{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T10:50:49Z","timestamp":1656327049539},"reference-count":44,"publisher":"Akademiai Kiado Zrt.","issue":"18","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,5,1]]},"abstract":"<jats:p>\n          <jats:italic>Bevezet\u00e9s:<\/jats:italic>\n Az egyedileg megtervezett sug\u00e1rter\u00e1pia a lok\u00e1lis kontroll \u00e9s a t\u00fal\u00e9l\u00e9s jav\u00edt\u00e1sa r\u00e9v\u00e9n alapvet\u0151 r\u00e9sze az eml\u0151r\u00e1k kurat\u00edv kezel\u00e9s\u00e9nek. A besug\u00e1rzand\u00f3 t\u00e9rfogat alakj\u00e1t k\u00f6vet\u0151 konform\u00e1lis besug\u00e1rz\u00e1s, \u00e9s a v\u00e9dend\u0151 szervek sug\u00e1rterhel\u00e9s\u00e9nek kontroll\u00e1l\u00e1s\u00e1t is lehet\u0151v\u00e9 tev\u0151 h\u00e1romdimenzi\u00f3s besug\u00e1rz\u00e1stervez\u00e9s n\u00f6velik a besug\u00e1rz\u00e1s biztons\u00e1g\u00e1t. \n <jats:italic>Beteganyag \u00e9s m\u00f3dszer:<\/jats:italic>\n A dolgozat a klinik\u00e1n 2002 \u00f3ta k\u00f6vetett m\u00f3dszereket ismerteti. Az eml\u0151\/mellkasfal, illetve a nyirokr\u00e9gi\u00f3k besug\u00e1rz\u00e1s\u00e1nak indik\u00e1ci\u00f3ja a lokoregion\u00e1lis relapsus legal\u00e1bb 10%-os kock\u00e1zata volt. CT-alap\u00fa h\u00e1romdimenzi\u00f3s besug\u00e1rz\u00e1s tervez\u00e9se \u00e9s egy\u00e9ni pozicion\u00e1l\u00e1s t\u00f6rt\u00e9nt, a vizsg\u00e1lat m\u00e1sodik szakasz\u00e1ban termoplasztikus maszk-r\u00f6gz\u00edt\u00e9ssel. A v\u00e9dend\u0151 szervek d\u00f3zisterhel\u00e9s\u00e9t az irodalmi adatok alapj\u00e1n \u00f6ssze\u00e1ll\u00edtott fels\u0151 hat\u00e1r\u00e9rt\u00e9kek korl\u00e1tozt\u00e1k. A betegek els\u0151 csoportj\u00e1ban individu\u00e1lisan tervezett blokkokat, a m\u00e1sodik csoportban \u201emultileaf\u201d kollim\u00e1tort (MLC), a harmadik csoportban pedig intenzit\u00e1smodul\u00e1lt sug\u00e1rnyal\u00e1bokat alkalmazva v\u00e9gezt\u00fck a besug\u00e1rz\u00e1st. \n <jats:italic>Eredm\u00e9nyek:<\/jats:italic>\n \u00d6sszesen 737 eml\u0151r\u00e1kos beteg r\u00e9szes\u00fclt individu\u00e1lis rizik\u00f3 alapj\u00e1n megtervezett konform\u00e1lis besug\u00e1rz\u00e1sban. H\u00e1romsz\u00e1zhetvenk\u00e9t esetben csak lok\u00e1lis, 365 esetben lokoregion\u00e1lis besug\u00e1rz\u00e1s t\u00f6rt\u00e9nt. A besug\u00e1rzott t\u00e9rfogatok d\u00f3ziseloszl\u00e1s\u00e1t a vizsg\u00e1lat m\u00e1sodik peri\u00f3dus\u00e1ban adott m\u0171szaki lehet\u0151s\u00e9gekkel jelent\u0151sen jav\u00edtani lehetett: a d\u00f3zis \u00b110%-kal ell\u00e1tott eml\u0151-\/mellkasfal-, axillaris-supraclavicularis, illetve mammaria interna t\u00e9rfogatok ar\u00e1nya az alkalmazott besug\u00e1rz\u00e1si technik\u00e1t\u00f3l f\u00fcgg\u0151en rendre 90,5\u201394,2%; 84,1\u201393,8% \u00e9s 86,7\u201391,6% k\u00f6z\u00f6tt mozgott. Az azonos oldali t\u00fcd\u0151 \u00e9s a sz\u00edv sug\u00e1rterhel\u00e9s\u00e9t reprezent\u00e1l\u00f3 d\u00f3zis-volumen param\u00e9terek szignifik\u00e1nsan magasabbak voltak lokoregion\u00e1lis besug\u00e1rz\u00e1s, mint csak lok\u00e1lis besug\u00e1rz\u00e1s eset\u00e9n. A vizsg\u00e1lat m\u00e1sodik peri\u00f3dus\u00e1ban lokoregion\u00e1lis besug\u00e1rz\u00e1s eset\u00e9n a t\u00fcd\u0151- \u00e9s sz\u00edvterhel\u00e9s a kor\u00e1bbin\u00e1l szignifik\u00e1nsan alacsonyabb volt, m\u00edg lok\u00e1lis besug\u00e1rz\u00e1sn\u00e1l ilyen hat\u00e1s nem jelentkezett. A maszkr\u00f6gz\u00edt\u00e9s bevezet\u00e9s\u00e9vel a be\u00e1ll\u00edt\u00e1si pontatlans\u00e1gb\u00f3l \u00e9s a l\u00e9gz\u00e9si mozg\u00e1sb\u00f3l ered\u0151 bizonytalans\u00e1g redukci\u00f3ja mellett az ellenoldali eml\u0151 sug\u00e1rterhel\u00e9s\u00e9t is cs\u00f6kkenteni lehetett. \n <jats:italic>K\u00f6vetkeztet\u00e9sek:<\/jats:italic>\n A posztoperat\u00edv besug\u00e1rz\u00e1st gondos kock\u00e1zat- \u00e9s haszonelemz\u00e9s ut\u00e1n kell megtervezni. A h\u00e1romdimenzi\u00f3s besug\u00e1rz\u00e1s-tervez\u00e9sen alapul\u00f3 konform\u00e1lis sug\u00e1rter\u00e1pia d\u00f3zis-volumen adatainak elemz\u00e9se sor\u00e1n egy\u00e9nileg sz\u00fcks\u00e9ges d\u00f6nteni az el\u0151ny\u00f6sebb megold\u00e1s \u00e9rdek\u00e9ben bevezetend\u0151 k\u00fcl\u00f6nleges technik\u00e1k alkalmaz\u00e1s\u00e1r\u00f3l.<\/jats:p>","DOI":"10.1556\/oh.2007.27877","type":"journal-article","created":{"date-parts":[[2007,4,30]],"date-time":"2007-04-30T19:29:19Z","timestamp":1177961359000},"page":"833-841","source":"Crossref","is-referenced-by-count":2,"title":["Approaches to individual radiotherapy in breast cancer: individual risk estimation and individualized techniques"],"prefix":"10.1556","volume":"148","author":[{"given":"Zsuzsanna","family":"Kah\u00e1n","sequence":"first","affiliation":[{"name":"1 Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvos- \u00e9s Gy\u00f3gyszer\u00e9sztudom\u00e1nyi Centrum, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Onkoter\u00e1pi\u00e1s Klinika Szeged Kor\u00e1nyi fasor 12. 6720"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Varga","sequence":"additional","affiliation":[{"name":"1 Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvos- \u00e9s Gy\u00f3gyszer\u00e9sztudom\u00e1nyi Centrum, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Onkoter\u00e1pi\u00e1s Klinika Szeged Kor\u00e1nyi fasor 12. 6720"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melinda","family":"Csenki","sequence":"additional","affiliation":[{"name":"1 Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvos- \u00e9s Gy\u00f3gyszer\u00e9sztudom\u00e1nyi Centrum, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Onkoter\u00e1pi\u00e1s Klinika Szeged Kor\u00e1nyi fasor 12. 6720"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00falia","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"1 Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvos- \u00e9s Gy\u00f3gyszer\u00e9sztudom\u00e1nyi Centrum, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Onkoter\u00e1pi\u00e1s Klinika Szeged Kor\u00e1nyi fasor 12. 6720"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elem\u00e9r","family":"Szil","sequence":"additional","affiliation":[{"name":"1 Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvos- \u00e9s Gy\u00f3gyszer\u00e9sztudom\u00e1nyi Centrum, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Onkoter\u00e1pi\u00e1s Klinika Szeged Kor\u00e1nyi fasor 12. 6720"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"Fekete","sequence":"additional","affiliation":[{"name":"1 Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvos- \u00e9s Gy\u00f3gyszer\u00e9sztudom\u00e1nyi Centrum, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Onkoter\u00e1pi\u00e1s Klinika Szeged Kor\u00e1nyi fasor 12. 6720"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katalin","family":"Hidegh\u00e9ty","sequence":"additional","affiliation":[{"name":"1 Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvos- \u00e9s Gy\u00f3gyszer\u00e9sztudom\u00e1nyi Centrum, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Onkoter\u00e1pi\u00e1s Klinika Szeged Kor\u00e1nyi fasor 12. 6720"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krisztina","family":"Boda","sequence":"additional","affiliation":[{"name":"2 Orvosi Informatikai Int\u00e9zet Szeged"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Thurz\u00f3","sequence":"additional","affiliation":[{"name":"1 Szegedi Tudom\u00e1nyegyetem, Szent-Gy\u00f6rgyi Albert Orvos- \u00e9s Gy\u00f3gyszer\u00e9sztudom\u00e1nyi Centrum, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Onkoter\u00e1pi\u00e1s Klinika Szeged Kor\u00e1nyi fasor 12. 6720"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"atypb1","first-page":"641","volume":"1","year":"1999","journal-title":"Int. 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