_TR
dc.subjectECG kapılı intravenöz kontrastlı CTtr_TR
dc.subject.lcshR/W - Tıptr_TR
dc.titleAkciğer Kanseri ve Sol Meme Radyoterapisinde Kardiyak Altyapı Marjlarının Oluşturulması ve Tedavi Planı Optimizasyonutr_TR
dc.typeinfo:eu-repo/semantics/masterThesistr_TR
dc.description.ozetTorasik ışınlamalarda koroner arterler (CA) istemsiz olarak radyasyona maruz kalır ve akabinde kardiyovasküler toksisiteler oluşabilir. Bunu önlemek için CA’nın güvenlik marjları (SM)’nı doğru bir şekilde oluşturmanın ve aldıkları dozları belirlemenin önemi son yıllarda anlaşılmıştır. Bu nedenle çalışmanın ilk kısmında; kanser olmayan hastalardan alınan elektrokardiyografi kapılı intravenöz kontrastlı bilgisayarlı tomografi (CT) çekilerek oluşturulan kardiyak CT’ler üzerinden, CA (sol koroner arter; LCA, sol anterior desendan arter; LAD, sirkumfleks arter; Cx, sağ koroner arter; RCA) bölümlere ayrılarak, çapları ve yer değiştirmeleri (d) ölçülmek suretiyle SM elde edilmiştir. Çalışmanın ikinci kısmında ise; hesaplanan bu SM kullanılarak önceden tedavileri yapılmış olan akciğer kanseri (LC) ve sol meme kanseri (LBC) hastalarının tedavi planlarına, LAD’ın konturu eklenerek optimizasyon (Op)’a dahil edilmesi sonucunda ortaya çıkan yeni tedavi planları (NTP), standart tedavi planları (STP) ile karşılaştırılmıştır. LCA, LAD1 ve RCA2’nın maksimum d radyal, Cx2 ve LAD2’nin maksimum d kranyokaudal yönde olurken, diğer kısımlarda bir genelleme yapılamamıştır. SM (mm), sagittal, transversal ve vertikal eksenlerde; nefes tutturularak oluşturulan planlama CT’lerde, LAD1 (üst bölüm) 10, 6, 4; LAD2 (orta bölüm) 2, 2, 5; LAD3 (alt bölüm) 4, 8, 6; internal hedef hacimli veya serbest nefeste oluşturulan planlama CT’lerde, LAD1 9, 5, 4; LAD2 2, 1, 4; LAD3 3, 7, 5 olarak bulunmuştur. NTP’de; hedeflerin ve diğer kritik organların aldıkları dozlarda anlamlı bir fark gözlenemezken, LC vakalarında; LAD V15 Gy, kalp ortalama doz, LBC vakalarında LAD V15 Gy, kalp V25 Gy, kalp V10 Gy anlamlı bir şekilde düşmüştür. Dolayısıyla, LAD’ın SM verilerek Op’a dahil edilmesi gerektiği sonucuna varılmıştır.tr_TR
dc.contributor.departmentRadyasyon Onkolojisitr_TR
dc.embargo.termsAcik erisimtr_TR
dc.embargo.lift2023-05-04T12:50:29Z
dc.fundingYoktr_TR
dc.subtypemedicineThesistr_TR


Bu öğenin dosyaları:

Bu öğe aşağıdaki koleksiyon(lar)da görünmektedir.

Basit öğe kaydını göster