Physical and Histopathological Assessment of the Effects of Metallic Stents on Radiation Therapy

DOI NDLデジタルコレクション PDF Web Site 参考文献31件
  • TSUJI Yoshihiko
    Departments of Radiation Oncology, Nara Medical University School of Medicine
  • YOSHIMURA Hitoshi
    Departments of Radiation Oncology, Nara Medical University School of Medicine
  • UTO Fumiaki
    Departments of Radiation Oncology, Nara Medical University School of Medicine
  • TAMADA Toshiaki
    Departments of Radiation Oncology, Nara Medical University School of Medicine
  • IWATA Kazuro
    Departments of Radiation Oncology, Nara Medical University School of Medicine
  • TAMAMOTO Tetsuro
    Departments of Radiation Oncology, Nara Medical University School of Medicine
  • ASAKAWA Isao
    Departments of Radiation Oncology, Nara Medical University School of Medicine
  • SHINKAI Takayuki
    Departments of Radiation Oncology, Nara Medical University School of Medicine
  • KICHIKAWA Kimihiko
    Departments of Radiology, Nara Medical University School of Medicine
  • HASEGAWA Masatoshi
    Departments of Radiation Oncology, Nara Medical University School of Medicine

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To evaluate whether simultaneous metallic stent (MS) placement and radiotherapy are feasible, phantom and animal experiments were performed. The interface dose by external irradiation (EI) or intracavity irradiation (II) to 5 kinds of MS was measured using the charge-coupled device (CCD) camera with a thermoluminescent (TL) sheet, and backscatter and absorption were evaluated using composite method. Lineac 10 MV X-ray irradiated the MS in close contact with the TL sheet. II was performed using 192Ir, and the irradiation dose transmitted through the MS was measured using the TL sheet. The ratio of the CCD value of the MS wire region to that of the MS non-wire region was defined as the dose perturbation factor (DPF). Furthermore, the effects of a combination of 60Co gamma-ray EI and MS placement in the normal common bile duct were histopathologically evaluated in dogs. In the phantom experiments of EI, in backscatter by the MS, the DPF was 1.09 for CZ, and 1.03 for Pal, but no backscatter was detected in the remaining 3 MS. In absorption by the MS, the DPF was 0.92, 0.97, 0.97, and 0.98 for CZ, Wall, Pal, and Vel, respectively, but no absorption was detected in U. Flex. In those of II, the DPF of absorption was 0.91, 0.98, and 0.98 for CZ, U. Flex, and Wall, respectively, but no absorption was detected in Pal and Vel. The animal experiments showed infiltration of inflammatory cells and fibrosis in the case of both MS placement and EI. These changes were marked in EI treating after MS placement, but neither severe ulcer nor perforation was found. In conclusion, these results suggested that the effect of MS should be considered carefully when simultaneous MS placement and EI is performed clinically.<br>

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