The document discusses the history and basics of radiotherapy and radiation protection. It describes some key events and discoveries, including Wilhelm Röntgen's discovery of X-rays in 1895, the discovery of radioactivity in the late 1890s, and the early uses of radiation to treat cancers in the late 1890s. It also notes that accurate measurement of absorbed radiation dose is important for treatment success and that dosimetric systems must be properly calibrated and traceable to national and international standards.

1. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 1



Radiotherapy and Radiation Protection



Radiotherapy and Radiation Protection



‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﻣﺗﻁﻠﺑﺎﺕ‬ ‫ﻧﺣﻘﻖ‬ ‫ﻛﻳﻑ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ؟؟‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﻣﺗﻁﻠﺑﺎﺕ‬ ‫ﻧﺣﻘﻖ‬ ‫ﻛﻳﻑ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ؟؟‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
•
‫ﻫﻲ‬ ‫ﻣﺎ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ؟‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
•
‫ﺍﻹﺷﻌﺎﻋﻴﺔ؟‬ ‫ﺍﻟﻮﻗﺎﻳﺔ‬ ‫ﺇﻟﻰ‬ ‫ﺑﺤﺎﺟﺔ‬ ‫ﻫﻢ‬ ‫ﺍﻟﺬﻱ‬ ‫ﺍﻷﻓﺮﺍﺩ‬ ‫ﻣﻦ‬
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ؟‬ ‫ﺑﺎﻟﻭﻗﺎﻳﺔ‬ ‫ﺧﺎﺻﺔ‬ ‫ﻭﺃﺩﻭﺍﺕ‬ ‫ﻭﺳﺎﺋﻝ‬ ‫ﺇﻟﻰ‬ ‫ﺑﺣﺎﺟﺔ‬ ‫ﻧﺣﻥ‬ ‫ﻫﻝ‬
•
‫ﺍﻹﺷﻌﺎﻋﻴﺔ؟؟‬ ‫ﺍﻟﻮﻗﺎﻳﺔ‬ ‫ﻗﻮﺍﻋﺪ‬ ‫ﺗﻄﺒﻴﻖ‬ ‫ﻋﻦ‬ ‫ﺍﻟﻤﺴﺆﻭﻝ‬ ‫ﻣﻦ‬
•
‫؟؟؟؟‬ ‫ﻭﺍﻟﻣﺭﺿﻰ‬ ‫ﻟﻠﻌﺎﻣﻠﻳﻥ‬ ‫ﺑﺎﻟﻧﺳﺑﺔ‬ ‫ﺍﻟﻣﻘﺑﻭﻟﺔ‬ ‫ﺍﻟﺳﻭﻳﺎﺕ‬ ‫ﻫﻲ‬ ‫ﻣﺎ‬
3
Osama Anjak
‫ﻣﻘﺩﻣﺔ‬
:
•
‫ﺍﻟﻣﻣﺗﺻﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﺗﻌﺗﺑﺭ‬
absorbed dose
‫ﺍﻟﻭﺭﻣﻳﺔ‬ ‫ﺍﻟﺧﻼﻳﺎ‬ ‫ﻗﺗﻝ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻔﻌﺎﻝ‬ ‫ﺍﻟﺩﻭﺍء‬
.
•
‫ﺍﻟﻘﺎﺳﻳﺔ؟؟؟؟؟‬ ‫ﺍﻟﻣﺿﺎﻋﻔﺎﺕ‬ ‫ﺑﻌﺽ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻳﺭﺍﻓﻖ‬ ‫ﻫﻝ‬
Ossama Anjak
‫ﻣﻘﺩﻣﺔ‬
:
•
‫ﺍﻟﻣﻣﺗﺻ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻘﺩﺍﺭ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻧﺟﺎﺡ‬ ‫ﻳﺗﻭﻗﻑ‬
‫ﺔ‬
absorbed dose
‫ﻟﻠﻣﺭﻳﺽ‬ ‫ﺗﻘﺩﻡ‬ ‫ﺍﻟﺗﻲ‬
)
‫ﺍﻟﻬﺩﻑ‬ ‫ﻣﻧﻁﻘﺔ‬
.(
Ossama Anjak
•
‫ﻗﻳﺎﺱ‬ ‫ﺗﺗﻡ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
‫ﺍﻟﺟﺭﻋﺔ‬
‫ﻣﺟﺭ‬ ‫ﻧﻅﺎﻡ‬ ‫ﺑﺎﺳﺗﺧﺩﺍﻡ‬
‫ﺍﻋﻳﺔ‬
dosimetric system
‫ﺍﻟﺩﻗﺔ‬ ‫ﻣﺳﺗﻭﻯ‬ ‫ﺣﻳﺙ‬ ‫ﻣﻥ‬ ‫ﻣﻭﺛﻭﻕ‬
accuracy
‫ﻭﺍﻹﺣﻛﺎﻡ‬
precision
•
‫ﻣﺭﺗﺑﻁﺔ‬ ‫ﺍﻟﻣﺟﺭﺍﻋﻳﺔ‬ ‫ﻧﻅﺎﻡ‬ ‫ﻣﻌﺎﻳﺭﺓ‬ ‫ﺗﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
traceable
‫ﺍﻟﻭﻁﻧﻳﺔ‬ ‫ﺑﺎﻟﻣﻌﺎﻳﻳﺭ‬
)
‫ﺍﻟﺩﻭﻟﻳﺔ‬
(
•
‫ﻣﻘﺩﻣﺔ‬
: •
‫ﻣﻘﺩﻣﺔ‬
:
Ossama Anjak
Accident (on Feb. 2001)
White
border of
lesion
Surgical scar
June 4, 01
October 2001
Dec 1, 2001
‫ﺁﻣﻥ‬ ‫ﺑﺷﻛﻝ‬ ‫ﺗﻣﺕ‬ ‫ﻗﺩ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
.

2. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 2
Awarded a first Noble prize in physics in 1901
December 26, 1895, took
the very first picture of his
wife’s hand with a ring
Wilhelm Conrad Röntgen: Discovery of X-ray (November 8 ,1895)
Wilhelm Conrad Röntgen: Discovery of X-ray (November 8 ,1895) •
‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﻧﺷﺎﻁ‬
Radioactivity •
‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﻧﺷﺎﻁ‬
Radioactivity
• Discovery of Radioactivity: 1896
• The Nobel Prize in Physics
1903.... awarded to “Antoine
Henri Becquerel “ in recognition
of the extraordinary services he
has rendered by his discovery of
spontaneous radioactivity"
8
Ossama Anjak
•
‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﻧﺷﺎﻁ‬
Radioactivity •
‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﻧﺷﺎﻁ‬
Radioactivity
• 1898: Discovery of Radium
And Polonium
• Marie and Pierre Curie shared
1903 Nobel prize in physics
with Becquerel
9
Ossama Anjak
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺩﺍﻳﺎﺕ‬ •
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺩﺍﻳﺎﺕ‬
•
‫ﺍﻷﺷﻌﺔ‬ ‫ﺇﻛﺗﺷﺎﻑ‬ ‫ﻋﻘﺏ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺩﺃﺕ‬
‫ﺍﻟﺳﻳﻧﻳﺔ‬
:
•
‫ﺍﻟﺛﺩﻱ‬ ‫ﻟﺳﺭﻁﺎﻥ‬ ‫ﺣﺎﻟﺔ‬ ‫ﺃﻭﻝ‬ ‫ﻋﻭﻟﺟﺕ‬
1896
.
•
‫ﺍﻟﺟﻠﺩﻳﺔ‬ ‫ﺍﻷﻭﺭﺍﻡ‬ ‫ﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻷﺷﻌﺔ‬ ‫ﺍﺳﺗﺧﺩﻣﺕ‬
Skin
Cancer
‫ﻓﻲ‬
1899
•
‫ﻋﺎﻡ‬ ‫ﻓﻲ‬
1903
‫ﺃﻭﻝ‬ ‫ﻧﺷﺭ‬ ‫ﺟﺭﻯ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺣﻭﻝ‬ ‫ﻛﺗﺎﺏ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
Authored first textbook of radiotherapy
Leopold
Freund
10
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺩﺍﻳﺎﺕ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺩﺍﻳﺎﺕ‬
• 1920s-1930s : Radioactive Quackery
Case of
“Radium Girls”
11
Ossama Anjak
‫ﻫﻲ‬ ‫ﻣﺎ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫؟‬ ‫ﻫﻲ‬ ‫ﻣﺎ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫؟‬
•
‫ﺃﺟﻝ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻣﺅﻳﻧﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺍﺳﺗﺧﺩﺍﻡ‬ ‫ﻫﻲ‬
‫ﺍﻷﻭﺭﺍﻡ‬ ‫ﻣﻌﺎﻟﺟﺔ‬
‫ﺑﻬﺩﻑ‬
:
•
‫ﺷﺎﻓﻳﺔ‬ ‫ﻣﻌﺎﻟﺟﺔ‬
Radical Treatment
•
‫ﺗﻠﻁﻳﻔﻳﺔ‬ ‫ﻣﻌﺎﻟﺟﺔ‬
Palliative Treatment
.
Osama Anjak 12

3. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 3
13
‫ﺑﻌﺩ‬ ‫ﻋﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
External Beam Radiotherapy
[EBRT]
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
Brachytherapy
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
Radiotherapy
~ 90 %
~10 %
Osama Anjak
‫؟‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻫﻲ‬ ‫ﻣﺎ‬
‫؟‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻫﻲ‬ ‫ﻣﺎ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﻌد‬ ‫ﻋ‬ ‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬ ‫ﺔ‬ ‫ﻌﺎﻟ‬ ‫اﻟ‬
‫ﺍﻟﻣﺳﺭﻋﺎﺕ‬
‫ﺍﻟﺧﻁﻳﺔ‬
‫ﺍﻟﻛﻭﺑﺎﻟﺕ‬ ‫ﺃﺟﻬﺯﺓ‬
-
60
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
)
‫ﺍﻟﻣﻭﺿﻌﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
(
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎﺩﺭ‬ ‫ﺍﻟﻣﺅﻗﺕ‬ ‫ﺍﻟﻐﺭﺱ‬
‫ﺑﺎﻟﺗﻣﺎﺱ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺍﻷﺟﻭﺍﻑ‬ ‫ﺩﺍﺧﻝ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎﺩﺭ‬ ‫ﺍﻟﺩﺍﺋﻡ‬ ‫ﺍﻟﻐﺭﺱ‬
‫ﺍﻟﺑﺭﻭﺳﺗﺎﺕ‬ ‫ﺃﻭﺭﺍﻡ‬ ‫ﻣﻌﺎﻟﺟﺔ‬
14
Ossama Anjak
‫ﻫﻲ‬ ‫ﻣﺎ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫؟‬ ‫ﻫﻲ‬ ‫ﻣﺎ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫؟‬
~ 90 % ~10 %
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺩﺍﻳﺎﺕ‬ •
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺩﺍﻳﺎﺕ‬
15
Ossama Anjak
• 1938 : Discovery of 60Co isotope
1951: Cobalt Bomb ( H.E. Johns)
• 1938 : Discovery of 60Co isotope
1951: Cobalt Bomb ( H.E. Johns)
First Cobalt-60 machine in
Saskatoon ,Canada
16
Ossama Anjak
• Advances in Radiotherapy 1950 to Present
• Advances in Radiotherapy 1950 to Present
17
Ossama Anjak
‫ﺔ‬ ‫ﻣﻌﺎﻟ‬
‫ﺔ‬ ‫إﺷﻌﺎﻋ‬
‫ﺔ‬ ‫ﺧﺎرﺟ‬
External Beam Therapy [EBT]
Osama Anjak 18
Patient






‫در‬ ‫اﻟ‬ ‫ﺑ‬ ‫اﻟﻔﺎﺻﻠﺔ‬ ‫ﺎﻓﺔ‬ ‫ﻣ‬
‫ﺔ‬ ‫ﻌﺎﻟ‬ ‫اﻟ‬ ‫ﺿﻊ‬ ‫وﻣ‬ ‫ﻊ‬ ‫اﻟ‬

4. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 4
‫ﻌد‬ ‫ﻋ‬ ‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬ ‫ﺔ‬ ‫ﻌﺎﻟ‬ ‫اﻟ‬
‫ﺍﻟﺧﻁﻳﺔ‬ ‫ﺍﻟﻣﺳﺭﻋﺎﺕ‬
‫ﺍﻟﺧﻁﻲ‬ ‫ﺍﻟﻣﺳﺭﻉ‬
Linac ‫ﻧﺎﻳﻑ‬ ‫ﺍﻟﺳﻭﺑﺭ‬
Cyberknife
‫ﺍﻟﻣﻘﻁﻌﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
Tomotherapy
‫ﺍﻟﻛﻭﺑﺎﻟﺕ‬ ‫ﺃﺟﻬﺯﺓ‬
-
60
‫ﺍﻟﻛﻭﺑﺎﻟﺕ‬ ‫ﺟﻬﺎﺯ‬
Co‐
60 Unit
‫ﻧﺎﻳﻑ‬ ‫ﺍﻟﻐﺎﻣﺎ‬
Gamma‐Knife
‫ﺍﻟﺩﻣﺎﻍ‬ ‫ﺃﻭﺭﺍﻡ‬ ‫ﻣﻌﺎﻟﺟﺔ‬
‫ﺍﻟﺳﻳﻧﻳﺔ‬ ‫ﺍﻷﺷﻌﺔ‬
19
Ossama Anjak
‫اﻟ‬ ‫ﺎت‬ ‫ﻘ‬ ‫اﻟ‬
‫دﻣﺔ‬
‫اﻟ‬ ‫ﻓﻲ‬
‫ﺔ‬ ‫ﻌﺎﻟ‬
‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬
‫اﻟ‬
‫ﺔ‬ ‫ﺎرﺟ‬ ‫اﻟ‬ ‫ﺎت‬ ‫ﻘ‬ ‫اﻟ‬
‫دﻣﺔ‬
‫اﻟ‬ ‫ﻓﻲ‬
‫ﺔ‬ ‫ﻌﺎﻟ‬
‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬
‫اﻟ‬
‫ﺔ‬ ‫ﺎرﺟ‬
Osama Anjak 20
PDD for different beams
PDD for different beams
Ossama Anjak 22


(Brachytherapy)
Brachytherapy: ‘Short distance’ therapy
‫ﻣﺸﻌﺔ‬ ‫ﻣﺼﺎﺩﺭ‬
‫ﻗﺛﻁﺭﺓ‬
Greek word: βραχυς brachys,
‫ﻋﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﻗﺭﺏ‬
)
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﺍﻟﻣﻭﺿﻌﻳﺔ‬
(
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎﺩﺭ‬ ‫ﺍﻟﻣﺅﻗﺕ‬ ‫ﺍﻟﻐﺭﺱ‬
‫ﺑﺎﻟﺗﻣﺎﺱ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﺍﻷﺟﻭﺍﻑ‬ ‫ﺩﺍﺧﻝ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﻟﻠﻣﺻﺎﺩ‬ ‫ﺍﻟﻳﺩﻭﻱ‬ ‫ﺍﻟﺷﺣﻥ‬
‫ﺭ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎﺩﺭ‬ ‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺷﺣﻥ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎﺩﺭ‬ ‫ﺍﻟﺩﺍﺋﻡ‬ ‫ﺍﻟﻐﺭﺱ‬
‫ﺍﻟﺩﻣﺎﻍ‬ ‫ﺃﻭﺭﺍﻡ‬ ‫ﻣﻌﺎﻟﺟﺔ‬
‫ﺍﻟﺑﺭﻭﺳﺗﺎﺕ‬ ‫ﺃﻭﺭﺍﻡ‬ ‫ﻣﻌﺎﻟﺟﺔ‬
23
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺣﺎﻛﺎﺓ‬ ‫ﺃﺟﻬﺯﺓ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺣﺎﻛﺎﺓ‬ ‫ﺃﺟﻬﺯﺓ‬
•
‫ﺍﻟﺗﻘﻠﻳﺩﻳﺔ‬ ‫ﺍﻟﻣﺣﺎﻛﺎﺓ‬ ‫ﺃﺟﻬﺯﺓ‬
Simulator
24
Ossama Anjak

5. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 5
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺗﻣﻣﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺗﻣﻣﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬
.1
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺣﺎﻛﺎﺓ‬ ‫ﺃﺟﻬﺯﺓ‬
•
‫ﺍﻟﺗﻘﻠﻳﺩﻳﺔ‬ ‫ﺍﻟﻣﺣﺎﻛﺎﺓ‬ ‫ﺃﺟﻬﺯﺓ‬
•
‫ﺍﻷﺑﻌﺎﺩ‬ ‫ﺛﻼﺛﻳﺔ‬ ‫ﺍﻟﻣﺣﺎﻛﺎﺓ‬
3D Simulation
25
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺣﺎﻛﺎﺓ‬ ‫ﺃﺟﻬﺯﺓ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺣﺎﻛﺎﺓ‬ ‫ﺃﺟﻬﺯﺓ‬
•
‫ﺍﻷﺑﻌﺎﺩ‬ ‫ﺛﻼﺛﻳﺔ‬ ‫ﺍﻟﻣﺣﺎﻛﺎﺓ‬
3D Simulation
26
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺗﻣﻣﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺗﻣﻣﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬
.2
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻉ‬ ‫ﺗﻭﺯﻉ‬ ‫ﺩﺭﺍﺳﺔ‬ ‫ﺃﺟﻬﺯﺓ‬
:
27
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺗﻣﻣﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺗﻣﻣﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬
.3
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻉ‬ ‫ﻗﻳﺎﺱ‬ ‫ﺃﺟﻬﺯﺓ‬
•
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﻣﺎﺋﻲ‬ ‫ﺍﻟﻔﺎﻧﺗﻭﻡ‬
•
‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻘﺎﻳﻳﺱ‬
+
‫ﺍﻟﺗﺄﻳﻥ‬ ‫ﺣﺟﻳﺭﺍﺕ‬
•
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺃﺩﺍء‬ ‫ﻣﻥ‬ ‫ﻭﺍﻟﺗﺣﻘﻖ‬ ‫ﺍﻟﺟﻭﺩﺓ‬ ‫ﺿﺑﻁ‬ ‫ﺃﺩﻭﺍﺕ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
28
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺃﻣﺛﻠﺔ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺃﻣﺛﻠﺔ‬
•
‫ﻣﺗﻁﻠﺑﺎﺕ‬
‫ﺍﻟﺗﺷﻐﻳﻝ‬ ‫ﺍﻟﺗﺻﻣﻳﻡ‬
•
‫ﻭﻗﻳﺎﺱ‬ ‫ﺍﻟﻣﻌﺎﻳﺭﺓ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺎﺕ‬
•
‫ﺿﻣﺎﻥ‬ ‫ﺑﺭﻧﺎﻣﺞ‬ ‫ﺗﻁﺑﻳﻖ‬
‫ﺍﻟﺟﻭﺩﺓ‬
•
‫ﺧﺎﺭﺝ‬ ‫ﺍﻟﺳﻠﻳﻣﺔ‬ ‫ﺍﻷﻧﺳﺟﺔ‬ ‫ﺇﻟﻰ‬ ‫ﺍﻟﻣﻌﻁﺎﺓ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﺗﻘﻠﻳﻝ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﻧﻁﻘﺔ‬
.
•
‫ﺍﻟﻣﻌﺎﻟﺞ‬ ‫ﺍﻟﺣﺟﻡ‬ ‫ﻓﻲ‬ ‫ﻣﺗﺟﺎﻧﺳﺔ‬ ‫ﺟﺭﻋﺔ‬
•
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺎﻟﻣﻧﻁﻘﺔ‬ ‫ﺍﻟﻣﺣﻳﻁﺔ‬ ‫ﺍﻟﺳﻠﻳﻣﺔ‬ ‫ﻟﻠﻧﺳﺞ‬ ‫ﺇﻟﻳﻪ‬ ‫ﺍﻟﻭﺻﻭﻝ‬ ‫ﻣﻣﻛﻥ‬ ‫ﺗﻌﺭﺽ‬ ‫ﺃﻗﻝ‬
.
•
‫ﻟﻠﻧﺳﺞ‬ ‫ﺑﻬﺎ‬ ‫ﺍﻟﻣﺳﻣﻭﺡ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻥ‬ ‫ﺃﻗﻝ‬ ‫ﺍﻟﻭﺭﻡ‬ ‫ﺧﻼﻳﺎ‬ ‫ﻟﻘﺗﻝ‬ ‫ﺍﻟﻣﻁﻠﻭﺑﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﺗﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
‫ﺍﻟﻁﺑﻳﻌﻳﺔ‬
.
•
‫ﺍﻟﻁﺑﻳ‬ ‫ﺍﻷﻧﺳﺟﺔ‬ ‫ﺧﻼﻳﺎ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻌﺩﺩ‬ ‫ﻧﻔﺱ‬ ‫ﻟﻘﺗﻝ‬ ‫ﺍﻟﻣﻁﻠﻭﺑﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻥ‬ ‫ﺃﻗﻝ‬ ‫ﺍﻟﻭﺭﻡ‬ ‫ﺧﻼﻳﺎ‬ ‫ﻣﻥ‬ ‫ﻣﻌﻳﻥ‬ ‫ﻋﺩﺩ‬ ‫ﻟﻘﺗﻝ‬ ‫ﺍﻟﻣﻁﻠﻭﺑﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬
‫ﻌﻳﺔ‬
Ossama Anjak
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﺗﺑﺭﻳﺭ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
: ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﺗﺑﺭﻳﺭ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
:
•
‫ﺍﻟ‬ ‫ﻣﺛﻝ‬ ‫ﺍﻟﺑﺩﻳﻠﺔ‬ ‫ﺍﻟﺗﻘﻧﻳﺎﺕ‬ ‫ﺍﻻﻋﺗﺑﺎﺭ‬ ‫ﺑﻌﻳﻥ‬ ‫ﻧﺄﺧﺫ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬ ‫ﻟﻠﻣﻌﺎﻟﺟﺔ‬ ‫ﺍﻟﻠﺟﻭء‬ ‫ﻗﺑﻝ‬
‫ﺃﻭ‬ ‫ﺟﺭﺍﺣﺔ‬
‫ﻭﺇﻣﻛﺎﻧﻳﺔ‬ ‫ﺍﻟﻛﻳﻣﻳﺎﺋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﺗﻁﺑﻳﻘﻬﺎ‬
.
•
‫ﺍﻟﻣﺛﺎﻝ‬ ‫ﺳﺑﻳﻝ‬ ‫ﻋﻠﻰ‬
:
•
‫ﺍﻟﺣﻣﻳﺩﺓ‬ ‫ﺍﻷﻭﺭﺍﻡ‬
:
‫ﺑﺩﻳ‬ ‫ﺗﻘﻧﻳﺎﺕ‬ ‫ﺍﺧﺗﻳﺎﺭ‬ ‫ﻳﺟﺏ‬ ،‫ﺍﻷﻭﻝ‬ ‫ﺍﻟﺧﻳﺎﺭ‬ ‫ﻫﻭ‬ ‫ﺍﻹﺷﻌﺎﻉ‬ ‫ﻳﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﻳﻧﺑﻐﻲ‬ ‫ﻻ‬
‫ﻗﺑﻝ‬ ‫ﻠﺔ‬
‫ﻟﻺﺷﻌﺎﻉ‬ ‫ﺍﻟﻠﺟﻭء‬
Ossama Anjak

6. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 6
‫ﻓﻲ‬ ‫ﺍﻟﻌﺎﻣﻠﻭﻥ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻗﺳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
: ‫ﻓﻲ‬ ‫ﺍﻟﻌﺎﻣﻠﻭﻥ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻗﺳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
:
•
‫ﺑﺎﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺧﺗﺻﻭﻥ‬ ‫ﺃﻁﺑﺎء‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
.
•
‫ﻟﻡ‬ ‫ﻣﺎ‬ ‫ﺇﺷﻌﺎﻋﻳﺔ‬ ‫ﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻳﺧﺿﻊ‬ ‫ﺃﻥ‬ ‫ﻣﺭﻳﺽ‬ ‫ﻷﻱ‬ ‫ﻳﻣﻛﻥ‬ ‫ﻻ‬
‫ﻁﺑﻳﺏ‬ ‫ﻗﺑﻝ‬ ‫ﻣﻥ‬ ‫ﻣﻭﺻﻭﻓﺔ‬ ‫ﺗﻛﻥ‬
‫ﻣﻌﺎﻟ‬
‫ﺟﺔ‬
‫ﻣﺅﻫﻝ‬ ‫ﺇﺷﻌﺎﻋﻳﺔ‬
.
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﻧﻁﻘﺔ‬ ‫ﺗﺣﺩﻳﺩ‬
)
GTV, CTV, ..
.(
•
‫ﻟﻠﻣﺭﻳﺽ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﺇﻋﻁﺎء‬ ‫ﻋﻠﻰ‬ ‫ﺍﻹﺷﺭﺍﻑ‬
.
•
‫ﻭ‬ ‫ﺍﻟﻣﺭﺿﻰ‬ ‫ﺭﻋﺎﻳﺔ‬
‫ﻣﺗﺎﺑﻌﺔ‬
‫ﺣﺎﻟﺔ‬ ‫ﺗﻁﻭﺭ‬ ‫ﺗﻘﻳﻳﻡ‬
‫ﺍﻟﻣﺭﻳﺽ‬
.
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻭﺻﻑ‬
)
‫ﻭﻁﺎﻗﺗﻬﺎ‬ ‫ﺍﻟﻣﺳﺗﺧﺩﻣﺔ‬ ‫ﺍﻷﺷﻌﺔ‬ ‫ﻧﻭﻉ‬ ،‫ﻣﻘﺩﺍﺭﻫﺎ‬
.(
•
‫ﺍﻟﻌﻼﺝ‬ ‫ﺧﻁﺔ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻟﻣﻭﺍﻓﻘﺔ‬
.
Ossama Anjak
‫ﻓﻲ‬ ‫ﺍﻟﻌﺎﻣﻠﻭﻥ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻗﺳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
: ‫ﻓﻲ‬ ‫ﺍﻟﻌﺎﻣﻠﻭﻥ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻗﺳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
:
•
‫ﺍﻟﻁﺑﻳﺔ‬ ‫ﺍﻟﻔﻳﺯﻳﺎء‬ ‫ﻓﻲ‬ ‫ﻣﺅﻫﻝ‬ ‫ﺧﺑﻳﺭ‬
.
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺧﻁﺔ‬ ‫ﺇﻋﺩﺍﺩ‬ ‫ﻓﻲ‬ ‫ﻣﺗﺧﺻﺹ‬
.
•
‫ﻭﻗﻳﺎﺳﻬﺎ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﺣﺳﺎﺑﺎﺕ‬
.
•
‫ﺍﻟﺟﺭﻋﺎﺕ‬ ‫ﻗﻳﺎﺱ‬ ‫ﻓﻲ‬ ‫ﻣﺗﺧﺻﺹ‬
Dosimetrist
•
‫ﺍﻟﺟﻭﺩﺓ‬ ‫ﺿﻣﺎﻥ‬ ‫ﺑﺭﻧﺎﻣﺞ‬ ‫ﺗﻁﺑﻳﻖ‬
.
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺇﺟﺭﺍءﺍﺕ‬
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺎﺕ‬ ‫ﻗﻳﺎﺱ‬
:
•
‫ﻓﻘﺩﺍﻥ‬
‫ﺍﻟﺟﺭﻋﺎﺕ‬ ‫ﻗﻳﺎﺱ‬ ‫ﻷﺟﻬﺯﺓ‬ ‫ﺍﻟﻣﻌﺎﻳﺭﺓ‬
‫ﺍﻟﻣﺷ‬ ‫ﻭﺍﻟﻣﺻﺎﺩﺭ‬
‫ﻌﺔ‬
‫ﺍﻟﻌﻭﺍﻣﻝ‬ ‫ﺃﻫﻡ‬ ‫ﻣﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺳﺗﺧﺩﻣﺔ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﻟﻠﺣﻭﺍﺩﺙ‬ ‫ﺍﻟﻣﺳﺑﺑﺔ‬
.
•
‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻌﺩﻝ‬ ‫ﺗﺣﺩﻳﺩ‬ ‫ﻓﻲ‬ ‫ﺧﻁﺄ‬ ‫ﺑﺳﺑﺏ‬ ‫ﺣﻭﺍﺩﺙ‬
)
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻣﻌﺎﻳﺭﺓ‬
(
‫ﺯﻳ‬ ‫ﺇﻟﻰ‬ ‫ﺃﺩﺕ‬
‫ﺎﺩﺓ‬
‫ﺇﻟﻰ‬ ‫ﺑﻣﻘﺩﺍﺭ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻓﻲ‬
60
%
‫ﻣﺭﻳﺽ‬ ‫ﻣﻥ‬ ‫ﻛﺑﻳﺭ‬ ‫ﻋﺩﺩ‬ ‫ﺇﻟﻰ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻥ‬
)
‫ﻣﺋﺎﺕ‬ ‫ﺑﺿﻊ‬
.(
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺎﺕ‬ ‫ﻗﻳﺎﺱ‬
:
•
‫ﺍﻟﻤﻠﺤﻖ‬
II.19.
‫ﻣﻦ‬
BSS
:
•
‫ﺍﻟﻤﻌﺎﻳﺮﺓ‬
:
ً‫ﺎ‬‫ﺛﺎﻧﻴ‬
-
19
:
‫ﻳﻠﻲ‬ ‫ﻣﻤﺎ‬ ‫ﻟﻬﻢ‬ ‫ﻭﺍﻟﻤﺮﺧﺺ‬ ‫ﺍﻟﻤﺴﺠﻠﻮﻥ‬ ‫ﻳﺘﺤﻘﻖ‬
:
)
‫ﺏ‬
(
‫ﻁﺎﻗﺘﻪ‬ ‫ﺃﻭ‬ ‫ﺍﻹﺷﻌﺎﻉ‬ ‫ﺑﻨﻮﻋﻴﺔ‬ ‫ﺍﻟﻤﺘﻌﻠﻘﺔ‬ ‫ﺍﻹﺷﻌﺎﻋﻴﺔ‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺗﺠﻬﻴﺰﺍﺕ‬ ‫ﻣﻌﺎﻳﺮﺓ‬
‫ﻅﻞ‬ ‫ﻓﻲ‬ ً‫ﺎ‬‫ﺳﻠﻔ‬ ‫ﻣﺤﺪﺩﺓ‬ ‫ﻣﺴﺎﻓﺔ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻟﻤﻤﺘﺼﺔ‬ ‫ﺍﻟﺠﺮﻋﺔ‬ ‫ﻣﻌﺪﻝ‬ ‫ﺃﻭ‬ ‫ﺍﻟﻤﻤﺘﺼﺔ‬ ‫ﻭﺍﻟﺠﺮﻋﺔ‬
‫ﺭﻗﻢ‬ ‫ﺍﻟﺘﻘﺮﻳﺮ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻮﺍﺭﺩﺓ‬ ‫ﺍﻟﺘﻮﺻﻴﺎﺕ‬ ‫ﺑﺈﺗﺒﺎﻉ‬ ،‫ﻣﻌﻴﻨﺔ‬ ‫ﻅﺮﻭﻑ‬
277
‫ﺍﻟﺘﻘﺎﺭﻳﺮ‬ ‫ﺳﻠﺴﻠﺔ‬ ‫ﻣﻦ‬
،‫ﺍﻟﻤﺜﺎﻝ‬ ‫ﺳﺒﻴﻞ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻟﺬﺭﻳﺔ‬ ‫ﻟﻠﻄﺎﻗﺔ‬ ‫ﺍﻟﺪﻭﻟﻴﺔ‬ ‫ﺍﻟﻮﻛﺎﻟﺔ‬ ‫ﺗﺼﺪﺭﻫﺎ‬ ‫ﺍﻟﺘﻲ‬ ‫ﺍﻟﺘﻘﻨﻴﺔ‬
....
.
Ossama Anjak
‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻘﺎﻳﻳﺱ‬ ‫ﻣﻌﺎﻳﺭﺓ‬
Calibration of Dosimeter
:
•
‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﻜﺎﺷﻒ‬ ‫ﺍﺳﺘﺠﺎﺑﺔ‬ ‫ﺗﺤﺪﻳﺪ‬
)
‫ﺍﻟﻤﻌﺎﻳﺮﺓ‬ ‫ﻣﻌﺎﻣﻞ‬ ‫ﺗﻌﻴﻦ‬
(
‫ﺍﻹﺷ‬ ‫ﻟﻠﺠﺮﻋﺔ‬
‫ﻌﺎﻋﻴﺔ‬
‫ﺍﻟﻤﻘﺎﺳﺔ‬ ‫ﺍﻟﻘﻴﻤﺔ‬ ‫ﻟﺘﺤﻮﻳﻞ‬
)
‫ﺍﻟﻜﻬﺮﺑﺎﺋﻴﺔ‬ ‫ﺍﻟﺸﺤﻨﺔ‬
(
‫ﻳﻌ‬ ‫ﻓﻴﺰﻳﺎﺋﻲ‬ ‫ﻣﻘﺪﺍﺭ‬ ‫ﺇﻟﻰ‬
‫ﻋﻦ‬ ‫ﺒﺮ‬
‫ﺍﻟﻤﻘﺎﺳﺔ‬ ‫ﺍﻟﺠﺮﻋﺔ‬ ‫ﻣﻘﺪﺍﺭ‬
.
Ossama Anjak



‫ﺑﺩﻗﺔ‬ ً‫ﺎ‬‫ﻣﻌﻠﻭﻣ‬ ‫ﻳﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
‫ﺍﻟﻣﻌﻳﺎﺭﻳﺔ‬ ‫ﻣﺧﺎﺑﺭ‬ ‫ﺃﺣﺩ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﻌﺎﻳﺭﺓ‬ ‫ﻋﻠﻰ‬ ‫ﺑﺎﻻﻋﺗﻣﺎﺩ‬
‫ﺔ‬ ‫اﻟ‬
‫ﺔ‬ ‫اﻟ‬

Gy
•
‫ﺍﻟﻬﺩﻑ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺎﺕ‬ ‫ﻣﻘﺎﻳﻳﺱ‬ ‫ﻣﻌﺎﻳﺭﺓ‬ ‫ﻣﻥ‬
:
•
‫ﻟﻠﻘﻳﺎﺱ‬ ‫ﺍﻟﻣﺭﺟﻌﻳﺔ‬ ‫ﺍﻟﺷﺭﻭﻁ‬ ‫ﺿﻣﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﺗﻛﻭﻥ‬ ‫ﺃﻥ‬
‫ﺑﻣﺧﺗﻠ‬ ‫ﻭﺍﺣﺩﺓ‬
‫ﻑ‬
‫ﺍﻷﻣﺎﻛﻥ‬
‫ﺍﻟﻌﺎﻟﻡ‬ ‫ﺣﻭﻝ‬
.
1Gy
1Gy
1Gy
1Gy
1Gy
1Gy
1Gy
1Gy
1Gy 1Gy
1Gy 1Gy
Ossama Anjak

7. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 7
‫ﺍﻟﻣﻌﺎﻳﺭﺓ‬ ‫ﺑﺭﻭﺗﻭﻛﻭﻻﺕ‬
Calibration protocols
:
•
‫ﺍﻟﻔ‬ ‫ﻓﻲ‬ ‫ﺧﺒﻴﺮ‬ ‫ﺇﺟﺮﺍءﻫﺎ‬ ‫ﻳﺘﻄﻠﺐ‬ ‫ﺍﻟﻤﻌﻘﺪﺓ‬ ‫ﺍﻹﺟﺮﺍءﺍﺕ‬ ‫ﻣﻦ‬ ‫ﺍﻟﻤﻌﺎﻳﺮﺓ‬ ‫ﺗﻌﺪ‬
‫ﻴﺰﻳﺎء‬
‫ﺍﻹﺷﻌﺎﻋﻴﺔ‬ ‫ﻭﺍﻟﻤﻌﺎﻟﺠﺔ‬
.
•
‫ﺑﻄﺮﺍﺋﻖ‬ ‫ﺗﺰﻭﺩﻧﺎ‬ ‫ﺍﻟﺘﻲ‬ ‫ﺍﻟﺠﺮﻉ‬ ‫ﻟﻘﻴﺎﺱ‬ ‫ﺑﺮﻭﺗﻮﻛﻮﻻﺕ‬ ‫ﻣﻦ‬ ‫ﻋﺪﺩ‬ ‫ﻳﻮﺟﺪ‬
‫ﺍﻟﻤﻌﺎﻳﺮﺓ‬
:
•
‫ﺩﻭﻟﻴﺔ‬
:
(eg IAEA TRS 277 or TRS 398)
•
‫ﻭﻁﻨﻴﺔ‬
:
‫ﺍﻹﺷﻌ‬ ‫ﻟﻠﻔﻴﺰﻳﺎء‬ ‫ﺍﻟﻮﻁﻨﻴﺔ‬ ‫ﺍﻟﻬﻴﺌﺔ‬ ‫ﻗﺒﻞ‬ ‫ﻣﻦ‬ ‫ﻣﻮﺿﻮﻋﺔ‬ ‫ﺗﻜﻮﻥ‬ ‫ﻋﺎﺩﺓ‬
‫ﺎﻋﻴﺔ‬
(AAPM TG 21, AAPM TG 51, DIN 68, ...)
Ossama Anjak
PDD% of 60Co Beams
PDD% of 60Co Beams
0.00
20.00
40.00
60.00
80.00
100.00
120.00
0 5 10 15 20 25 30
PDD%
Depth in water (cm)
Field Size cm2 5x5
Field Size cm2 10x10
Field Size cm2 15x15
Field Size cm2 20x20
Field Size cm2 25x25
Field Size cm2 30x30
Field Size cm2 35x35
Field Size cm2 40x40
PDD for 60co (SSD=100cm)
15%
‫ﺑﺎﻟﻌﻣﻖ‬ ‫ﻟﻠﺟﺭﻋﺔ‬ ‫ﺍﻟﻣﺋﻭﻳﺔ‬ ‫ﺍﻟﻧﺳﺑﺔ‬
PDD%
Percentage Depth Dose
‫ﺑﺎﻟﻌﻣﻖ‬ ‫ﻟﻠﺟﺭﻋﺔ‬ ‫ﺍﻟﻣﺋﻭﻳﺔ‬ ‫ﺍﻟﻧﺳﺑﺔ‬
PDD%
Percentage Depth Dose
The photon dose calculation problem
The photon dose calculation problem
(a) Beam calibration in
water (b) Calculation of the dose
distribution in patient
Shielding (irregular)
‐ 3D Countering
‐ Inhamogeneities
Tray
Penumbra
Wedge Filter
Primary Collimator
Flatting Filter
Radiation Source
Compensator
Detector
Water
Ref. Field
SSD
SSDp
Field Collimator
‫ﺑﺎﻟﻌﻣﻖ‬ ‫ﻟﻠﺟﺭﻋﺔ‬ ‫ﺍﻟﻣﺋﻭﻳﺔ‬ ‫ﺍﻟﻧﺳﺑﺔ‬
PDD%
Percentage Depth Dose
‫ﺑﺎﻟﻌﻣﻖ‬ ‫ﻟﻠﺟﺭﻋﺔ‬ ‫ﺍﻟﻣﺋﻭﻳﺔ‬ ‫ﺍﻟﻧﺳﺑﺔ‬
PDD%
Percentage Depth Dose .1
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗﻘﻧﻳﺔ‬
: .1
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗﻘﻧﻳﺔ‬
:
•
‫ﺑﺗﻘﻧﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
SAD=fixed
:
Source
Aix
SAD= fixed
SAD= fixed

8. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 8
.2
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺧﻁﺔ‬
Treatment Plan .2
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺧﻁﺔ‬
Treatment Plan
•
‫ﻭﺍﺣﺩﺓ‬ ‫ﺑﺳﺎﺣﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
Direct beam
•
‫ﺑﺎﻹﻟﻛﺗﺭﻭﻧﺎﺕ‬ ‫ﻣﻌﺎﻟﺟﺔ‬
100%
Patient with prostate cancer. Shown is a typical slice of the planning CT in the pelvis with different radiation plans calculated: Left
image: Conventional 4-field 3D-conformal plan; middle image: intensity modulated volumetric arc plan, right image: 4 field
proton plan. The arrows show the target contour (prostate, red), the rectum (black with inflated rectum balloon) and the hips. Red
volume signifies high dose, green volume intermediate dose and blue volume low dose. The rectum is the major organ that has to be
spared from radiation in the case of prostate cancer. In order to protect the rectum an endorectal balloon is inserted before every
radiation fraction and inflated with air. The rectum balloon serves to move major parts of the rectal wall away from the prostate and the
high dose volume. The volumetric arc plan spares the rectum much better and conforms the dose better to the prostate than the 3D
Plan. In comparison the proton plan shows equal target coverage as the VMAT plan but much
Patient with prostate cancer. Shown is a typical slice of the planning CT in the pelvis with different radiation plans calculated: Left
image: Conventional 4-field 3D-conformal plan; middle image: intensity modulated volumetric arc plan, right image: 4 field
proton plan. The arrows show the target contour (prostate, red), the rectum (black with inflated rectum balloon) and the hips. Red
volume signifies high dose, green volume intermediate dose and blue volume low dose. The rectum is the major organ that has to be
spared from radiation in the case of prostate cancer. In order to protect the rectum an endorectal balloon is inserted before every
radiation fraction and inflated with air. The rectum balloon serves to move major parts of the rectal wall away from the prostate and the
high dose volume. The volumetric arc plan spares the rectum much better and conforms the dose better to the prostate than the 3D
Plan. In comparison the proton plan shows equal target coverage as the VMAT plan but much
‫ﻓﻲ‬ ‫ﺍﻟﻌﺎﻣﻠﻭﻥ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻗﺳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
: ‫ﻓﻲ‬ ‫ﺍﻟﻌﺎﻣﻠﻭﻥ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻗﺳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬
:
•
‫ﻓﻧﻲ‬
‫ﺍﻟﻘﻭﺍﻟﺏ‬ ‫ﻭﺗﺣﺿﻳﺭ‬ ‫ﺇﺷﻌﺎﻋﻳﺔ‬ ‫ﻣﻌﺎﻟﺟﺔ‬
•
‫ﻭﺍﻻﺟﺗﻣﺎﻋﻲ‬ ‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻣﺭﻳﺽ‬ ‫ﻋﻧﺎﺻﺭ‬
.
•
‫ﺍﻹﺩﺍﺭﻱ‬ ‫ﺍﻟﻁﺎﻗﻡ‬
)
،‫ﺻﻳﺎﻧﺔ‬ ‫ﻋﻣﺎﻝ‬ ،‫ﺩﻭﺍﻡ‬ ‫ﻣﺭﺍﻗﺏ‬ ،‫ﻣﺣﺎﺳﺏ‬
(....
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﻭﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺗﺻﻣﻳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﻭﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺗﺻﻣﻳﻡ‬
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﻳﺅﻣﻥ‬ ‫ﻭﺍﻗﻲ‬ ‫ﺩﺭﻉ‬ ‫ﺿﻣﻥ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺗﻭﺿﻊ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﻭﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺗﺻﻣﻳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﻭﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺗﺻﻣﻳﻡ‬
•
‫ﺍﻵﻟﻳﺔ‬ ‫ﺍﻟﺣﺭﻛﺔ‬ ‫ﺗﻌﻁﻝ‬ ‫ﺣﺎﻝ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻭﺍﻗﻲ‬ ‫ﺍﻟﺩﺭﻉ‬ ‫ﺩﺍﺧﻝ‬ ‫ﺇﻟﻰ‬ ‫ﺍﻟﻣﺻﺩﺭ‬ ‫ﺇﻋﺎﺩﺓ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
.
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﻭﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺗﺻﻣﻳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﻭﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺗﺻﻣﻳﻡ‬
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﻳﺅﻣﻥ‬ ‫ﻭﺍﻗﻲ‬ ‫ﺩﺭﻉ‬ ‫ﺿﻣﻥ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺗﻭﺿﻊ‬

9. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 9
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻑ‬ ‫ﺗﺻﻣﻳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻑ‬ ‫ﺗﺻﻣﻳﻡ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻑ‬ ‫ﺗﺻﻣﻳﻡ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻑ‬ ‫ﺗﺻﻣﻳﻡ‬
•
‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
‫ﻣﺭﺍﻗﺑﺔ‬ ‫ﻧﻅﺎﻡ‬ ‫ﻳﺗﻭﻓﺭ‬
)
‫ﻛﺎﻣﻳﺭﺍ‬
(
‫ﻟﺭﺅﻳﺔ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻓﺔ‬ ‫ﺩﺍﺧﻝ‬ ‫ﻣﻌﻪ‬ ‫ﻭﺍﻟﺗﺣﺩﺙ‬ ‫ﺍﻟﻣﺭﻳﺽ‬
.
•
‫ﻷﺟﻝ‬
‫ﺍﻟﺟﻭﺩﺓ‬ ‫ﺿﺑﻁ‬ ‫ﺇﺟﺭﺍءﺍﺕ‬ ‫ﻭ‬ ‫ﺍﻟﺟﺭﻉ‬ ‫ﻗﻳﺎﺳﺎﺕ‬
‫ﻣﻧﺎﺳﺑﺔ‬ ‫ﺑﻔﺗﺣﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻓﺔ‬ ‫ﺗﺯﻭﺩ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
‫ﻭﺁﻣﻧﺔ‬
‫ﻣﻥ‬ ‫ﺍﻟﻘﻳﺎﺱ‬ ‫ﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﻛﺎﺑﻼﺕ‬ ‫ﻹﺩﺧﺎﻝ‬
‫ﻣﻧﻁﻘﺔ‬
‫ﺩﺍﺧﻝ‬ ‫ﺇﻟﻰ‬ ‫ﻭﺍﻟﺗﺷﻐﻳﻝ‬ ‫ﺍﻟﺗﺣﻛﻡ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻓﺔ‬
)
‫ﺛﻘﺏ‬
‫ﻏﺭﻓﺔ‬ ‫ﺟﺩﺍﺭ‬ ‫ﻓﻲ‬ ‫ﻣﺎﺋﻝ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
.(
Ossama Anjak
‫ﺇﺷﺎﺭﺍﺕ‬
‫ﺍﻟﺗﺣﺫﻳﺭ‬ ‫ﺇﺷﺎﺭﺍﺕ‬
‫ﺍﻟﺗﺣﺫﻳﺭ‬
•
‫ﺿﻭﺋﻳﺔ‬ ‫ﺇﺷﺎﺭﺍﺕ‬
.
•
‫ﺍﻟﺗﺷﻐﻳﻝ‬ ‫ﻭﺿﻌﻳﺔ‬ ‫ﻋﻠﻰ‬ ‫ﺗﺩﻝ‬
)
ON, OFF
(
•
‫ﺗﺣﺫﻳﺭﻳﺔ‬ ‫ﻟﻭﺣﺎﺕ‬
.
•
‫ﺇﺷﻌﺎﻋﻳﺔ‬ ‫ﻣﺭﺍﻗﺑﺔ‬ ‫ﺟﻬﺎﺯ‬
•
‫ﺍﻟﻛﻭﺑﺎﻟﺕ‬ ‫ﻏﺭﻑ‬
-
60
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺑﺎﻟﻭﻗﺎﻳﺔ‬ ‫ﺧﺎﺻﺔ‬ ‫ﺇﺟﺭﺍءﺍﺕ‬
:‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺑﺎﻟﻭﻗﺎﻳﺔ‬ ‫ﺧﺎﺻﺔ‬ ‫ﺇﺟﺭﺍءﺍﺕ‬
:
•
‫ﻣﻥ‬ ً‫ﺎ‬‫ﺇﺷﻌﺎﻋﻳ‬ ‫ﺍﻟﻣﺻﻧﻔﻳﻥ‬ ‫ﺍﻟﻌﺎﻣﻠﻳﻥ‬ ‫ﻭﻛﺎﻓﺔ‬ ‫ﺍﻟﺗﺷﻐﻳﻝ‬ ‫ﻁﺎﻗﻡ‬ ‫ﺃﻓﺭﺍﺩ‬ ‫ﻛﺎﻓﺔ‬ ‫ﻋﻠﻰ‬ ‫ﻳﺟﺏ‬
‫ﺃﻁﺑﺎء‬
‫ﻭﺗﻣﺭﻳﺽ‬ ‫ﻭﻓﻳﺯﻳﺎﺋﻳﻳﻥ‬
…
.
‫ﺍﻟﺦ‬
:
•
‫ﻓﺭﺩ‬ ‫ﺑﻛﻝ‬ ‫ﺧﺎﺻﺔ‬ ‫ﺟﺭﻉ‬ ‫ﻣﻘﺎﻳﻳﺱ‬ ‫ﺣﻣﻝ‬
)
‫ﺣﺭﺍﺭﻱ‬ ‫ﻭﻣﻳﺽ‬ ‫ﻣﻘﻳﺎﺱ‬ ،‫ﻓﻠﻡ‬
TLD
،
…....
.(
•
‫ﺃﻥ‬
‫ﺍﻟﺫﺭﻳﺔ‬ ‫ﻟﻠﻁﺎﻗﺔ‬ ‫ﺍﻟﺩﻭﻟﻳﺔ‬ ‫ﺍﻟﻭﻛﺎﻟﺔ‬ ‫ﺑﺗﻭﺻﻳﺎﺕ‬ ‫ﻋﻣﻼ‬ ً‫ﺎ‬‫ﺩﻭﺭﻳ‬ ‫ﻳﺑﺩﻝ‬
.
•
‫ﺇﺷﻌﺎﻋﻲ‬ ‫ﻣﺳﺢ‬ ‫ﺟﻬﺎﺯ‬ ‫ﺗﻭﻓﺭ‬ ‫ﻳﺟﺏ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺇﺟﺭﺍءﺍﺕ‬
:
‫ﺍﻟﺟﻭﺩﺓ‬ ‫ﺿﻣﺎﻥ‬ ‫ﺑﺭﻧﺎﻣﺞ‬ ‫ﺗﻁﺑﻳﻖ‬
: ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺇﺟﺭﺍءﺍﺕ‬
:
‫ﺍﻟﺟﻭﺩﺓ‬ ‫ﺿﻣﺎﻥ‬ ‫ﺑﺭﻧﺎﻣﺞ‬ ‫ﺗﻁﺑﻳﻖ‬
:
•
‫ﺍﻟﺟﻭﺩﺓ‬ ‫ﺿﻣﺎﻥ‬ ‫ﺑﺭﻧﺎﻣﺞ‬ ‫ﻳﻬﺩﻑ‬
:
•
‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺃﺩﺍء‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬
•
‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﻳﺗﻠﻘﺎﻫﺎ‬ ‫ﺍﻟﺗﻲ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺎﺕ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬
.
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺳﺗﺧﺩﻣﺔ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺑﻳﻥ‬ ‫ﺍﻟﺗﻭﺍﻓﻖ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬
:
•
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺃﺟﻬﺯﺓ‬
)
‫ﻛﻭﺑﺎﻟﺕ‬ ،‫ﻣﺳﺭﻉ‬
-
60
.(
•
‫ﺍﻟﺗﺧﻁﻳﻁ‬ ‫ﺃﺟﻬﺯﺓ‬
)
CT Simulation
(
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﺗﻭﺯﻉ‬ ‫ﺩﺭﺍﺳﺔ‬ ‫ﺃﺟﻬﺯﺓ‬
.
•
‫ﺍﻵﺧﺭﻳﻥ‬ ‫ﻗﺑﻝ‬ ‫ﻣﻥ‬ ‫ﺑﻬﺎ‬ ‫ﺗﻌﺩﻳﻠﻬﺎ‬ ‫ﻭﻋﺩﻡ‬ ‫ﺍﻟﺑﻳﺎﻧﺎﺕ‬ ‫ﺗﺧﺯﻳﻥ‬ ‫ﻓﻲ‬ ‫ﺍﻟﺩﻗﺔ‬ ‫ﺍﻟﺗﺣﻘﻖ‬
)
‫ﺯﻣﻥ‬ ‫ﻟﺣﺳﺎﺏ‬ ‫ﻳﺩﻭﻱ‬ ‫ﺗﺩﻗﻳﻖ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
.(
Ossama Anjak
•
‫ﺍﻟﺟﻭﺩﺓ‬ ‫ﻭﺿﻣﺎﻥ‬ ‫ﺍﻟﻣﻌﺎﻳﺭﺍﺕ‬
QA
Ossama Anjak
‫ﺍﻟﺿﻭﺋﻳﺔ‬ ‫ﺍﻟﺳﺎﺣﺔ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺳﺎﺣﺔ‬

10. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 10
BSS ‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
Planned exposure ‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
Planned exposure ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬
‫ﺃﻧﺟﻖ‬ ‫ﺃﺳﺎﻣﺔ‬
-
‫ﻭﺍﻷﻣﺎﻥ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﻗﺳﻡ‬ 56
‫ﺍﻟﺘﻘﻨﲔ‬
Optimization
Equipment
design and
suppliers
Advice of
qualified
expert
‫ﺍﳌﺴﺆﻭﻟﻴﺎﺕ‬
Responsibilities
‫ﺍﳉﻮﺩﺓ‬ ‫ﺿﻤﺎﻥ‬
Quality
assurance
‫ﺍﻟﺘﱪﻳﺮ‬
Justification
Training criteria
Physician
Patient
Protection
BSS
12/11/2018
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬
‫ﺃﻧﺟﻖ‬ ‫ﺃﺳﺎﻣﺔ‬
-
‫ﻭﺍﻷﻣﺎﻥ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﻗﺳﻡ‬ 57
‫ﺍﻟﻁﺑﻳﺔ‬ ‫ﺍﻟﻣﺭﺍﻗﺑﺔ‬
Health surveillance
‫ﺍﻟﻌﻣﻝ‬ ‫ﻣﻛﺎﻥ‬ ‫ﻣﺭﺍﻗﺑﺔ‬
Workplace monitoring
‫ﺍﻟﻭﻗﻳﺔ‬ ‫ﺃﺩﻭﺍﺕ‬
‫ﺍﻟﻔﺭﺩﻳﺔ‬
Personal
protective devices
‫ﺍﻟﻣﺳﺅﻭﻟﻳﺎﺕ‬
Responsibilities
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﻣﺳﺗﻠﺯﻣﺎﺕ‬ ‫ﻛﺎﻓﺔ‬ ‫ﺗﺄﻣﻳﻥ‬
‫ﺍﻟﺣﻭﺍﻣﻝ‬ ‫ﺍﻟﻌﺎﻣﻼﺕ‬
Pregnant workers
‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻘﺎﻳﻳﺱ‬
‫ﺍﻟﻔﺭﺩﻳﺔ‬
Individual exposure
monitoring
‫ﺍﻟﻣﻬﻧﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
Occupational
Protection
BSS
12/11/2018
Osama Anjak 59




(Brachytherapy)
‫؟‬
‫ﻣﻘﺩﻣﺔ‬
:‫ﻣﻘﺩﻣﺔ‬
:
•
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
Brachytherapy
)
‫ﺍﻟﻛﻭﺭﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺎﺳﻡ‬ ‫ﺃﺣﻳﺎﻧﺎ‬ ‫ﺇﻟﻳﻬﺎ‬ ‫ﻳﺷﺎﺭ‬
curietherapy
(
‫ﻣﺳﺎﻓﺔ‬ ‫ﻣﻥ‬ ‫ﻟﻸﻭﺭﺍﻡ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻟﻭﺻﻑ‬ ‫ﻳﺳﺗﺧﺩﻡ‬ ‫ﻣﺻﻁﻠﺢ‬ ‫ﻫﻭ‬
‫ﻗﺻﻳﺭﺓ‬
‫ﻣﻐﻠﻘﺔ‬ ‫ﻣﺷﻌﺔ‬ ‫ﻣﺻﺎﺩﺭ‬ ‫ﺑﺎﺳﺗﺧﺩﺍﻡ‬
)
‫ﻣﻐﻠﻔﺔ‬
(
‫ﺍﻟﺣﺟﻡ‬ ‫ﺻﻐﻳﺭﺓ‬
.
•
‫ﺑﺎ‬ ‫ﺃﻭ‬ ‫ﻓﻲ‬ ‫ﻣﺑﺎﺷﺭﺓ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻭﺿﻊ‬ ‫ﻁﺭﻳﻘﺔ‬ ‫ﻋﻥ‬ ‫ﺍﻟﺗﻘﻧﻳﺔ‬ ‫ﺑﻬﺫﻩ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗﺗﻡ‬
‫ﻣﻥ‬ ‫ﻟﻘﺭﺏ‬
‫ﺍﻟ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﻧﻁﻘﺔ‬
)
‫ﺍﻟﻬﺩﻑ‬
Target
(
‫ﺍﻷﺷﻌﺔ‬ ‫ﺇﻟﻰ‬ ‫ﻋﻼﺟﻪ‬ ‫ﺍﻟﻣﺭﺍﺩ‬ ‫ﺍﻟﻌﺿﻭ‬ ‫ﻳﺗﻌﺭﺽ‬ ‫ﺣﻳﺙ‬
‫ﻳﺑﻘﻰ‬ ‫ﺍﻟﺗﻲ‬ ‫ﺍﻟﻣﺩﺓ‬ ‫ﻁﻠﻳﺔ‬ ‫ﺑﺎﺳﺗﻣﺭﺍﺭ‬
‫ﻓﻳ‬
‫ﺍﻟﻣﺻ‬ ‫ﻬﺎ‬
‫ﺩ‬
‫ﺍﻟﺟﺳﻡ‬ ‫ﺿﻣﻥ‬ ‫ﺍﻟﻣﺷﻊ‬ ‫ﺭ‬
Osama Anjak 60

11. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 11


(Brachytherapy)
‫؟‬ 

(Brachytherapy)
‫؟‬
•
‫رض‬ ‫اﻟ‬ ‫ﺟ‬ ‫داﺧﻞ‬ ‫ﺿﻊ‬ ‫ﺗ‬ ‫اﻟ‬ ‫ة‬
‫ر‬ ‫ﺻﻐ‬ ‫ﻣﻐﻠﻘﺔ‬ ‫ﻌﺔ‬ ‫ﻣ‬ ‫ﺎدر‬ ‫ﻣ‬ ‫دام‬ ‫اﺳ‬ ‫ﻫﻲ‬
.
•
‫ﺧﺎﺻﺔ‬ ‫ﻘﺎت‬ ‫ﻣ‬ ‫دام‬ ‫ﺎﺳ‬
)
‫ﻟﻠ‬ ‫ﺔ‬ ‫ﻌ‬ ‫اﻟ‬ ‫ﺎت‬ ‫اﻟﻔ‬ ‫ر‬ ‫ﻋ‬
intracavitary
.(
•
‫اﺣﺔ‬
‫ر‬ ‫اﻟ‬ ‫ﺔ‬ ‫اﺳ‬ ‫ﺑ‬
interstitial
)
‫داﺋ‬ ‫أو‬ ‫ﻣؤﻗت‬ ‫ﻞ‬ ‫ﺔ‬ ‫اﻷﻧ‬ ‫ﺿ‬ ‫ﺗزرع‬
.(
•
‫ﺔ‬ ‫ﺳ‬ ‫ﻘﺎت‬ ‫ﻣ‬
surface application
‫ﻠد‬ ‫اﻟ‬ ‫ﻋﻠﻰ‬ ‫ﺿﻊ‬ ‫ﺗ‬
.
Osama Anjak 61
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
Brachytherapy
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
Brachytherapy
‫ﺍﻟﻣﺳﺗﺧﺩﻣﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬
‫ﻣﻘﺩﻣﺔ‬
:‫ﻣﻘﺩﻣﺔ‬
:
•
‫ﻣﻌﻅﻡ‬
‫ﺍﻟﻔﻭﺗﻭﻧﺎﺕ‬ ‫ﺗﺻﺩﺭ‬ ‫ﺍﻟﺗﻘﻧﻳﺔ‬ ‫ﺑﻬﺫﻩ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺳﺗﺧﺩﻣﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
)
‫ﺃﺷﻌﺔ‬
‫ﻏﺎﻣﺎ‬

(
.
•
‫ﺍﻟﻬﺩﻑ‬ ‫ﻣﻧﻁﻘﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻣﺻﺩﺭ‬ ‫ﻳﻭﺿﻊ‬
:
•
‫ﺍﻟﺯﻣﻥ‬ ‫ﻣﻥ‬ ‫ﻗﺻﻳﺭﺓ‬ ‫ﻟﻔﺗﺭﺓ‬
)
‫ﺍﻟﻣﺅﻗﺕ‬ ‫ﺍﻟﺯﺭﻉ‬
temporary implants
(
‫ﺃﻭ‬
•
‫ﺩﺍﺋﻡ‬ ‫ﺯﺭﻉ‬
permanent implants
‫ﻋﻣﺭ‬ ‫ﻁﻳﻠﺔ‬ ‫ﻟﻺﺷﻌﺎﻉ‬ ‫ﺗﺗﻌﺭﺽ‬ ‫ﺍﻟﻬﺩﻑ‬ ‫ﻣﻧﻁﻘﺔ‬ ‫ﺗﺑﻘﻰ‬ ‫ﺣﻳﺙ‬
‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻣﺻﺩﺭ‬
.
Osama Anjak 63
‫ﻣﻘﺩﻣﺔ‬
:‫ﻣﻘﺩﻣﺔ‬
:
•
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﻥ‬ ‫ﺭﺋﻳﺳﻳﻥ‬ ‫ﻧﻭﻋﻳﻥ‬ ‫ﻳﻭﺟﺩ‬
:
.1
‫ﺍﻟ‬
‫ﺯﺭﻉ‬
‫ﺍﻷﺟﻭﺍﻑ‬ ‫ﺿﻣﻥ‬
Intracavitary
:
‫ﻣﻘﺭﺑﺔ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻭﺿﻊ‬ ‫ﻳﺟﺭﻯ‬ ‫ﺣﻳﺙ‬
‫ﺍﻟﻁﺑ‬ ‫ﺍﻷﺟﻭﺍﻑ‬ ‫ﻋﺑﺭ‬ ‫ﺍﻟﻭﺭﻡ‬ ‫ﻣﻥ‬
‫ﻳ‬
‫ﻌﻳﺔ‬
)
‫ﺍﻟﻣﺭﻱ‬
،‫ﺍﻟﻬﻭﺍﺋﻳﺔ‬ ‫ﺍﻟﻘﺻﺑﺔ‬ ،‫ﺍﻟﺭﺣﻡ‬ ،
.....
.(
.2
‫ﺍﻟﺯﺭﻉ‬
‫ﺍﻟﺧﻼﻟﻲ‬
Interstitial
:
‫ﺍﻟﻧﺳﻳﺞ‬ ‫ﺿﻣﻥ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺯﺭﻉ‬ ‫ﻳﺗﻡ‬ ‫ﺍﻟﺣﺎﻟﺔ‬ ‫ﻫﺫﻩ‬ ‫ﻓﻲ‬
‫ﺍﻟﻭﺭﻣﻲ‬
tumor volume
.
•
‫ﻣﺛﻝ‬ ً‫ﺎ‬‫ﺷﻳﻭﻋ‬ ‫ﺍﻷﻗﻝ‬ ‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻷﺷﻛﺎﻝ‬ ‫ﺑﻌﺽ‬ ‫ﺗﻭﺟﺩ‬
‫ﺍﻟﻣﻌﺎﻟﺟ‬
‫ﺔ‬
‫ﺍﻟﺳﻁﺣﻳﺔ‬
Surfers Applicator
‫ﺍﻟﻌﻣﻝ‬ ‫ﺃﺛﻧﺎء‬ ‫ﻭﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺍﻟﻠﻣﻌﺔ‬ ‫ﺩﺍﺧﻝ‬ ‫ﻭﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﺍﻟﺩﻣﻭﻳﺔ‬ ‫ﺍﻷﻭﻋﻳﺔ‬ ‫ﻣﻌﺎﻟﺟﺔ‬ ‫ﻭﺫﻟﻙ‬ ‫ﺍﻟﺟﺭﺍﺣﻳﺔ‬
•
‫ﻏﺎﻣﺎ‬ ‫ﻷﺷﻌﺔ‬ ‫ﻣﺻﺩﺭﺓ‬ ‫ﻣﺷﻌﺔ‬ ‫ﻣﺻﺎﺩﺭ‬ ‫ﺗﺳﺗﺧﺩﻡ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻧﻣﻁ‬ ‫ﻫﺫﺍ‬ ‫ﻓﻲ‬

‫ﺑﻳﺗﺎ‬ ‫ﺟﺳﻳﻣﺎﺕ‬ ‫ﺃﻭ‬

.
Osama Anjak 64
‫ﻣﻘﺩﻣﺔ‬
:‫ﻣﻘﺩﻣﺔ‬
:
•
‫ﺍﻟﺧﺎﺭﺟﻳ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻋﻠﻰ‬ ‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗﻣﺗﺎﺯ‬ ‫ﺍﻟﻔﻳﺯﻳﺎﺋﻳﺔ‬ ‫ﺍﻟﻧﺎﺣﻳﺔ‬ ‫ﻣﻥ‬
‫ﺔ‬
•
‫ﺍﻟﻬﺩﻑ‬ ‫ﺍﻟﺣﺟﻡ‬ ‫ﻳﺗﻠﻘﺎﻫﺎ‬ ‫ﺍﻟﺗﻲ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﺑﺗﺣﺳﻥ‬
target volume
‫ﻧﺭﻏﺏ‬ ‫ﺍﻟﺫﻱ‬
‫ﺑﻣﻌﺎﻟﺟﺗﻪ‬
•
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﻘﻧﻳﺔ‬ ‫ﻫﺫﻩ‬ ‫ﻣﺳﺎﺅﻯ‬ ‫ﺃﻣﺎ‬
‫ﻓﻬﻲ‬
:
•
ً‫ﺎ‬‫ﻧﺳﺑﻳ‬ ‫ﺍﻟﺣﺟﻡ‬ ‫ﻭﺻﻐﻳﺭﺓ‬ ‫ﺍﻟﻣﻭﺿﻌﻳﺔ‬ ‫ﺍﻷﻭﺭﺍﻡ‬ ‫ﻋﻠﻰ‬ ‫ﺗﻁﺑﻳﻘﻬﺎ‬ ‫ﻳﻘﺗﺻﺭ‬
.
•
‫ﺣﻭﺍﻟﻲ‬ ‫ﻋﻠﻰ‬ ‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗﻁﺑﻖ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺃﻗﺳﺎﻡ‬ ‫ﻓﻲ‬
10
-
20
‫ﺑﺎﻹﺷﻌﺎﻉ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﻳﻥ‬ ‫ﻟﻠﻣﺭﺿﻰ‬ ‫ﺍﻟﻛﻠﻲ‬ ‫ﺍﻟﻌﺩﺩ‬ ‫ﻣﻥ‬ ٪
Osama Anjak 65
‫ﺍﻟﺒﺪﺍﻳﺎﺕ‬
‫ﺍﻟﺒﺪﺍﻳﺎﺕ‬
•
‫ﻫﻧﺭﻱ‬ ‫ﺃﻛﺗﺷﻑ‬
‫ﺑﻛﺭﻝ‬
Henri Becquerel
‫ﻓﻲ‬ ‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﻧﺷﺎﻁ‬
February
1896
26
•
‫ﺍﻟﻌﺎﻡ‬ ‫ﻧﻔﺱ‬ ‫ﻓﻲ‬
)
1898
(
‫ﺗﻣﻛﻥ‬
‫ﺑﻳﺭ‬
‫ﻛﻭﺭﻱ‬
Pierre Curie
‫ﻋﻧﺻﺭ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻟﺣﺻﻭﻝ‬ ‫ﻣﻥ‬
‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﺭﺍﺩﻳﻭﻡ‬
Ra-226
•
‫ﻋﺎﻡ‬
1901
‫ﺃﻗﺗﺭﺡ‬
‫ﻛﻭﺭﻱ‬ ‫ﺑﻳﻳﺭ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﺭﺍﺩﻳﻭﻡ‬ ‫ﺍﺳﺗﺧﺩﺍﻡ‬
)
‫ﻣﻌﺎﻟﺟ‬
‫ﺔ‬
‫ﺍﻷﻭﺭﺍﻡ‬
(
‫ﺑﺎﻟﺗﻣﺎﺱ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑﺗﻘﻧﻳﺔ‬
Brachytherapy
•
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻧﻣﻁ‬ ‫ﻫﺫﺍ‬ ‫ﻋﻠﻰ‬ ‫ﻳﻁﻠﻖ‬ ‫ﺍﻟﻣﺭﺍﺟﻊ‬ ‫ﺑﻌﺽ‬ ‫ﻓﻲ‬
:
‫ﺍﻟﻛﻭﺭﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
Curie Therapy
Osama Anjak 66

12. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 12
‫ﺍﻟﺒﺪﺍﻳﺎﺕ‬
‫ﺍﻟﺒﺪﺍﻳﺎﺕ‬
•
Pierre Curie’s self inflicted severe skin Curie’s self-reaction to
radium.
1903
Osama Anjak 67
•
July, 1895. Mme. Curie s post doctoral work was to study the
“Uranium rays”
Osama Anjak 68
‫ﺍﻟﺑﺩﺍﻳﺎﺕ‬
‫ﺍﻟﺑﺩﺍﻳﺎﺕ‬
• The first successful brachytherapy treatments were performed soon after Marie and Pierre
Curie’s discovery of radium in 1898. This picture shows how radium (226Ra) surface
applicators were used for the treatment of skin cancer.
Osama Anjak 69
‫ﺍﻟﺑﺩﺍﻳﺎﺕ‬
‫ﺍﻟﺑﺩﺍﻳﺎﺕ‬
•
Radium applicators for surface and intracavitary applications, used
by Danlos and later by Wickham
Osama Anjak 70


(Brachytherapy)
‫؟‬ 

(Brachytherapy)
‫؟‬
Osama Anjak 71
Brachytherapy: ‘Short distance’ therapy
‫ﻣﺸﻌﺔ‬ ‫ﻣﺼﺎﺩﺭ‬
‫ﻗﺛﻁﺭﺓ‬
Greek word βραχυς brachys,
‫ﺍﻟﻤﺸﻌﺔ‬ ‫ﺍﻟﻤﺼﺎﺩﺭ‬
Osama Anjak 72
Radiation Sources

13. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 13
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
•
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺗﺳﺗﺧﺩﻡ‬
‫ﻣﻐﻠﻘﺔ‬ ‫ﻣﺷﻌﺔ‬ ‫ﻣﺻﺎﺩﺭ‬
Sealed Radioactive
sources
•
‫ﻣﺷﻌﺔ‬ ‫ﻣﺎﺩﺓ‬ ‫ﻭﻫﻲ‬
:
•
‫ﺃﻭ‬ ،‫ﻛﺑﺳﻭﻟﺔ‬ ‫ﺩﺍﺧﻝ‬ ‫ﺩﺍﺋﻣﺔ‬ ‫ﺑﺻﻭﺭﺓ‬ ‫ﻣﺧﺗﻭﻣﺔ‬
•
‫ﺻﻠﺑﺔ‬ ‫ﻣﺎﺩﺓ‬ ‫ﺷﻛﻝ‬ ‫ﻋﻠﻰ‬ ‫ﺑﺈﺣﻛﺎﻡ‬ ‫ﻣﻐﻠﻘﺔ‬
.
‫ﺩﺭﺟﺔ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻟﻣﺧﺗﻭﻡ‬ ‫ﺍﻟﻣﺻﺩﺭ‬ ‫ﻣﺎﺩﺓ‬ ‫ﺃﻭ‬ ‫ﺍﻟﻛﺑﺳﻭﻟﺔ‬ ‫ﺗﻛﻭﻥ‬
‫ﻣﻥ‬
‫ﻭﻛﺫ‬ ،‫ﺃﺟﻠﻪ‬ ‫ﻣﻥ‬ ‫ﺻﻣﻣﺕ‬ ‫ﺍﻟﺫﻱ‬ ‫ﺍﻟﻧﺣﻭ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻻﺳﺗﻌﻣﺎﻝ‬ ‫ﻅﺭﻭﻑ‬ ‫ﻓﻲ‬ ‫ﺍﻟﺗﺳﺭﺏ‬ ‫ﻟﻣﻧﻊ‬ ‫ﺗﻛﻔﻲ‬ ‫ﺍﻟﻣﺗﺎﻧﺔ‬
‫ﻓﻲ‬ ‫ﻟﻙ‬
‫ﺍﻟﻣﺗﻭﻗﻌﺔ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺎﻟﺔ‬
[BSS]
Osama Anjak 73
‫ﺍﻟﻣﻐﻠﻘﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺍﻟﻣﻐﻠﻘﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
•
‫ﺑﺈﺣﻛﺎﻡ‬ ‫ﻣﻐﻠﻘﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
:
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺎﺩﺓ‬ ‫ﺃﻱ‬
activity
‫ﻣﻐﻠﻘﺔ‬ ‫ﺣﺎﻭﻳﺔ‬ ‫ﺿﻣﻥ‬ ‫ﻣﻭﺟﻭﺩﺓ‬
‫ﻳ‬ ‫ﻟﻡ‬ ‫ﻣﺎ‬ ‫ﺍﻟﻧﻘﻝ‬ ‫ﻋﻣﻠﻳﺔ‬ ‫ﺧﻼﻝ‬ ‫ﻟﻠﺑﻳﺋﺔ‬ ‫ﺗﻠﻭﺙ‬ ‫ﺃﻱ‬ ‫ﺣﺩﻭﺙ‬ ‫ﺩﻭﻥ‬ ‫ﻵﺧﺭ‬ ‫ﻣﻛﺎﻥ‬ ‫ﻣﻥ‬ ‫ﻧﻘﻠﻬﺎ‬ ‫ﻳﺳﻬﻝ‬
‫ﺗﻌﺭﺽ‬
‫ﻟﻠﺗﺧﺭﻳﺏ‬ ‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻣﺻﺩﺭ‬
.
•
‫ﺩﻭﺭﻱ‬ ‫ﺑﺷﻛﻝ‬ ‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻣﺻﺩﺭ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻟﺣﺎﻭﻱ‬ ‫ﺍﻟﻐﻼﻑ‬ ‫ﺳﻼﻣﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬ ‫ﻳﺗﻡ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
‫ﻭﺫﻟﻙ‬
‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻣﺻﺩﺭ‬ ‫ﺳﻼﻣﺔ‬ ‫ﻣﻥ‬ ‫ﻟﻠﺗﺣﻘﻖ‬
.
•
‫ﺍﻟﻣﺳﺢ‬ ‫ﺍﺧﺗﺑﺎﺭ‬ ‫ﺇﺟﺭﺍء‬ ‫ﻟﺫﻟﻙ‬ ‫ﻁﺭﻳﻘﺔ‬ ‫ﺃﻓﺿﻝ‬
wipe tests
Osama Anjak 74




 




•
‫ﺍﻟﻭﺭﻡ‬ ‫ﺗﻭﺿﻊ‬ ‫ﺑﺣﺳﺏ‬ ‫ﻣﻧﺎﺳﺑﺔ‬ ‫ﻭﺑﻁﺎﻗﺔ‬ ‫ﻓﻘﻁ‬ ‫ﻏﺎﻣﺎ‬ ‫ﻷﺷﻌﺔ‬ ‫ﻣﺻﺩﺭ‬
.
•
‫ﺍﻟﻧﻭﻋﻳﺔ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻧﺷﺎﻁﻳﺔ‬ ‫ﺗﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
Specific Activity
)
‫ﺑﻭﺣﺩﺓ‬ ‫ﺍﻟﺟﺭﻋﺔ‬
‫ﺍﻟﻛﺗﻠﺔ‬
(
‫ﻋﺎﻟﻳﺔ‬
.
•
‫ﺍ‬
‫ﻟﺭﺍﺩﻳﻭﻡ‬
-
226
:
 = 0.988 Ci/g (original definition: 1 Ci/g)
•
‫ﺍﻟﻛﻭﺑﺎﻟﺕ‬
-
60
:
 = 1130 Ci/g (carrier free); 300 Ci/g (in practice)
•
‫ﺍﻟﺳﻳﺯﻳﻭﻡ‬
-
137
:
 = 80 Ci/g.
•
‫ﻣﺭﺗﻔﻊ‬ ‫ﺟﺭﻋﺔ‬ ‫ﺑﻣﻌﺩﻝ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗﻁﺑﻳﻘﺎﺕ‬ ‫ﺃﺟﻝ‬ ‫ﻣﻥ‬ ‫ﻣﻧﺎﺳﺏ‬
HDR
•
‫ﺍﻹﻳﺭﻳﺩﻳﻭﻡ‬
-
192
]
[Ir-192
•
‫ﺍﻟﻛﻭﺑﺎﻟﺕ‬
-
60
[Co-60]
Osama Anjak 75
‫ﻋﻥ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺛﺎﻟﻲ‬ ‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻣﺻﺩﺭ‬
‫ﻗﺭﺏ‬
The Ideal Brachytherapy source ‫ﻋﻥ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺛﺎﻟﻲ‬ ‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻣﺻﺩﺭ‬
‫ﻗﺭﺏ‬
The Ideal Brachytherapy source
•
‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﺗﻔﻛﻙ‬ ‫ﻋﻥ‬ ‫ﺍﻟﻧﺎﺗﺞ‬ ‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻧﻛﻠﻳﺩ‬ ‫ﻳﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
daughter product
‫ﻣﻧﺎﺳﺏ‬
.
•
‫ﺍﻟﺭﺍﺩﻳﻭﻡ‬ ‫ﺍﺳﺗﺧﺩﺍﻡ‬ ‫ﺇﻟﻐﺎء‬ ‫ﺗﻡ‬ ‫ﺍﻟﺳﺑﺏ‬ ‫ﻟﻬﺫﺍ‬
-
226
)
Ra
226
.(
•
‫ﺍﻟﻧﺻﻑ‬ ‫ﻋﻣﺭ‬ ‫ﻳﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﺍﻟﻣﻧﺎﺳﺏ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻣﺅﻗﺕ‬ ‫ﺍﻟﺯﺭﻉ‬ ‫ﺃﺟﻝ‬ ‫ﻣﻥ‬
‫ﻁﻭﻳﻝ‬
long half life
.
)
Cs
137
،
Co
60
(
•
‫ﺍﻻﻗﺗﺻﺎﺩﻳﺔ‬ ‫ﺍﻟﻧﺎﺣﻳﺔ‬ ‫ﻣﻥ‬ ‫ﺫﻟﻙ‬ ‫ﻳﻔﻳﺩ‬
–
‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻣﺻﺩﺭ‬ ‫ﺍﺳﺗﻌﻣﺎﻝ‬ ‫ﺇﻋﺎﺩﺓ‬ ‫ﻳﻣﻛﻥ‬ ‫ﺣﻳﺙ‬
•
‫ﺍﻟﻧﺻﻑ‬ ‫ﻋﻣﺭ‬ ‫ﻳﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﺍﻟﻣﻧﺎﺳﺏ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺩﺍﺋﻡ‬ ‫ﺍﻟﺯﺭﻉ‬ ‫ﺃﺟﻝ‬ ‫ﻣﻥ‬
‫ﻗﺻﻳﺭ‬ ‫ﺃﻭ‬ ‫ﻣﺗﻭﺳﻁ‬
)
‫ﺍﻷﻳ‬ ‫ﻣﻥ‬ ‫ّﺓ‬‫ﺩ‬‫ﻋ‬
‫ﺎﻡ‬
(
medium half life
)
I
125
(
.
Osama Anjak 76
Brachytherapy Sources
Brachytherapy Sources
Osama Anjak 77
Radionuclide Half-life Photon Energy (MeV) Half-value Layer
(mm lead)
226Ra 1600 years 0.047 - 2.45 (0.83 ave) 8.0
222Rn 3.83 days 0.047 - 2.45 (0.83 ave) 8.0
60Co 5.26 years 1.17, 1.33 11.0
192Ir 74.2 days 0.136 - 1.06 (0.38 ave) 2.5
137Cs 30.0 years 0.662 5.5
198Au 2.7 days 0.412 2.5
125I 60.2 days 0.028 ave 0.025
103Pd 17.0 days 0 021 ave 0 008
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺳﺗﺧﺩﻣﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
:‫ﻗﺭﺏ‬ ‫ﻋﻥ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻣﺳﺗﺧﺩﻣﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
:
Osama Anjak 78
The SI unit of activity is the Becquerel (Bq) given as
1 Bq = 1 s−1.
The old unit of activity, the curie (Ci), was initially defined
as the activity of 1 g of radium‐226 and given as
1 Ci = 3.7×1010 s−1.
1 Ci = 3.7 × 1010 Bq
1 Ci = 37 GBq
1 mCi = 37 MBq

14. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 14
Ossama Anjak
‫ﺗﻁﺑﻳﻖ‬ ‫ﻳﺗﻡ‬ ‫ﻛﻳﻑ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﻗ‬ ‫ﻋﻥ‬
‫ﺭﺏ؟‬
•
‫ﺗﻁﺑﻳﻖ‬ ‫ﻳﺗﻡ‬ ‫ﻛﻳﻑ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﻗﺭﺏ؟‬ ‫ﻋﻥ‬
Ossama Anjak
‫اﻹﺷﻌﺎﻋ‬ ‫ﺔ‬ ‫ﻌﺎﻟ‬ ‫اﻟ‬ ‫ار‬
‫ر‬‫وﻗ‬ ‫ص‬ ‫اﻟ‬
‫ﺔ‬
‫ﺎﻛﺎة‬ ‫اﻟ‬
Simulations
)
‫اﻟﻬدف‬ ،‫ﺔ‬ ‫ﻌﺎﻟ‬ ‫اﻟ‬ ‫ﺿﻊ‬ ‫ﻣ‬ ‫دﯾد‬ ‫ﺗ‬
(
‫ﻘﺎت‬ ‫اﻟ‬ ‫زرع‬
‫دد‬ ‫اﻟ‬ ‫ﺿﻊ‬ ‫اﻟ‬ ‫ﻓﻲ‬
)
‫ﺎدر‬ ‫ﻣ‬
‫ﻌﺔ‬ ‫ﻣ‬ ‫ر‬ ‫ﻏ‬
(
AP radiographs of cervix treatment
tandem
ovoid
•
‫ﺗﻁﺑﻳﻖ‬ ‫ﻳﺗﻡ‬ ‫ﻛﻳﻑ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﻗﺭﺏ؟‬ ‫ﻋﻥ‬
Ossama Anjak
‫ﻋﺔ‬
‫ر‬ ‫اﻟ‬ ‫زع‬ ‫ﺗ‬ ‫اﺳﺔ‬
‫ر‬‫د‬
‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬
+
‫ﻋدد‬ ‫دﯾد‬ ‫ﺗ‬
‫ﻌﺔ‬ ‫اﻟ‬ ‫ﺎدر‬ ‫اﻟ‬
‫ﺔ‬ ‫ﻌﺎﻟ‬ ‫اﻟ‬ ‫ﺔ‬ ‫ﺟﻠ‬ ‫ﻣدة‬ ‫ﺎب‬ ‫ﺣ‬
‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬ ‫ﺔ‬ ‫ﻌﺎﻟ‬ ‫اﻟ‬ ‫ﺗ‬
‫إﻟﻰ‬ ‫ﻌﺔ‬ ‫اﻟ‬ ‫ﺎدر‬ ‫اﻟ‬ ‫ﻧﻘﻞ‬
‫اﻟ‬
‫ﺿ‬
‫دد‬ ‫اﻟ‬ ‫ﻊ‬
)
‫ﻣؤﻗ‬ ، ‫داﺋ‬
‫ت‬
(
‫ﺔ‬ ‫ﻠ‬ ‫اﻟ‬ ‫ﻋﺔ‬
‫ر‬ ‫اﻟ‬
40 – 70 Gy
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
‫ﻗﺭﺏ‬ ‫ﻋﻥ‬
Ossama Anjak
•
‫ﺍﻟﺟﺳﻡ؟؟‬ ‫ﺿﻣﻥ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺯﺭﻉ‬ ‫ﻳﻣﻛﻥ‬ ‫ﺃﻳﻥ‬
Ossama Anjak
Body sites in which brachytherapy
can be used to treat cancer
Ossama Anjak
‫ﺍﻟﻤﺮﻳﺾ‬ ‫ﺇﻟﻰ‬ ‫ﺍﻟﻤﺸﻌﺔ‬ ‫ﺍﻟﻤﺼﺎﺩﺭ‬ ‫ﺷﺤﻦ‬ ‫ﺁﻟﻴﺔ‬
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺷﺣﻥ‬
‫ﺁﻟﻳﺎ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻧﻘﻝ‬ ‫ﻳﺗﻡ‬
)
‫ﺁﻟﻲ‬ ‫ﺗﺣﻛﻡ‬
(
‫ﺍﻟﻳﺩﻭﻱ‬ ‫ﺍﻟﺷﺣﻥ‬
‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺗﺣﻣﻳﻝ‬ ‫ﻳﺟﺭﻱ‬
‫ﺑﺎﻟﻳﺩ‬ ‫ﺍﻟﻣﺷﻌﺔ‬

15. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 15
•
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎﺩﺭ‬ ‫ﺍﻟﻳﺩﻭﻱ‬ ‫ﺍﻟﺷﺣﻥ‬
•
‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﺟﺳﻡ‬ ‫ﺇﻟﻰ‬ ‫ﺍﻟﺣﺎﻭﻳﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻏﺭﺱ‬ ‫ﺃﻭ‬ ‫ﻧﻘﻝ‬
)
‫ﺍﻟﻣﻁﺑﻘﺎﺕ‬
(
ً‫ﺎ‬‫ﻳﺩﻭﻳ‬
.
Ossama Anjak
•
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎﺩﺭ‬ ‫ﺍﻟﻳﺩﻭﻱ‬ ‫ﺍﻟﺷﺣﻥ‬
Ossama Anjak
•
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎﺩﺭ‬ ‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺷﺣﻥ‬
•
‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﺟﺳﻡ‬ ‫ﺇﻟﻰ‬ ‫ﺍﻟﺣﺎﻭﻳﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻏﺭﺱ‬ ‫ﺃﻭ‬ ‫ﻧﻘﻝ‬
)
‫ﺍﻟﻣﻁﺑﻘﺎﺕ‬
(
ً‫ﺎ‬‫ﺁﻟﻳ‬
.
Ossama Anjak
•
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺣﺎﻗﻥ‬ ‫ﺟﻬﺎﺯ‬
Brachytherapy Afterloading
Ossama Anjak
•
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺣﺎﻗﻥ‬ ‫ﺟﻬﺎﺯ‬
Brachytherapy Afterloading
•
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺗﺣﻣﻳﻝ‬ ‫ﺁﻟﻳﺔ‬
Remote Afterloading
:
‫ﻓﻳﻬﺎ‬ ‫ﻳﺗﻡ‬ ‫ﺍﻟﺗﻲ‬ ‫ﺍﻟﺗﻘﻧﻳﺔ‬ ‫ﺗﻠﻙ‬ ‫ﻫﻲ‬
:
•
‫ﺍﻟﻣﻁﺑﻘﺎﺕ‬ ‫ﺯﺭﻉ‬ ‫ﻳﺟﺭﻱ‬ ‫ﺣﻳﺙ‬ ً‫ﺎ‬‫ﻣﺳﺑﻘ‬ ‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﺗﺟﻬﻳﺯ‬
)
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻭﺿﻊ‬ ‫ﺩﻭﻥ‬
(
‫ﺍﻷﻧﺎ‬ ‫ﺃﻭ‬
‫ﺑﻳﺏ‬
‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﻓﻲ‬
.
•
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻭﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺍﻟﻣﻁﺑﻘﺎﺕ‬ ‫ﻣﻭﺿﻊ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬ ‫ﻳﺟﺭﻱ‬
)
‫ﻭﻫﻣﻳﺔ‬ ‫ﻣﺷﻌﺔ‬ ‫ﻣﺻﺎﺩﺭ‬ ‫ﻳﺳﺗﺧﺩﻡ‬
.(
•
‫ﺍﻟﻣ‬ ‫ﺗﺣﻣﻳﻝ‬ ‫ﻳﺗﻡ‬
‫ﺻﺎﺩﺭ‬
ً‫ﺎ‬‫ﺁﻟﻳ‬ ‫ﺍﻟﻣﻁﺑﻘﺎﺕ‬ ‫ﺗﻠﻙ‬ ‫ﺇﻟﻰ‬
Remote Afterloading
.
•
‫ﺍﺳﺗﺧﺩﺍﻡ‬ ‫ﺣﺎﻝ‬ ‫ﻓﻲ‬ ‫ﻭﺗﻁﺑﻖ‬ ‫ﺍﻟﺟﻬﺎﺯ‬ ‫ﻭﻣﻭﺩﻳﻝ‬ ‫ﺍﻟﺻﺎﻧﻌﺔ‬ ‫ﺍﻟﺷﺭﻛﺔ‬ ‫ﻋﻠﻰ‬ ‫ﺗﻌﺗﻣﺩ‬ ‫ﺍﻵﻟﻳﺔ‬ ‫ﻫﺫﻩ‬
‫ﻣﺻﺎﺩﺭ‬
‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﻧﺷﺎﻁ‬ ‫ﻋﺎﻟﻳﺔ‬
Cs
137
Co or
60
Ir,
192
.
Ossama Anjak
•
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺣﺎﻗﻥ‬ ‫ﺟﻬﺎﺯ‬
Brachytherapy Afterloading
Ossama Anjak
Remote Afterloading
ELEKTA
Brachytherapy Afterloading
GyneSource
HDR‐Afterloader

16. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 16
Ossama Anjak
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺇﺟﺭﺍءﺍﺕ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺇﺟﺭﺍءﺍﺕ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻣﻭﺿﻊ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻣﻭﺿﻊ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬
•
‫ﻣﻭﺿﻊ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬ ‫ﻳﻣﻛﻥ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺍﻟﺗﺻﻭﻳﺭ‬ ‫ﺃﻓﻼﻡ‬ ‫ﺑﺎﺳﺗﺧﺩﺍﻡ‬
Ossama Anjak
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻣﻭﺿﻊ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻣﻭﺿﻊ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬
•
‫ﻧ‬ ‫ﻣﻥ‬ ‫ﺃﻓﻼﻡ‬ ‫ﻳﺳﺗﺧﺩﻡ‬ ‫ﺍﻻﺧﺗﺑﺎﺭ‬ ‫ﻫﺫﺍ‬ ‫ﻹﺟﺭﺍء‬
‫ﻭﻉ‬
Auto-radiograph
‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬ ‫ﺃﺟﻝ‬ ‫ﻣﻥ‬
‫ﻓﻲ‬ ‫ﺍﻟﻣﺳﺗﺧﺩﻣﺔ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻣﻭﺿﻊ‬
‫ﻧﻣﻁ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
HDR
.
Ossama Anjak
•
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺗﺧﺯﻳﻥ‬ •
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺗﺧﺯﻳﻥ‬
•
‫ﺗﺧﺯﻥ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺃﺟﻝ‬ ‫ﻣﻥ‬ ‫ﻛﺎﻑ‬ ‫ﺗﺩﺭﻳﻊ‬ ‫ﺫﺍﺕ‬ ‫ﺧﺎﺻﺔ‬ ‫ﺣﺎﻭﻳﺎﺕ‬ ‫ﻓﻲ‬
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬
•
‫ﻭﻛﻣﻳ‬ ‫ﻧﻭﻋﻳﺔ‬ ‫ﻋﻠﻰ‬ ً‫ﺍ‬‫ﺍﻋﺗﻣﺎﺩ‬ ‫ﺍﻟﻐﺎﻳﺔ‬ ‫ﻟﻬﺫﻩ‬ ً‫ﺎ‬‫ﻣﺳﺑﻘ‬ ‫ﻣﻌﺩﺓ‬ ‫ﺍﻟﺗﺧﺯﻳﻥ‬ ‫ﺃﻣﺎﻛﻥ‬ ‫ﺗﻛﻭﻥ‬ ‫ﺃﻥ‬
‫ﺍﻟﻣﻭﺍﺩ‬ ‫ﺔ‬
‫ﺿﻣﻧﻪ‬ ‫ﺳﺗﺧﺯﻥ‬ ‫ﺍﻟﺗﻲ‬ ‫ﺍﻟﻣﺷﻌﺔ‬
.
•
‫ﺑ‬ ‫ﺃﻳﺿﺎ‬ ‫ﻭﻳﺳﻣﺢ‬ ‫ﺑﺳﻬﻭﻟﺔ‬ ‫ﺇﻟﻳﻪ‬ ‫ﻟﻠﺩﺧﻭﻝ‬ ‫ﺃﺟﺯﺍء‬ ‫ﺇﻟﻰ‬ ً‫ﺎ‬‫ﻣﻘﺳﻣ‬ ‫ﺍﻟﻣﺧﺯﻥ‬ ‫ﻳﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﻳﺟﺏ‬
‫ﺳﻬﻭﻟﺔ‬
‫ﻣﺭﺍﻗﺑﺔ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺣﺩﺓ‬ ‫ﻋﻠﻰ‬ ‫ﻛﻝ‬
Ossama Anjak
•
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻧﻘﻝ‬ •
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻧﻘﻝ‬
•
‫ﻧﻘﻝ‬ ‫ﻳﺟﺏ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺑﺳﺭﻋﺔ‬ ‫ﺍﻟﺣﺎﻭﻳﺔ‬ ‫ﺇﻟﻰ‬
Ossama Anjak
•
‫ﺑﺎﻟﻣﺭﻳﺽ‬ ‫ﺍﻟﻌﻧﺎﻳﺔ‬ •
‫ﺑﺎﻟﻣﺭﻳﺽ‬ ‫ﺍﻟﻌﻧﺎﻳﺔ‬
•
‫ﺍﻹﺷ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﻳﺅﻣﻥ‬ ‫ﺧﺎﺹ‬ ‫ﺣﺎﺟﺯ‬ ‫ﺧﻠﻑ‬ ‫ﺍﻟﻭﻗﻭﻑ‬ ‫ﻳﺟﺏ‬ ‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﻣﻊ‬ ‫ﺍﻟﺗﺣﺩﺙ‬ ‫ﻋﻧﺩ‬
‫ﻌﺎﻉ‬
•
‫ﺇﻟﻰ‬ ‫ﺍﻟﺩﺧﻭﻝ‬ ‫ﻗﺑﻝ‬ ‫ﺍﻟﺣﺎﻭﻳﺔ‬ ‫ﺇﻟﻰ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﺇﻋﺎﺩﺓ‬ ‫ﻳﺟﺏ‬ ‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺷﺣﻥ‬ ‫ﺣﺎﻝ‬ ‫ﻓﻲ‬
‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﻏﺭﻓﺔ‬
Ossama Anjak

17. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 17
•
‫ﺑﺎﻟﻣﺭﻳﺽ‬ ‫ﺍﻟﻌﻧﺎﻳﺔ‬ •
‫ﺑﺎﻟﻣﺭﻳﺽ‬ ‫ﺍﻟﻌﻧﺎﻳﺔ‬
•
‫ﺗﺣﻣﻳﻝ‬ ‫ﻋﻘﺏ‬ ‫ﺍﻟﻐﺭﻓﺔ‬ ‫ﺑﺎﺏ‬ ‫ﻋﻠﻰ‬ ‫ﺗﺣﺫﺭ‬ ‫ﺇﺷﺎﺭﺓ‬ ‫ﻭﺿﻊ‬ ‫ﻳﺟﺏ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺩﺍﺧ‬
‫ﻝ‬
‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﺟﺳﻡ‬
Ossama Anjak
•
‫ﺑﺎﻟﻣﺭﻳﺽ‬ ‫ﺍﻟﻌﻧﺎﻳﺔ‬ •
‫ﺑﺎﻟﻣﺭﻳﺽ‬ ‫ﺍﻟﻌﻧﺎﻳﺔ‬
•
‫ﻧﺯﻉ‬ ‫ﻋﻧﺩ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺍﻟﺗﺄﻛﺩ‬ ‫ﻳﺟﺏ‬ ‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﻣﻥ‬
:
•
‫ﻋﺩﺩ‬ ‫ﻣﻥ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﻟﻌﺩﺩ‬ ً‫ﺎ‬‫ﻣﻁﺎﺑﻘ‬ ‫ﻳﻛﻭﻥ‬ ‫ﺃﻥ‬ ‫ﻭﻳﺟﺏ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺍﻟﻣﺯﺭﻭﻋﺔ‬
.
•
‫ﺍﻟﺣﺎﻭﻳﺔ‬ ‫ﺇﻟﻰ‬ ‫ﻣﺑﺎﺷﺭﺓ‬ ‫ﺇﻋﺎﺩﺗﻬﺎ‬ ‫ﻳﺟﺏ‬
.
•
‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﺃﺩﻭﺍﺕ‬ ‫ﺍﺳﺗﻌﻣﺎﻝ‬ ‫ﻳﺟﺏ‬
.
Ossama Anjak
‫ﺑﺎﻟﻣﺭﻳﺽ‬ ‫ﺍﻟﻌﻧﺎﻳﺔ‬
‫ﺑﺎﻟﻣﺭﻳﺽ‬ ‫ﺍﻟﻌﻧﺎﻳﺔ‬
•
‫ﻭﺇﻋﺎﺩ‬ ‫ﺍﻟﻣﻧﺎﺑﻊ‬ ‫ﻛﺎﻓﺔ‬ ‫ﻧﺯﻉ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺄﻛﺩ‬ ‫ﻳﺟﺏ‬ ‫ﺍﻟﻣﺭﻳﺽ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻧﺯﻉ‬ ‫ﻋﻧﺩ‬
‫ﺗﻬﺎ‬
‫ﻟﻠﺣﺎﻭﻳﺔ‬
.
•
‫ﻧﻘﻝ‬ ‫ﺑﻌﺩ‬ ‫ﻭﺍﻟﻣﺭﻳﺿﺔ‬ ‫ﻟﻠﻐﺭﻓﺔ‬ ‫ﺇﺷﻌﺎﻋﻲ‬ ‫ﻣﺳﺢ‬ ‫ﺇﺟﺭﺍء‬ ‫ﻳﺟﺏ‬
‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬
‫ﺍﻟﻐﺭﻓ‬ ‫ﻣﻥ‬
‫ﺔ‬
Ossama Anjak
•
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻑ‬ ‫ﺗﺻﻣﻳﻡ‬
•
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺣﺎﻗﻥ‬ ‫ﺟﻬﺎﺯ‬
•
‫ﺍﻹﻳﺭﻳﺩﻳﻭﻡ‬
HDR Iridium-192 Source
•
‫ﺍﻹﺷﻌﺎﻋﻲ‬ ‫ﺍﻟﻧﺷﺎﻁ‬
Activity = 370 GBq (10 Ci) source, but up to 15 Ci
•
‫ﻣﻥ‬ ‫ﻛﺑﺳﻭﻟﺔ‬ ‫ﺿﻣﻥ‬ ‫ﻣﻭﺿﻭﻉ‬
‫ﺍﻟﺳﺗﺎﻟﺱ‬
‫ﺳﺗﻳﻝ‬
stainless steel
‫ﻓﻭﻻﺫﻱ‬ ‫ﻛﺑﻝ‬ ‫ﺇﻟﻰ‬ ‫ﻣﻭﺻﻭﻟﺔ‬
‫ﻣﺭﻥ‬
)
‫ﻧﺎﺑﺿﻲ‬
.(
•
‫ﺍﻟﺗﻧﻐﺳﺗﻳﻥ‬ ‫ﻣﻥ‬ ‫ﺣﺎﻭﻳﺔ‬ ‫ﺿﻣﻥ‬ ‫ﺁﻣﻥ‬ ‫ﺑﺷﻛﻝ‬ ‫ﻣﺧﺯﻥ‬ ‫ﺍﻟﻣﺷﻊ‬ ‫ﺍﻟﻣﺻﺩﺭ‬
tungsten
‫ﺟﻬﺎﺯ‬ ‫ﺿﻣﻥ‬
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺣﺎﻗﻥ‬
.
•
‫ﺑﻌﺩ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻌﺩﻝ‬
5 cm
‫ﻣﻥ‬ ‫ﺃﻗﻝ‬ ‫ﺍﻟﺣﺎﻭﻳﺔ‬ ‫ﺳﻁﺢ‬ ‫ﻣﻥ‬
:
0.1mSv/h
‫ﻟﻠﻣﻭﺍﺻﻔﺔ‬ ً‫ﺎ‬‫ﻭﻓﻘ‬
)
IEC 60601-2-17
(
‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻧﻭﻉ‬ ‫ﺑﻬﺫﺍ‬ ‫ﺍﻟﺧﺎﺻﺔ‬
.
Ossama Anjak
15 Ci @ 30 cm = 670 mGy/h
•
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻑ‬ ‫ﺗﺻﻣﻳﻡ‬
Ossama Anjak
•
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻑ‬ ‫ﺗﺻﻣﻳﻡ‬
Ossama Anjak
0.3 m
Floor to ceiling
(typically 4.3 m)
1 m
0.5 m
1.7 m
Distances to be used in shielding calculations
0.3 m
Floor to ceiling
(typically 4.3 m)
1 m
0.5 m
1.7 m
Floor to ceiling
(typically 4.3 m)
Brachytherapy
Room
Distances to be used in shielding calculations

18. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 18
•
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻏﺭﻑ‬ ‫ﺗﺻﻣﻳﻡ‬
•
‫ﺍﻟﻣﺩﺧﻝ‬
Entrance
:
•
‫ﻣﺗﺎﻫﺔ‬
Maze
.
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻭﻗﺎﻳﺔ‬ ‫ﻳﺅﻣﻥ‬ ‫ﺑﺎﺏ‬
Protection Door
.
Ossama Anjak
•
‫ﺍﻻﺭﻳﺩﻳﻭﻡ‬ ‫ﻏﺭﺱ‬
LDR Iridium Implant
•
‫ﺍﻟﻣﻭﺿﻌﻲ‬ ‫ﺍﻟﺗﺩﺭﻳﻊ‬ ‫ﺍﺳﺗﺧﺩﺍﻡ‬ ‫ﻳﻣﻛﻥ‬
Ossama Anjak
•
‫ﻟﻠﺳﻼﻣﺔ‬ ‫ﺃﺧﺭﻯ‬ ‫ﻣﺗﻁﻠﺑﺎﺕ‬
Other Safety Features
•
‫ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﻏﺮﻓﺔ‬ ‫ﺑﺎﺏ‬ ‫ﻳﻜﻮﻥ‬ ‫ﺃﻥ‬ ‫ﻳﺠﺐ‬
)
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺤﺎﻗﻦ‬ ‫ﻏﺮﻓﺔ‬
(
‫ﻣﺮﺗﺒﻂ‬
Door interlocked
‫ﻣﻊ‬
‫ﺍﻟﻤﺸﻊ‬ ‫ﺍﻟﻤﺼﺪﺭ‬ ‫ﺣﺮﻛﺔ‬
•
‫ﻣﻔﺘﻮﺡ‬ ‫ﺍﻟﺒﺎﺏ‬ ‫ﻛﺎﻥ‬ ‫ﺣﺎﻝ‬ ‫ﻓﻲ‬ ‫ﺍﻟﻤﺸﻊ‬ ‫ﺍﻟﻤﺼﺪﺭ‬ ‫ﻳﺘﺤﺮﻙ‬ ‫ﻻ‬
•
‫ﻣﻔﺎﺟﺊ‬ ‫ﺑﺸﻜﻞ‬ ‫ﺍﻟﺒﺎﺏ‬ ‫ﻓﺘﺢ‬ ‫ﻋﻨﺪ‬ ‫ﺍﻟﺘﺨﺰﻳﻦ‬ ‫ﻣﻮﺿﻊ‬ ‫ﺇﻟﻰ‬ ‫ﺍﻟﻤﺸﻊ‬ ‫ﺍﻟﻤﺼﺪﺭ‬ ‫ﻳﻌﻮﺩ‬
.
•
ً‫ﺎ‬‫ﻳﺪﻭﻳ‬ ‫ﻟﻠﻔﺘﺢ‬ ‫ﻗﺎﺑﻞ‬ ‫ﺍﻟﺒﺎﺏ‬ ‫ﻳﻜﻮﻥ‬ ‫ﺃﻥ‬ ‫ﻳﺠﺐ‬
.
•
‫ﺗﻠﻔﺰﻳﻮﻧﻴﺔ‬ ‫ﻛﺎﻣﻴﺮﺍ‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﻏﺮﻓﺔ‬ ‫ﻓﻲ‬ ‫ﻳﺘﻮﻓﺮ‬ ‫ﺃﻥ‬ ‫ﻳﺠﺐ‬
CCTV
‫ﺍﻟﻤﺸﻊ‬ ‫ﻭﺍﻟﻤﺼﺪﺭ‬ ‫ﺍﻟﻤﺮﻳﺾ‬ ‫ﻟﻤﺮﺍﻗﺒﺔ‬
.
•
‫ﻟ‬ ‫ﺍﻟﻤﺸﻊ‬ ‫ﺍﻟﻤﺼﺪﺭ‬ ‫ﺗﻌﺮﺽ‬ ‫ﺩﻭﻥ‬ ‫ﻟﻠﺤﻴﻠﻮﻟﺔ‬ ‫ﻭﺁﻣﺎﻥ‬ ‫ﻣﺮﺍﻗﺒﺔ‬ ‫ﻧﻈﺎﻡ‬ ‫ﺍﻟﻐﺮﻓﺔ‬ ‫ﻓﻲ‬ ‫ﻳﺘﻮﻓﺮ‬ ‫ﺃﻥ‬ ‫ﻳﺠﺐ‬
‫ﻸﻋﻤﺎﻝ‬
‫ﺍﻹﺭﻫﺎﺑﻴﺔ‬
)
‫ﺍﻟﻤﺸﻊ‬ ‫ﺍﻟﻤﺼﺪﺭ‬ ‫ﺳﺮﻗﺔ‬
.(
•
‫ﺗﺤﺬﻳﺮ‬ ‫ﺿﻮء‬ ‫ﻳﺘﻮﻓﺮ‬ ‫ﺃﻥ‬ ‫ﻳﺠﺐ‬
Warning lights
‫ﺍﻟﻤﺸﻊ‬ ‫ﺍﻟﻤﺼﺪﺭ‬ ‫ﺣﺎﻟﺔ‬ ‫ﻳﺒﻴﻦ‬ ‫ﺍﻟﻐﺮﻓﺔ‬ ‫ﺑﺎﺏ‬ ‫ﻋﻠﻰ‬
)
‫ﺗﺸﻌﻴﻊ‬
،
‫ﺁﻣﺎﻥ‬
(
Ossama Anjak
•
‫ﺍﻵﻟﻲ‬ ‫ﺍﻟﺤﺎﻗﻦ‬ ‫ﻏﺮﻓﺔ‬
Ir-192 HDR
Ossama Anjak
‫ﻣﻥ‬ ‫ﻁﺑﻘﺔ‬ ‫ﻣﻊ‬ ‫ﺑﺎﺏ‬
‫ﺍﻟﺭﺻﺎﺹ‬
‫ﺍﻟﻣﺗﺎﻫﺔ‬
‫ﻛﺎﺷﻑ‬
‫ﺇﺷﻌﺎﻋﻲ‬
‫ﻛﺎﻣﻳﺭﺍ‬
CCTV
‫ﻟﻠﻣﺭﺍﻗﺑﺔ‬
HDR
unit
‫ﺍﻟﻣﺭﻳﺽ‬
•
‫ﻟﻠﺳﻼﻣﺔ‬ ‫ﺃﺧﺭﻯ‬ ‫ﻣﺗﻁﻠﺑﺎﺕ‬
Other Safety Features
•
‫ﻣﺣﻣﻭﻝ‬ ‫ﺇﺷﻌﺎﻋﻳﺔ‬ ‫ﻣﺭﺍﻗﺑﺔ‬ ‫ﺟﻬﺎﺯ‬ ‫ﺗﻭﻓﺭ‬
)
‫ﺇﺷﻌﺎﻋﻲ‬ ‫ﻣﺳﺢ‬ ‫ﺟﻬﺎﺯ‬
.(
•
‫ﻣﺳﺗﻘﻝ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻌﺩﻝ‬ ‫ﻗﻳﺎﺱ‬ ‫ﺟﻬﺎﺯ‬
Independent dose rate meter
‫ﺑﺑﻁﺎﺭﻳﺔ‬ ‫ﻭﻣﺯﻭﺩ‬
•
‫ﺍﻟﺿﺭﻭﺭﺓ‬ ‫ﻋﻧﺩ‬ ‫ﺍﻟﻌﻣﻝ‬ ‫ﺇﻳﻘﺎﻑ‬ ‫ﺃﺟﻝ‬ ‫ﻣﻥ‬ ‫ﻛﻬﺭﺑﺎﺋﻲ‬ ‫ﻗﺎﻁﻊ‬
Emergency off
•
‫ﺍﻟﻁﻭﺍﺭﺉ‬ ‫ﻟﺣﺎﻟﺔ‬ ‫ﺧﺎﺻﺔ‬ ‫ﺣﺎﻭﻳﺔ‬
Emergency container
‫ﻗﺎﻁﻌﺔ‬ ‫ﻣﻊ‬
‫ﺃﺳﻼﻙ‬
cutters
.
Ossama Anjak Ossama Anjak
‫ﺍﻟﺩﺍﺋﻡ‬ ‫ﺍﻟﻐﺭﺱ‬
Permanent Seed Implants
‫ﺍﻟﺩﺍﺋﻡ‬ ‫ﺍﻟﻐﺭﺱ‬
Permanent Seed Implants

19. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 19
•
‫ﺍﻟﺩﺍﺋﻡ‬ ‫ﺍﻟﻐﺭﺱ‬
Permanent Seed Implants
•
‫ﺍﻟﺑﺭﻭﺳﺗﺎﺕ‬ ‫ﺳﺭﻁﺎﻥ‬ ‫ﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻳﺳﺗﺧﺩﻡ‬
prostate cancer
•
‫ﻗﺻﻳﺭ‬ ‫ﻧﺻﻑ‬ ‫ﻭﻋﻣﺭ‬ ‫ﻣﻧﺧﻔﺿﺔ‬ ‫ﺍﻟﻔﻭﺗﻭﻧﺎﺕ‬ ‫ﻁﺎﻗﺔ‬
:
•
life
-
day half
59
keV photons,
28
I,
125
•
life
-
day half
17
keV photons,
21
Pd,
103
Ossama Anjak
•
‫ﺍﻟﺩﺍﺋﻡ‬ ‫ﺍﻟﻐﺭﺱ‬
–
‫ﻟﺟﺭﻋﺔ‬ ‫ﻣﻌﺩﻝ‬
•
‫د‬ ‫ﺎﻟ‬ ‫اﻟﻐرس‬ ‫ﻋﻘب‬ ‫رض‬ ‫اﻟ‬ ‫ﻋ‬ ‫ة‬
‫ر‬‫ﺎد‬ ‫اﻟ‬ ‫ﻋﺔ‬
‫ر‬ ‫اﻟ‬ ‫ﻣﻌدل‬
-
125
Leeds
(
implanted patient
I)
125
.
• patient surface 2-67 Sv/h
• @ 1 metre 0 - 1.6 Sv/h
•
‫ذور‬ ‫اﻟ‬ ‫ﻣ‬ ‫ﻋﺔ‬
‫ر‬ ‫اﻟ‬ ‫ﻣﻌدل‬
Dose rate from seed
:
• On contact 100 Sv/h
• @ 1 cm 5 mSv/h
• @ 1 m 5 Sv/h
•
‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬ ‫ﺔ‬ ‫ﻗﺎ‬ ‫اﻟ‬ ‫أﺟﻞ‬ ‫ﻣ‬
:
•
‫ﻔض‬ ‫ﻣ‬ ‫ﻊ‬ ‫ﺗدر‬ ‫إﻟﻰ‬ ‫ﺎج‬ ‫ﻧ‬
•
‫رﺻﺎﺻﻲ‬ ‫دوق‬ ‫ﺻ‬
lead pig
‫ﻌﺔ‬ ‫اﻟ‬ ‫ﺎدر‬ ‫اﻟ‬ ‫ز‬ ‫ﺗ‬ ‫أﺟﻞ‬ ‫ﻣ‬
•
‫ﻌﺔ‬ ‫اﻟ‬ ‫ﺎدر‬ ‫اﻟ‬‫و‬ ‫ض‬ ‫ر‬ ‫اﻟ‬ ‫ﻋ‬ ‫ﻟﺔ‬ ‫ﻣﻘ‬ ‫ﺎﻓﺔ‬ ‫ﻣ‬ ‫ﻋﻠﻰ‬ ‫ﺔ‬ ‫ﺎﻓ‬ ‫اﻟ‬
.
•
‫ﻊ‬ ‫ﺗدر‬ ‫إﻟﻰ‬ ‫اﻟﻐرس‬ ‫ﻏرﻓﺔ‬ ‫ﺎج‬ ‫ﺗ‬ ‫ﻻ‬
.
Ossama Anjak
•
‫ﺍﻟﺩﺍﺋﻡ‬ ‫ﺍﻟﻐﺭﺱ‬
–
‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬
Ossama Anjak Ossama Anjak
XOFT – Electronic
Brachytherapy
XOFT – Electronic
Brachytherapy
• XOFT – Electronic Brachytherapy
Ossama Anjak
•
XOFT – Electronic Brachytherapy
•
‫ﻟﻠﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺷﺎﺑﻪ‬
‫ﺑﺎﻹﻳﺭﻳﺩﻳﻭﻡ‬
-
192
•
‫ﺍﻟﻁﺎﻗﺔ‬ ‫ﻣﻧﺧﻔﺿﺔ‬ ‫ﺳﻳﻧﻳﺔ‬ ‫ﺃﺷﻌﺔ‬
)
‫ﻧﺎﻋﻣﺔ‬
Soft X-Ray
(
‫ﻣﻧﺧﻔﺽ‬ ‫ﺗﺩﺭﻳﻊ‬ ‫ﺗﺗﻁﻠﺏ‬
.
•
‫ﺑﺎﻟﻭﻥ‬ ‫ﻣﻁﺑﻖ‬ ‫ﺇﻟﻰ‬ ‫ﺗﺣﺗﺎﺝ‬
.
•
‫ﺍﻟﺟﺭﻋﺔ‬
34Gy
‫ﻋﻠﻰ‬
10
‫ﺟﻠﺳﺎﺕ‬
•
‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬ ‫ﺔ‬ ‫ﻗﺎ‬ ‫اﻟ‬ ‫أﺟﻞ‬ ‫ﻣ‬
:
•
‫ﻌﺔ‬ ‫اﻟ‬ ‫ﺎدر‬ ‫اﻟ‬‫و‬ ‫ض‬ ‫ر‬ ‫اﻟ‬ ‫ﻋ‬ ‫ﻟﺔ‬ ‫ﻣﻘ‬ ‫ﺎﻓﺔ‬ ‫ﻣ‬ ‫ﻋﻠﻰ‬ ‫ﺔ‬ ‫ﺎﻓ‬ ‫اﻟ‬
•
‫ﻊ‬ ‫ﺗدر‬ ‫إﻟﻰ‬ ‫ﻏرﻓﺔ‬ ‫ﺎج‬ ‫ﺗ‬ ‫ﻻ‬
.
Ossama Anjak

20. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 20
• XOFT – Electronic Brachytherapy
Ossama Anjak
• XOFT – Electronic Brachytherapy
Ossama Anjak
Ossama Anjak
‫ﻓﻲ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺻﻭﻝ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
)
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
(
‫ﻓﻲ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺻﻭﻝ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
)
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
(
‫ﻓﻲ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺻﻭﻝ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
IAEA Safety Report
Series 17
“Lessons learned from
accidental exposures
in radiotherapy”
‫ﻓﻲ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺻﻭﻝ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
•
‫ﺍﻟﻤﺒﺎﺷﺮ‬ ‫ﻟﺴﺒﺒﻬﺎ‬ ً‫ﺎ‬‫ﺗﺒﻌ‬ ‫ﺍﻹﺷﻌﺎﻋﻴﺔ‬ ‫ﺍﻟﺤﻮﺍﺩﺙ‬ ‫ﺗﺼﻨﻴﻒ‬ ‫ﺟﺮﻯ‬
:
•
‫ﺍﻟﺘﺠﻬﻴﺰﺍﺕ‬ ‫ﺗﺼﻤﻴﻢ‬
Equipment design
•
‫ﺍﻹﺷﻌﺎﻋﻴﺔ‬ ‫ﺍﻟﺤﺰﻡ‬ ‫ﻣﻌﺎﻳﺮﺓ‬
Calibration of beams
.
•
‫ﺍﻟﺼﻴﺎﻧﺔ‬ ‫ﺑﺈﺟﺮﺍءﺍﺕ‬ ‫ﺧﻠﻞ‬
Maintenance
.
•
‫ﺍﻟﺠﺮﻋﺔ‬ ‫ﻭﺣﺴﺎﺏ‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺗﺨﻄﻴﻂ‬ ‫ﻧﻈﻢ‬ ‫ﻓﻲ‬ ‫ﺧﻠﻞ‬
Treatment planning and dose
calculation
.
•
‫ﺍﻟﻤﺤﺎﻛﺎﺓ‬
Simulation
.
•
‫ﺍﻟﻌﻼﺟﻴﺔ‬ ‫ﺍﻟﺠﺮﻋﺔ‬ ‫ﻭﺇﻋﻄﺎء‬ ‫ﺍﻟﻤﺮﻳﺾ‬ ‫ﻭﺿﻌﻴﺔ‬
Treatment set-up and deliver
‫ﻓﻲ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺻﻭﻝ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
• Accidents in EBT, IAEA, SRS No. 17 Vienna 2000
Category No of cases %
‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺗﺻﻣﻳﻡ‬Equipment
design
3 7
Calibration ‫ﺍﻟﻣﻌﺎﻳﺭﺓ‬ 14 30
Maintenance ‫ﺍﻟﺼﻴﺎﻧﺔ‬ 3 7
Planning ‫ﺍﻟﺘﺨﻄﻴﻂ‬ 13 28
Simulation ‫ﺍﻟﻤﺤﺎﻛﺎﺓ‬ 4 9
Set-up ‫ﺍﻟﻤﺮﻳﺾ‬ ‫ﺗﻬﻴﺌﺔ‬ 9 20
Total; 46

21. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 21
‫ﻓﻲ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺻﻭﻝ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
• Accidents in Brachytherapy,, IAEA, SRS No. 17 Vienna 2000
Category No of cases %
‫ﺍﻟﺘﺠﻬﻴﺰﺍﺕ‬ ‫ﺗﺼﻤﻴﻢ‬
Equipment design 5 15
Calibration ‫ﺍﻟﻤﻌﺎﻳﺮﺓ‬ 5 15
Preparation ‫ﺍﻟﺘﺤﻀﻴﺮ‬ 6 18
Planning and dose calculation ‫ﺍﻟﺠﺮﻋﺔ‬ ‫ﺣﺴﺎﺏ‬ 11 34
Source order and delivery ‫ﺍﻟﻤﺼﺎﺩﺭ‬ ‫ﻁﻠﺐ‬ 3 9
Source Removal ‫ﺍﻟﻤﺼﺎﺩﺭ‬ ‫ﻧﺰﻉ‬ 3 9
Total; 33
‫ﻓﻲ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺻﻭﻝ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
October 2001
Dec 1, 2001
Dose 25 Gy 8 MeV + ?
June 4, 01
Scar, future necrosis
White border
‫ﻓﻲ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺻﻭﻝ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
Dose 5 Gy 8 MeV+ ?
Dec 1, 01
October 2001
June 4, 01
‫ﻓﻲ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﺣﺻﻭﻝ‬ ‫ﺇﻣﻛﺎﻧﻳﺔ‬
‫ﺍﻟﻁﺑﻲ‬ ‫ﺍﻟﺗﻌﺭﺽ‬
•
‫ﻭ‬ ‫ﺍﻟﺫﺭﻳﺔ‬ ‫ﻟﻠﻁﺎﻗﺔ‬ ‫ﺍﻟﺩﻭﻟﻳﺔ‬ ‫ﻟﻠﻭﻛﺎﻟﺔ‬ ‫ﺧﺑﺭﺍء‬ ‫ﻗﺑﻝ‬ ‫ﻣﻥ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﻟﻠﺟﺭﻋﺔ‬ ‫ﻗﻳﺎﺱ‬ ‫ﺟﺭﻯ‬
‫ﻓﻲ‬
‫ﻟﻠﺣﺎﺩﺙ‬ ‫ﻣﻣﺎﺛﻠﺔ‬ ‫ﺗﺷﻐﻳﻝ‬ ‫ﻅﺭﻭﻑ‬
‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻌﺩﻝ‬
(Gy/150MU) ‫ﻁﺭﻳﻘﺔ‬
‫ﺍﻟﻘﻳﺎﺱ‬
127 ± 4
•
‫ﺣﺟﻳﺭﺓ‬
‫ﺗﺄﻳﻥ‬
Plane parallel ionization
chamber (Roos)
122 ± 4 •
Alanine
115 ± 3 •
GAF chromic film
‫ﺍﻟﻌﺎﺩﻳﺔ‬ ‫ﺗﺷﻐﻳﻝ‬ ‫ﻅﺭﻭﻑ‬ ‫ﻓﻲ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬
2‐3 Gy
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬ ‫ﻭﻗﻭﻉ‬ ‫ﻣﻥ‬ ‫ﻭﺍﻟﺗﻘﻠﻳﻝ‬ ‫ﺍﻷﺧﻁﺎء‬ ‫ﺗﻼﻓﻲ‬
•
‫ﻭﺟ‬ ‫ﺃﺩﺍﻫﺎ‬ ‫ﺩﻗﺔ‬ ‫ﻣﻥ‬ ‫ﻭﺍﻟﺗﺄﻛﺩ‬ ‫ﺍﻟﻘﺑﻭﻝ‬ ‫ﺍﺧﺗﺑﺎﺭﺍﺕ‬ ‫ﻭﺇﺟﺭﺍء‬ ‫ﺟﻳﺩ‬ ‫ﺑﺷﻛﻝ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺍﺳﺗﻼﻡ‬
‫ﺎﻫﺯﻳﺗﻬﺎ‬
‫ﻟﻠﻌﻣﻝ‬
.
•
‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﻭﺍﻟﺣﺯﻡ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎﺩﺭ‬ ‫ﺍﻟﺩﻭﺭﻳﺔ‬ ‫ﺍﻟﻣﻌﺎﻳﺭﺍﺕ‬ ‫ﺇﺟﺭﺍء‬
•
‫ﺍﻟﻣﺳﺗﺧﺩﻣﺔ‬ ‫ﺍﻹﺷﻌﺎﻋﻳﺔ‬ ‫ﺍﻟﺣﺯﻣﺔ‬ ‫ﻭﻁﺎﻗﺔ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺄﻛﺩ‬ ‫ﺑﻌﺩ‬ ‫ﺇﻻ‬ ‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺇﺟﺭﺍء‬ ‫ﻋﺩﻡ‬
‫ﻓﻲ‬
‫ﺍﻟﻣﻌﺎﻟﺟﺔ‬
.
•
‫ﻣﺷﻌﺔ‬ ‫ﻣﺻﺎﺩﺭ‬ ‫ﻋﻠﻰ‬ ‫ﺗﺣﺗﻭﻱ‬ ‫ﺍﻟﺗﻲ‬ ‫ﺍﻟﺗﺟﻬﻳﺯﺍﺕ‬ ‫ﺃﻭ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺧﻠﺹ‬
.
•
‫ﺧﻁﺔ‬ ‫ﺍﻋﺗﻣﺎﺩ‬
)
‫ﺑﺭﺗﻭﻛﻭﻝ‬
(
‫ﺍﻟﺩﻭﻟﻳﺔ‬ ‫ﺍﻟﻬﻳﺋﺎﺕ‬ ‫ﻗﺑﻝ‬ ‫ﻣﻥ‬ ‫ﻣﻌﺗﻣﺩ‬ ‫ﻣﻌﺎﻳﺭﺓ‬
•
‫ﻣﺳﺗﻘﻠﺔ‬ ‫ﺟﻬﺔ‬ ‫ﻗﺑﻝ‬ ‫ﻣﻥ‬ ‫ﺍﻟﻣﺷﻌﺔ‬ ‫ﺍﻟﻣﺻﺎﺩﺭ‬ ‫ﻭﻣﻌﺎﻳﺭﺓ‬ ‫ﺍﻟﻘﻳﺎﺳﺎﺕ‬ ‫ﺩﻗﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺣﻘﻖ‬
.
‫ﺧﺎﻁﺋﺔ؟‬ ‫ﻧﺗﺎﺋﺞ‬ ‫ﻳﻌﻁﻲ‬ ‫ﺃﻥ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻟﻣﻘﻳﺎﺱ‬ ‫ﻳﻣﻛﻥ‬ ‫ﻛﻳﻑ‬
•
‫ﺍﻟﻘﻳﺎﺱ‬ ‫ﺑﻧﻅﺎﻡ‬ ‫ﺍﻟﻣﺭﺗﺑﻁﺔ‬ ‫ﺍﻟﺣﻭﺍﺩﺙ‬
:
(1
‫ﺍﻟﻣﺭﺟﻌﻲ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻟﻣﻘﻳﺎﺱ‬ ‫ﺍﻟﻣﻌﺎﻳﺭﺓ‬ ‫ﻟﻣﻌﺎﻣﻝ‬ ‫ﺻﺣﻳﺢ‬ ‫ﻏﻳﺭ‬ ‫ﺍﺳﺗﻌﻣﺎﻝ‬
Reference dosimeter
(2
‫ﺧﺎﻁﺊ‬ ‫ﺑﺷﻛﻝ‬ ‫ﺛﺎﻧﻭﻱ‬ ‫ﻣﻌﻳﺎﺭ‬ ‫ﻣﻊ‬ ‫ﺩﺍﺧﻠﻳﺔ‬ ‫ﻣﻘﺎﺭﻧﺔ‬
.
(3
‫ﺧﺎﻁﺊ‬ ‫ﺑﺷﻛﻝ‬ ‫ﺍﻟﺟﺭﻋﺔ‬ ‫ﻣﻘﻳﺎﺱ‬ ‫ﺍﺳﺗﻌﻣﺎﻝ‬
.
•
‫ﺧﺎﻁﺊ‬ ‫ﺑﺷﻛﻝ‬ ‫ﺍﻟﻣﻘﻳﺎﺱ‬ ‫ﻣﻛﺗﺑﺔ‬ ‫ﺿﻣﻥ‬ ‫ﺍﻟﻣﻌﺎﻳﺭﺓ‬ ‫ﻣﻌﺎﻣﻝ‬ ‫ﺗﺧﺯﻳﻥ‬
•
‫ﺍﻟﻣﻘﻳﺎﺱ‬ ‫ﻣﻛﺗﺑﺔ‬ ‫ﻣﻥ‬ ‫ﺍﻟﺗﺄﻳﻥ‬ ‫ﻟﺣﺟﻳﺭﺓ‬ ‫ﺧﺎﻁﺊ‬ ‫ﺍﺧﺗﻳﺎﺭ‬
(4
‫ﺍﻟﻣﻌﺎﻳﺭﺓ‬ ‫ﺇﺟﺭﺍء‬ ‫ﻓﻲ‬ ‫ﺍﻟﻌﻣﻠﻳﺔ‬ ‫ﺍﻟﺧﺑﺭﺓ‬ ‫ﻗﻠﺔ‬

22. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 22
‫ﻼﺻﺔ‬ ‫اﻟ‬

‫اءات‬
‫ر‬‫إﺟ‬ ‫ﺗ‬ ‫أﺟﻞ‬ ‫ﻣ‬
‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬ ‫ﺔ‬ ‫ﻗﺎ‬ ‫اﻟ‬
:

‫ﻏﻪ‬ ‫ﺑﻠ‬ ‫ﺣد‬ ‫أدﻧﻰ‬ ‫إﻟﻰ‬ ‫اﻹﺷﻌﺎﻋﻲ‬ ‫ﻌرض‬ ‫اﻟ‬ ‫ض‬ ‫ﻔ‬ ‫ﺗ‬ ‫ب‬
ALARA
.

‫ﻲ‬ ‫ﻬ‬ ‫اﻟ‬ ‫ﻌرض‬ ‫اﻟ‬ ‫ﺔ‬ ‫اﻗ‬
‫ر‬ ‫د‬ ‫ﻘ‬ ‫اﻟ‬ ‫ب‬
)
‫ﺔ‬ ‫اﻟﻔرد‬ ‫ﻋﺔ‬
‫ر‬ ‫اﻟ‬ ‫س‬ ‫ﻣﻘﺎﯾ‬ ‫دام‬ ‫اﺳ‬
.(

‫ﻟذﻟ‬ ‫ﺔ‬ ‫ﻧ‬ ‫اﻟﻔﺎﺋدة‬ ‫ﻣ‬ ‫ﻘ‬ ‫اﻟ‬ ‫دون‬ ‫ﺔ‬ ‫اﻟ‬ ‫ر‬ ‫اﻟ‬ ‫ار‬
‫ر‬ ‫ﺗ‬ ‫ﻋدم‬
.

‫ﺔ‬ ‫ﻋﺎﻟ‬ ‫دة‬ ‫ﺟ‬ ‫ذات‬ ‫ﺔ‬ ‫إﺷﻌﺎﻋ‬ ‫ة‬
‫ر‬ ‫ﺻ‬ ‫ﻋﻠﻰ‬ ‫ل‬ ‫اﻟ‬ ‫إﻟﻰ‬ ‫ﺗؤد‬ ‫ر‬ ‫ﺗ‬ ‫اءات‬
‫ر‬‫إﺟ‬ ‫ﺎد‬ ‫اﻋ‬
.

‫دﻣﺔ‬ ‫اﻟ‬ ‫ات‬
‫ز‬ ‫ﻬ‬ ‫اﻟ‬ ‫دة‬ ‫ﺟ‬ ‫ﻣ‬ ‫ﻘ‬ ‫اﻟ‬
)
‫ﺔ‬ ‫اﻟدور‬ ‫دة‬ ‫اﻟ‬ ‫ط‬ ‫ﺿ‬ ‫اءات‬
‫ر‬‫إﺟ‬ ‫ﺗ‬
.(

‫ات‬
‫ز‬ ‫ﻬ‬ ‫ﻟﻠ‬ ‫ﻞ‬ ‫اﻷﻣ‬ ‫دام‬ ‫اﺳ‬ ‫ﻋﻠﻰ‬ ‫اﻟﻌﺎﻣﻠ‬ ‫ب‬ ‫در‬ ‫ﺑ‬ ‫ﺎم‬ ‫اﻻﻫ‬
.

‫ﺔ‬ ‫اﻹﺷﻌﺎﻋ‬ ‫ﺔ‬ ‫ﻗﺎ‬ ‫اﻟ‬ ‫س‬ ‫ﻣﻼ‬ ‫ﺎل‬ ‫ﻌ‬ ‫ﺎﺳ‬ ‫ﺎم‬ ‫اﻻﻫ‬
.
Ossama Anjak
oanjak@yahoo.com
‫أﻧ‬ ‫أﺳﺎﻣﺔ‬
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‫اﻷﻣﺎن‬‫و‬ ‫ﺔ‬ ‫ﻗﺎ‬ ‫اﻟ‬ ‫ﻗ‬
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•
‫ﺍﻟﻣﺭﺍﺟﻊ‬
:
• International Commission on Radiation Units and Measurements. Determination of dose equivalent
resulting from external sources, ICRU report 39. Bethesda: ICRU; 1985.
• International Commission on Radiation Units and Measurements,. Prescribing, recording, and reporting
interstitial brachytherapy. ICRU 55; Bethesda1993.
• Nath R, Anderson LL, Luxton G, Weaver KA, Williamson JF, Meigooni AS. Dosimetry of interstitial
brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group No 43:
American Association of Physicists in Medicine. Med Phys. 1995;22:209–34
• Smith RP, Jacobs BL, Beriwal S, Gibbons EP, Benoit RM. Description and predictive factors of urinary
toxicity following prostate brachytherapy using 131Cs. Brachytherapy. 2009;8:172–3
Ossama Anjak
•
‫ﺍﻟﻣﺭﺍﺟﻊ‬
:
• IAEA: Radiation Oncology Physics: A Handbook for Teachers and Students,
IAEA publication (ISBN 92-0-107304-6) IAEA Vienna 2005
• Johns H E and Cunningham J R: The Physics of Radiology, 4th ed.
(Springfield: C Thomas) 1983
• Khan F M.: The Physics of Radiation Therapy, 4th edition (Williams &
Wilkins, Baltimore)
• Williams J R and Thwaites D I: Radiotherapy Physics in Practice (Oxford:
Oxford University Press) 1993
Ossama Anjak

23. Ossama Anjak, oanjak@yahoo.com 12/11/2018
Radiotherapy and radiation protection 23
‫أﻧ‬ ‫أﺳﺎﻣﺔ‬
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‫اﻷﻣﺎن‬‫و‬ ‫ﺔ‬ ‫ﻗﺎ‬ ‫اﻟ‬ ‫ﻗ‬
133 12/11/2018