o:20803 Uporedna analiza doznih parametara u planiranju radikalne brahiterapije karcinoma grlića materice standardnom radiografijom i magnetnom rezonancom doktorska disertacija Comparative analisys of dose parameters in cervical cancer radical brachytherapy planning with standard radiography and magnetic resonance : doctoral dissertation sr Karcinom grlića materice se prema podacima registra za rak za centralnu Srbiju nalazi na četvrtom mestu po učestalosti među malignim oboljenjima kod žena, sa incidencom od 26.1/100.000 godišnje i mortalitetom od 13.4/100.000 godišnje. Osnova lečenja uznapredovalih stadijuma karcinoma grlića materice (FIGO stadijuma IIb – IVa) je konkomitantna primena zračne terapije i Cisplatina hemo-potencijacije. Zračna terapija podrazumeva kombinaciju transkutane zračne terapije (TRT) i brahiterapije (BRT). Visoke doze koje se isporučuju tkivima u blizini aplikatorskog sistema i radioaktivnog izvora, daju brahiterapiji nezamenjljivu terapijski značaj u postizanju tumoricidne doze zračenja, ali zbog bliskih anatomskih odnosa u maloj karlici, takođe i veliki značaj u nastanku postiradijacionih sekvela na okolnim organima od rizika (OAR) (bešika, rektum, sigmoidni kolon, tanko crevo). U toku 2D radiografski baziranog planiranja, koje je osnova brahiterapijskog planiranja u proteklim decenijama, dozna opterećenja na organima od rizika (bešici i rektumu) se određuju indirektno, na osnovu položaja kontrasta plasiranog u ove šuplje organe, dok dozna opterećenja na sigmoidnom kolonu i tankom crevu ostaju potpuno nepoznata. Takođe, obzirom na nemogućnost radiografske vizuelizacije tumorskog tkiva, nepoznata je i pokrivenost ciljnih (tumorskih) volumena terapijskom dozom. Sa tehnološkim napretkom i uvođenjem MR u brahiterapiju, stvoreni su uslovi za razvoj 3D volumnog brahiterapijskog planiranja. Prilikom MR brahiterapijskog planiranja, vizuelizuje se cela debljina zida OAR, te su nam poznata dozna opterećenja u malim volumenima njihovog zida (0.1ccm, 1ccm, 2ccm) koja su u uskoj korelaciji sa kasnijim razvojem postiradijacionih sekvela... According to the Cancer registry of central Serbia, cervical cancer is in the fourth place among malignant diseases in women, with the incidence of 26.1/100.000 and mortality of 13.4/100.000 per year. A standard primary curative treatment of advanced cervical cancer (FIGO stage IIb – IVa) is concomitant Cisplatin-based chemoradiation (CCRT). Radiotherapy is presented as a combination of external beam radiotherapy (EBRT) and brachytherapy (BRT). In that setting, brachytherapy with its high contact doses near the irradiation source, has an irreplaceable role in achieving tumoricidal dose, but also due to the close anatomic relations in pelvis, also has an important role in developing post-radiation toxicity to the surrounding organs at risk (OAR) (bladder, rectum, sigmoid colon, small bowel). During 2D radiography based planning, bladder and rectum doses are obtained indirectly, according to the position of the contrast injected in these hollow organs, while doses to the sigmoid colon and bowel remain unknown. Also, since there is no direct radiography visualization of the tumor tissue, target volumes coverage with the therapeutic dose is also unknown. In the last few decades, MR imaging has found its place in brachytherapy, and inducted development of 3D volumetric brachytherapy planning. With MR imaging we can precisely visualize the position of all of the OAR, and get the exact information of the level and the position of the maximum registered doses in small volumes of their wall (D0.1ccm, D1ccm, D2ccm), that closely correspond with the development of late post-irradiation toxicity afterward. Precise tumor tissue visualization makes it possible to define several target volumes (GTV, HR-CTV, IR-CTV), with a precise assessment of their coverage with the prescribed BRT dose... medicina - radiologija / medicine- radiology Datum odbrane: 20.09.2019. karcinom grlića materice, magnetna rezonanca, 3D brahiterapija, radioterapija cervical cancer, magnetic resonance imaging, 3D brachytherapy, radiotherapy 616.146-006.6:615.8(043.3) yes 51747343 91552101 7130 91552100 51747343 2020-01-21T10:41:21.053Z 45 no 46 mentor Aleksandar, 1973- 17590887 Tomašević 2019 63 mentor Vesna, 1958- 12510567 Plešinac-Karapandžić 2019 63 komentor Zorica, 1957- 12483687 Milošević 2019 63 član komisije Marina, 1959- 12530023 Nikitović 2019 63 član komisije Suzana, 1969- 9728871 Stojanović-Rundić 2019 63 član komisije Aljoša, 1973- 5605223 Mandić 2019 86 listova 2932408 http://phaidrabg.bg.ac.rs/o:20803 no yes 4 2020-01-21T10:41:21.320Z 70 11 1066950 1066978 karcinom grlića materice, magnetna rezonanca, 3D brahiterapija, radioterapija cervical cancer, magnetic resonance imaging, 3D brachytherapy, radiotherapy 616.146-006.6:615.8(043.3) 1738 11A32 2019