Radiation Oncology, Chulolongkorn University : ¡ÒÃãÊèáÃèã¹â¾Ã§Á´ÅÙ¡áÅÐªèÍ§¤ÅÍ´

Radiation Oncology Chulolongkorn University

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¶éÒà»ç¹¡ÒÃÊÍ´ãÊèáÃèà¢éÒä»â´ÂµÃ§ËÃ×ÍÊÍ´ãÊèà¤Ã×èÍ§Á×Í·ÕèÁÕáÃèºÃÃ¨ØÍÂÙè¡èÍ¹áÅéÇàÃÕÂ¡ÇèÒ
preloading technique «Öè§»Ñ¨¨ØºÑ¹¹ÕéäÁèà»ç¹·Õè¹ÔÂÁà¹×èÍ§¨Ò¡á¾·ÂìáÅÐºØ¤¤ÅÒ¡ÃÍ×è¹ æ ä´éÃÑºÃÑ§ÊÕâ´ÂµÃ§
µèÍÁÒä´éÁÕ¡ÒÃ¾Ñ²¹Òâ´ÂãÊèà¤Ã×èÍ§Á×Íà¢éÒäÇéã¹ÍÇÑÂÇÐ·Õèà»ç¹ÁÐàÃç§ËÃ×Íã¹¡éÍ¹ÁÐàÃç§ â´Âà¤Ã×èÍ§Á×Í¨ÐÁÕ
ÃÙ¡ÅÇ§ ÀÒÂËÅÑ§·ÕèÁÕ¡ÒÃµÃÇ¨ÊÍºµÓáË¹è§¶Ù¡µéÍ§áÅéÇ¨Ö§ÊÍ´ãÊèáÃèà¢éÒä»ã¹ÃÙ¡ÅÇ§¢Í§à¤Ã×èÍ§Á×ÍÍÕ¡·Õ
àÃÕÂ¡ÇÔ¸Õ¡ÒÃ¹ÕéÇèÒ afterloading technique «Öè§ÁÕ»ÃÐâÂª¹ìã¹á§èÅ´ radiation hazard ¶éÒà»ç¹¡ÒÃÊÍ´ãÊèáÃè
´éÇÂÁ×Í¨ÐàÃÕÂ¡ manual afterloading technique áµè¶éÒà»ç¹¡ÒÃÊÍ´ãÊèáÃè´éÇÂà¤Ã×èÍ§Á×ÍÍÔàÅ¤·ÃÍ¹Ô¤¤Çº¤ØÁ
¡ÒÃãÊè¨Ò¡ÀÒÂ¹Í¡ËéÍ§àÃÕÂ¡ÇèÒ remote control afterloading technique
ÇÔ¸Õ¡ÒÃ¹Õéà»ç¹¡ÒÃãËé»ÃÔÁÒ³ÃÑ§ÊÕ¢¹Ò´ÊÙ§·ÕèµÑÇ»Ò¡Á´ÅÙ¡, â¾Ã§Á´ÅÙ¡ ªèÍ§¤ÅÍ´ÊèÇ¹º¹ áÅÐ
paracervical tissue â´Â»ÃÔÁÒ³ÃÑ§ÊÕ¨ÐÅ´Å§ÍÂèÒ§ÃÇ´àÃçÇµèÍà¹×éÍàÂ×èÍ·ÕèÍÂÙèËèÒ§ÍÍ¡ä»¨Ò¡µé¹¡Óà¹Ô´¢Í§ÃÑ§ÊÕ
à·¤¹Ô¤·Õèãªéã¹¡ÒÃãÊèáÃèÊÓËÃÑº¼Ùé»èÇÂÁÐàÃç§»Ò¡Á´ÅÙ¡ ÁÕËÅÒÂÊ¶ÒºÑ¹ àªè¹
- The stockholm technique
- The Paris technique
- The Manchester technique
- The Fletcher technique
ÊÓËÃÑºÊÒ¢ÒÃÑ§ÊÕÃÑ¡ÉÒ ÀÒ¤ÇÔªÒÃÑ§ÊÕÇÔ·ÂÒ ¤³Ðá¾·ÂÈÒÊµÃì âÃ§¾ÂÒºÒÅ¨ØÌÒÅ§¡Ã³ì ·Õè¼èÒ¹ÁÒ
¹ÔÂÁãªé The Manchester áÅÐ The Fletcher technique «Öè§à»ç¹ preloading áÅÐ manual after loading system
µÒÁÅÓ´Ñº â´ÂãªéáÃèàÃà´ÕÂÁ-226 à»ç¹áËÅè§¾ÅÑ§§Ò¹ÃÑ§ÊÕ ÊÓËÃÑº»ÃÔÁÒ³¢Í§áÃèàÃà´ÕÂÁ-226 ·Õèãªéà»ç¹
Standard loading 15-10-10 mg Ra in Tandem áÅÐ 20 mg Ra in each standard vagina ovoids51-53 â´Â¨ÐãËé
»ÃÔÁÒ³ÃÑ§ÊÕ·Õè Point A ÃÐËÇèÒ§ 40-60 cGy µèÍªÑèÇâÁ§ «Öè§¶×ÍÇèÒà»ç¹ standard low dose rate system
¢Ñé¹µÍ¹¢Í§¡ÒÃãÊèáÃè
1. ¡ÒÃàµÃÕÂÁ¤¹ä¢é¡èÍ¹¡ÒÃãÊèáÃè µéÍ§·Ó¤ÇÒÁÊÐÍÒ´ºÃÔàÇ³ perineum ÊÇ¹ÅéÒ§ªèÍ§¤ÅÍ´áÅÐÊÇ¹
ÅéÒ§·ÇÒÃË¹Ñ¡ à¾×èÍ·Ó¤ÇÒÁÊÐÍÒ´ÅÓäÊéãËèäÁèãËéÁÕÍØ¨¨ÒÃÐ¤éÒ§ã¹ÅÓäÊé à»ç¹¡ÒÃ»éÍ§¡Ñ¹äÁèãËéÁÕÍØ¨¨ÒÃÐäËÅ
ÁÒà»ÃÍÐà»×éÍ¹ºÃÔàÇ³·Õè¨Ð·Ó¡ÒÃãÊèáÃèà¾×èÍ»éÍ§¡Ñ¹¡ÒÃµÔ´àª×éÍ
2. ãÊèÊÒÂÊÇ¹»ÑÊÊÒÇÐ¤ÒäÇé ¢³Ð·Ó¡ÒÃÃÑ¡ÉÒ´éÇÂ¡ÒÃãÊèáÃè à¹×èÍ§¨Ò¡¼Ùé»èÇÂäÁèÊÒÁÒÃ¶ÅØ¡¢Öé¹»ÑÊÊÒÇÐ
àÍ§ä´é à¾ÃÒÐÁÕà¤Ã×èÍ§Á×Í¤ÒÍÂÙèã¹â¾Ã§Á´ÅÙ¡áÅÐªèÍ§¤ÅÍ´ ãªé Contrast media 7 cm3 ©Õ´à¢éÒä»ã¹ balloon
¢Í§ catheter áÅéÇ´Ö§ balloon ÁÒ·Õè Bladder neck
3. µÃÇ¨ÀÒÂã¹ à¾×èÍ·ÃÒºµÓáË¹è§¢Í§µÑÇÁ´ÅÙ¡ÇèÒÇÒ§µÑÇ¤ÇèÓËÃ×ÍË§ÒÂ áÅÐ¤ÅÓ´ÙËÒµÓáË¹è§¢Í§
cervical os
4. ãªé Sound ÇÑ´¢¹Ò´¢Í§â¾Ã§Á´ÅÙ¡ÇèÒÁÕ¢¹Ò´à·èÒã´ Á´ÅÙ¡»¡µÔ ¨ÐÁÕ¢¹Ò´ 5-7 à«ç¹µÔàÁµÃ
5. ËÅÑ§¨Ò¡¹Ñé¹·Ó¡ÒÃ¢ÂÒÂ»Ò¡Á´ÅÙ¡â´Âãªé Hegar dilator ¨¹¶Ö§àºÍÃì 8
6. ãÊè Uterine tandem à¢éÒä»ã¹â¾Ã§Á´ÅÙ¡ ¤ÇÒÁÅÖ¡µÒÁ¢¹Ò´·ÕèÇÑ´ä´é (áµèÊèÇ¹ÁÒ¡¨ÐãÊè¤ÇÒÁÅÖ¡
äÁèà¡Ô¹ 6 à«ç¹µÔàÁµÃ) áÅÐµÒÁ´éÇÂ¡ÒÃãÊè vagina ovoids ¢ÇÒáÅÐ«éÒÂµÒÁÅÓ´Ñº ·Ó¡ÒÃ lock à¤Ã×èÍ§Á×Íà¢éÒäÇé
´éÇÂ¡Ñ¹µÒÁª¹Ô´¢Í§à¤Ã×èÍ§Á×Í·Õèãªé â´ÂãËéµÓáË¹è§¢Í§ uterine tandem áÅÐvagina ovoids µÑé§©Ò¡«Öè§¡Ñ¹áÅÐ
¡Ñ¹ (´Ñ§ÃÙ»·Õè 9A áÅÐ 9B)
7. µèÍÁÒãªé¼éÒ sterile guaze packing à¾×èÍà¾ÔèÁÃÐÂÐËèÒ§¢Í§áÃè¡Ñº·ÇÒÃË¹Ñ¡áÅÐ¡ÃÐà¾ÒÐ»ÑÊÊÒÇÐ
áÅÐà¾×èÍ·ÓãËéà¤Ã×èÍ§Á×Í·ÕèãÊèäÇéÍÂÙèã¹µÓáË¹è§¤§·Õè »éÍ§¡Ñ¹äÁèãËéÁÕ¡ÒÃ¢ÂÑºàÅ×èÍ¹ËÅØ´ÍÍ¡ÁÒ¢³Ð·Ó¡ÒÃÃÑ¡ÉÒ
¹Í¡¨Ò¡¹ÕéÍÒ¨ãªé¾ÅÒÊàµÍÃì¾Ñ¹à¤Ã×èÍ§Á×Í áÅéÇÂÖ´µÔ´äÇé¡ÑºµÑÇ¼Ùé»èÇÂ´éÇÂ
8. ãÊèÊÒÂ rectal tube ·ÕèÁÕàÁç´µÐ¡ÑèÇÇÒ§àÃÕÂ§ÍÂÙèà¢éÒã¹ÃÙ·ÇÒÃË¹Ñ¡à¾×èÍºÍ¡µÓáË¹è§ anterior wall
¢Í§·ÇÒÃË¹Ñ¡
9. àÁ×èÍãÊèà¤Ã×èÍ§Á×ÍµèÒ§ æ àÃÕÂºÃéÍÂáÅéÇ ¶èÒÂ¿ÔÅìÁàÍ¡«àÃÂì¢Í§¼Ùé»èÇÂºÃÔàÇ³ÍØé§àªÔ§¡ÃÒ¹ã¹·èÒ
anteroposterior áÅÐ lateral à¾×èÍãËéá¹èã¨ÇèÒà¤Ã×èÍ§Á×Í·ÕèãÊèÍÂÙèã¹µÓáË¹è§·ÕèµéÍ§¡ÒÃáÅÐàËÁÒÐÊÁ
10. ¿ÔÅìÁ·Õèä´éÊÒÁÒÃ¶¹Óä»ãªé¤Ó¹Ç¹ËÒ»ÃÔÁÒ³ÃÑ§ÊÕ·Õè Point A, ·ÇÒÃË¹Ñ¡áÅÐ¡ÃÐà¾ÒÐ»ÑÊÊÒÇÐ
11. ·Ó¡ÒÃãÊèáÃèà¢éÒä»ã¹à¤Ã×èÍ§Á×Í·Õèà»ç¹áºº manual after loading system

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Last modified on 25 October 1996