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Brachytherapy mrp007

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Published on March 9, 2014

Author: mtv243

Source: slideshare.net

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By Ossama Anjak
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Barchytherapy Equipment and Protection 15/03/2011 ‫א‬ ‫א‬ ‫א‬ ‫מא‬ ‫א‬ –‫מ‬ ‫א‬ ‫א‬ ‫א‬ ‫א‬ − 2010- 2011 ‫א‬ Ossama Anjak, oanjak@yahoo.com, Damascus, SYRIA ‫א‬ ‫א‬ ‫א‬ ‫א‬ ‫מא‬ ‫א‬ 1

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫ﺍﻟﺘﻌﺭﻑ ﻋﻠﻰ:‬ ‫• ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﺸﻌﺔ ﺍﻟﻤﻐﻠﻘﺔ ﻭﺍﻷﺩﻭﺍﺕ ﻭﺍﻟﺘﺠﻬﻴﺯﺍﺕ ﺍﻟﻤﺴﺘﺨﺩﻤﺔ‬ ‫ﻓﻲ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ ﻋﻥ ﻗﺭﺏ‬ ‫• ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﻭﻗﺎﻴﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ‬ ‫• ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﻤﻌﺎﻴﺭﺓ ﻭﻀﺒﻁ ﺍﻟﺠﻭﺩﺓ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 3‬ ‫1102/30/51‬ ‫ﺍﻟﻤﺤﺘﻭﻯ‬ ‫• ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﺸﻌﺔ‬ ‫• ﺃﺠﻬﺯﺓ ﺍﻟﺘﺤﻤﻴل ﺍﻵﻟﻲ )‪ LDR‬ﻭ ‪.(HDR‬‬ ‫• ﺯﺭﻉ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﺸﻌﺔ )ﺍﻟﺩﺍﺌﻡ ﻭﺍﻟﻤﺅﻗﺕ(.‬ ‫• ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻥ ﻗﺭﺏ ﻀﻤﻥ ﺍﻷﻭﻋﻴﺔ )‪.(IVB‬‬ ‫• ﺘﻘﻨﻴﺎﺕ ﺃﺨﺭﻯ )ﻤﺜل ﻤﻁﺒﻘﺎﺕ ﺍﻟﻌﻴﻥ(.‬ ‫• ﺘﺨﻁﻴﻁ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻥ ﻗﺭﺏ.‬ ‫• ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ:‬ ‫• ﻤﻌﺎﻴﺭﺓ ﺍﻟﻤﻨﺎﺒﻊ ﻭﻗﻴﺎﺱ ﺍﻟﺠﺭﻉ ﻓﻲ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻥ ﻗﺭﺏ.‬ ‫• ﺇﺠﺭﺍﺀﺍﺕ ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ﻭﺍﻟﻭﻗﺎﻴﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 4‬ ‫2‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫א‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 5‬ ‫א‬ ‫1102/30/51‬ ‫א‬ ‫א א‬ ‫)‪Internal Radiation Therapy (Brachytherapy‬‬ ‫ﻫﻲ ﺍﺴﺘﺨﺩﺍﻡ ﻤﺼﺎﺩﺭ ﻤﺸﻌﺔ ﻤﻐﻠﻘﺔ ﺼﻐﻴﺭﺓ ﺍﻟﺤﺠﻡ ﺘﻭﻀﻊ ﺩﺍﺨل ﺠﺴﻡ‬ ‫ﺍﻟﻤﺭﻴﺽ.‬ ‫ ﺒﺎﺴﺘﺨﺩﺍﻡ ﻤﻁﺒﻘﺎﺕ ﺨﺎﺼﺔ )ﻋﺒﺭ ﺍﻟﻔﺘﺤﺎﺕ ﺍﻟﻁﺒﻴﻌﻴﺔ ﻟﻠﺠﺴﻡ(.‬‫ ﺒﻭﺍﺴﻁﺔ ﺍﻟﺠﺭﺍﺤﺔ )ﺘﺯﺭﻉ ﻀﻤﻥ ﺍﻷﻨﺴﺠﺔ ﺒﺸﻜل ﻤﺅﻗﺕ ﺃﻭ ﺩﺍﺌﻡ(.‬‫ﺍﻟﻬﺩﻑ ﺍﻷﺴﺎﺴﻲ ﻟﻬﺫﺍ ﺍﻟﻨﻭﻉ ﻤﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ:‬ ‫• ﻫﻭ ﺇﻋﻁﺎﺀ ﺠﺭﻋﺔ ﺇﺸﻌﺎﻋﻴﺔ ﻜﺒﻴﺭﺓ ﻟﻤﻨﻁﻘﺔ ﺍﻟﻬﺩﻑ.‬ ‫• ﻭﻗﺎﻴﺔ ﺍﻟﻨﺴﺞ ﺍﻟﻤﺤﻴﻁﺔ ﺃﻱ ﺘﻌﺭﻴﺽ ﺍﻟﻨﺴﺞ ﺍﻟﺴﻠﻴﻤﺔ ﺍﻟﻤﺤﻴﻁﺔ ﺒﺎﻟﻭﺭﻡ‬ ‫ﻟﺠﺭﻋﺔ ﺇﺸﻌﺎﻋﻴﺔ ﺃﻗل ﻤﺎ ﻴﻤﻜﻥ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 6‬ ‫3‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫??? ‪Brachytherapy‬‬ ‫‪(Greek:) ‘Short distance’ therapy‬‬ ‫‪source‬‬ ‫‪guidance plate‬‬ ‫‪needles‬‬ ‫‪Ossama Anjak‬‬ ‫1102/51/3‬ ‫א‬ ‫7‬ ‫א‬ ‫אמ‬ ‫ﺍﻟﺘﻁﺒﻴﻘﺎﺕ ﻓﻲ ﻤﻌﺎﻟﺠﺔ ﺍﻷﻭﺭﺍﻡ)*(:‬ ‫• ﻤﻌﺎﻟﺠﺔ ﺁﻓﺎﺕ ﺍﻟﺒﺭﻭﺴﺘﺎﺕ )ﻴﺯﺩﺍﺩ ﺘﻁﺒﻴﻕ ﻫﺫﺍ ﺍﻟﻨﻭﻉ ﻤﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺒﺴﺭﻋﺔ ﻜﺒﻴﺭﺓ ﺒﺴﺒﺏ ﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﻤﻤﺘﺎﺯﺓ(‬ ‫• ﺍﻟﺜﺩﻱ ‪Breast‬‬ ‫• ﺍﻟﻌﻨﻕ ﻭﺍﻟﺭﻗﺒﺔ ‪Head and Neck‬‬ ‫• ﺍﻟﺭﺤﻡ ﻭﻋﻨﻕ ﺍﻟﺭﺤﻡ ‪Uterus and Cervix‬‬ ‫• ﺍﻟﺭﺌﺔ ‪Lung‬‬ ‫• ﺍﻟﻤﺭﻱ ‪.Esophagus‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 8‬ ‫4‬ ‫)*( أﻳﻀﺎ ﺗﺴﺘﺨﺪم اﻟﻤﻌﺎﻟﺠﺔ ﻋﻦ ﻗﺮب‬ ‫ً‬ ‫ﻓﻲ ﺑﻌﺾ اﻟﻌﻤﻠﻴﺎت اﻟﻘﻠﺒﻴﺔ.‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א א‬ ‫ﺘﺘﻤﻴﺯ ﻫﺫﻩ ﺍﻟﺘﻘﻨﻴﺔ ﻋﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ ﻋﻥ ﺒﻌﺩ ﺒﻤﺎ ﻴﻠﻲ:‬ ‫• ﺒﻬﺫﻩ ﺍﻟﺘﻘﻨﻴﺔ ﺘﻁﺒﻕ ﺍﻟﺠﺭﻉ ﻓﻲ ﺍﻟﻤﻭﻀﻊ ﺍﻟﺫﻱ ﻴﺤﺘﺎﺝ ﺇﻟﻰ ﻤﻌﺎﻟﺠﺔ.‬ ‫• ﺘﺅﻤﻥ ﺭﺍﺤﺔ ﺃﻜﺜﺭ ﻟﻠﻤﺭﻴﺽ ﺨﻼل ﻭﺒﻌﺩ ﺇﺠﺭﺍﺀ ﺍﻟﻤﻌﺎﻟﺠﺔ )ﻻ ﻴﻭﺠﺩ‬ ‫ﺃﺫﻯ ﻋﻠﻰ ﺍﻟﺠﻠﺩ، ......... (‬ ‫• ﺘﻨﺨﻔﺽ ﺍﻟﺠﺭﻋﺔ ﻟﻸﻋﻀﺎﺀ ﺍﻟﺤﺴﺎﺴﺔ ﻟﻺﺸﻌﺎﻉ.‬ ‫• ﺘﺄﺜﻴﺭﺍﺕ ﺠﺎﻨﺒﻴﺔ ﺃﻗل ﺘﻨﺸﺄ ﻋﻥ ﻫﺫﻩ ﺍﻟﺘﻘﻨﻴﺔ.‬ ‫• ﺯﻤﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺃﻗل ﻭﺍﻟﻤﺭﻴﺽ ﻴﻌﻭﺩ ﺇﻟﻰ ﺍﻟﻤﻨﺯل ﺒﻌﺩ ﺍﻟﻌﻼﺝ ﻤﺒﺎﺸﺭﺓ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 9‬ ‫1102/30/51‬ ‫‪Brachytherapy & EBT‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 01‬ ‫5‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

Barchytherapy Equipment and Protection 15/03/2011 Brachytherapy & EBT Treated volume Dose distribution EBRT Brachytherapy Homogenous Heterogeneous Large Dose rate Small Variable HDR, LDR, (PDR) Few Short; hours to days Low Fractionation Treatment duration Multiple Long; weeks to months 11 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 15/03/2011 ‫א‬ Photon energy Isotope (MeV) Cs-137 30 Y 0.662 1.17Co-60 5.26 Y 1.33 Au-198 2.7 d 0.41 HalfLife Ir-192 74 d 0.3-0.6 I-131 60 d Ra-226 1640Y 0.0270.036 15/03/2011 Ossama Anjak, oanjak@yahoo.com, Damascus, SYRIA 0.2-2.4 ‫א‬ ‫א‬ HVL Air Kerma rate per GBq at 1m (mGy.h-1) 5.5 0.078 11.0 0.307 Needles and tubes 2.5 0.055 Grains for PI 2.5 0.113 Wire and pins Pellets for HDR 3.11 0.034 Seeds for PI 8.0 0.195 Needles and tubes (mm Pb) Sources available Needles and tubes Pellets for HDR 12 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 6

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫ﻤﺎﺩﺓ ﻤﺸﻌﺔ ﻭﻫﻲ:‬ ‫)‪(a‬‬ ‫)‪(b‬‬ ‫ﻤﺨﺘﻭﻤﺔ ﺒﺼﻭﺭﺓ ﺩﺍﺌﻤﺔ ﺩﺍﺨل ﻜﺒﺴﻭﻟﺔ، ﺃﻭ‬ ‫ﻤﻐﻠﻘﺔ ﺒﺈﺤﻜﺎﻡ ﻭﻋﻠﻰ ﺸﻜل ﻤﺎﺩﺓ ﺼﻠﺒﺔ. ﻭﺘﻜﻭﻥ ﺍﻟﻜﺒﺴﻭﻟﺔ ﺃﻭ ﻤﺎﺩﺓ‬ ‫ﺍﻟﻤﺼﺩﺭ ﺍﻟﻤﺨﺘﻭﻡ ﻋﻠﻰ ﺩﺭﺠﺔ ﻤﻥ ﺍﻟﻤﺘﺎﻨﺔ ﺘﻜﻔﻲ ﻟﻤﻨﻊ ﺍﻟﺘﺴﺭﺏ ﻓﻲ ﻅﺭﻭﻑ‬ ‫ﺍﻻﺴﺘﻌﻤﺎل ﻋﻠﻰ ﺍﻟﻨﺤﻭ ﺍﻟﺫﻱ ﺼﻤﻤﺕ ﻤﻥ ﺃﺠﻠﻪ، ﻭﻜﺫﻟﻙ ﻓﻲ ﺤﺎﻟﺔ‬ ‫ﺍﻟﺤﻭﺍﺩﺙ ﺍﻟﻤﺘﻭﻗﻌﺔ ]‪.[BSS‬‬ ‫ﻫﻭ ﺸﻜل ﺨﺎﺹ ﻤﻥ ﺍﻟﻤﺎﺩﺓ ﺍﻟﻤﺸﻌﺔ ﺍﻟﺘﻲ ﺘﻌﻨﻲ ﺍﻟﻤﺎﺩﺓ ﺍﻟﻤﺸﻌﺔ ﺍﻟﺼﻠﺒﺔ ﺒﺼﻭﺭﺓ‬ ‫ﺃﺴﺎﺴﻴﺔ ﺃﻭ ﻜﺒﺴﻭﻟﺔ ﺼﻠﺒﺔ ﺘﺤﻭﻱ ﻤﺎﺩﺓ ﻤﺸﻌﺔ ] ﺘﺸﺭﻴﻌﺎﺕ ﺍﻟﻨﻘل ﺍﻟﺼﺎﺩﺭﺓ‬ ‫ﻋﻥ ﺍﻟﻭﻜﺎﻟﺔ ﺍﻟﺩﻭﻟﻴﺔ ﻟﻠﻁﺎﻗﺔ ﺍﻟﺫﺭﻴﺔ ‪.[ IAEA‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 31‬ ‫א‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫• ﻤﺼﺩﺭ ﻷﺸﻌﺔ ﻏﺎﻤﺎ ﻓﻘﻁ ﺒﻁﺎﻗﺔ ﻤﻨﺎﺴﺒﺔ ﻟﻤﻭﻀﻊ ﺍﻟﻤﻌﺎﻟﺠﺔ.‬ ‫ﺍﻟﻨﺸﺎﻁﻴﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ ﺍﻟﻨﻭﻋﻴﺔ ﻋﺎﻟﻴﺔ.‬ ‫ﻤﻨﺎﺴﺏ ﻤﻥ ﺃﺠل ﺘﻁﺒﻴﻘﺎﺕ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺒﻤﻌﺩل ﺠﺭﻋﺔ ﻤﺭﺘﻔﻊ ‪.HDR‬‬ ‫ﺼﻐﻴﺭ ﺍﻟﺤﺠﻡ.‬ ‫ﻤﻥ ﺃﺠل ﺍﻟﺯﺭﻉ ﺍﻟﻤﺅﻗﺕ، ﻋﻤﺭ ﺍﻟﻨﺼﻑ ﻁﻭﻴل.‬ ‫ﺤﺘﻰ ﻨﺘﻤﻜﻥ ﻤﻥ ﺇﻋﺎﺩﺓ ﺍﺴﺘﻌﻤﺎل ﺍﻟﻤﻨﺎﺒﻊ ، ﺘﻭﻓﻴﺭ ﻓﻲ ﺍﻟﻜﻠﻔﺔ.‬ ‫ﻤﻥ ﺃﺠل ﺍﻟﺯﺭﻉ ﺍﻟﺩﺍﺌﻡ، ﻋﻤﺭ ﺍﻟﻨﺼﻑ ﻤﺘﻭﺴﻁ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 41‬ ‫7‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫:‬ ‫א‬ ‫• ﺘﻘﺩﻡ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ ﺒﻤﺭﻭﻨﺔ ﻋﺎﻟﻴﺔ.‬ ‫• ﺘﻌﻴﻥ ﻤﻭﻀﻊ ﺍﻟﻤﺼﺩﺭ ﻴﺤﺩﺩ ﻨﺠﺎﺡ ﺍﻟﻤﻌﺎﻟﺠﺔ .‬ ‫• ﻤﻥ ﺍﻟﻨﺎﺤﻴﺔ ﺍﻟﻌﻤﻠﻴﺔ ﺘﻘﺎﺒل ﻫﺫﻩ ﺍﻟﺘﻘﻨﻴﺔ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻹﺸﻌﺎﻋﻴﺔ‬ ‫ﺍﻟﻤﻁﺎﺒﻘﺔ ‪. ‘conformal’ radiotherapy‬‬ ‫• ﺘﻌﺘﻤﺩ ﺒﺩﺭﺠﺔ ﻋﺎﻟﻴﺔ ﻋﻠﻰ ﺤﺎﻟﺔ ﺍﻟﻤﻌﺎﻟﺠﺔ.‬ ‫• ﺘﻌﺘﻤﺩ ﺒﺩﺭﺠﺔ ﻜﺒﻴﺭﺓ ﻋﻠﻰ ﺨﺒﺭﺓ ﺍﻟﻤﺸﻐل ﻭﻤﻬﺎﺭﺘﻪ.‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻤﻁﺎﺒﻘﺔ : ﻫﻲ ﻤﺤﺎﻭل ﻤﺤﺎﻜﺎﺓ ﺍﻟﺤﺠﻡ ﺍﻟﻤﻌﺎﻟﺞ ﻟﻴﻜﻭﻥ ﻤﻤﺎﺜل ﻗﺩﺭ‬ ‫ﺍﻻﻤﻜﺎﻥ ﻟﺤﺠﻡ ﺍﻟﻬﺩﻑ ﺍﻟﻔﻌﻠﻲ ﻤﻊ ﺘﺠﻨﺏ ﺍﻟﻨﺴﺞ ﺍﻟﺴﻠﻴﻤﺔ ﺍﻟﻤﺤﻴﻁﺔ ﻤﺎ ﺃﻤﻜﻥ .‬ ‫ﺒﺼﻭﺭﺓ ﻋﺎﻤﺔ ﺍﻻﻫﺘﻤﺎﻤﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻷﻤﺎﻥ ﺍﻹﺸﻌﺎﻋﻲ ﺘﻁﺒﻕ ﺃﻴﻀﺎ ﻓﻲ‬ ‫ﹰ‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻤﻁﺎﺒﻘﺔ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 51‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫ﺯﺭﻉ ﺒﺫﻭﺭ ﺍﻟﻴﻭﺩ‬ ‫א א‬ ‫‪125I‬‬ ‫:‬ ‫ﻓﻲ ﺍﻟﺒﺭﻭﺴﺘﺎﺕ:‬ ‫• ‪100 seeds of ~ 13 MBq/seed = 1.3 GBq‬‬ ‫• ‪< 0.0025 mSv/h at 1m‬‬ ‫• ‪~ 17 days for 1 mSv at 1m‬‬ ‫ﺯﺭﻉ ﺒﺫﻭﺭ ﺍﻟﺫﻫﺏ‬ ‫‪198Au‬‬ ‫ﻓﻲ ﺍﻟﺸﻔﺔ:‬ ‫• ‪8 seeds of ~ 110 MBq/seed = 880 MBq‬‬ ‫• ‪~ 0.06 mSv/h at 1m‬‬ ‫• ‪~17 hours for 1 mSv at 1m‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 61‬ ‫8‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫ﺘﻭﺠﺩ ﻋﺩﺩ ﺘﻘﻨﻴﺎﺕ ﻟﺘﻁﺒﻴﻕ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻥ ﻗﺭﺏ ﻴﺩﻭﻴﺎ ﻭﻫﻲ :‬ ‫ﹰ‬ ‫• ﺍﻟﺯﺭﻉ ﻀﻤﻥ ﺍﻟﻨﺴﺞ ﺍﻟﺴﺭﻁﺎﻨﻴﺔ.‬ ‫• ﻤﻌﺎﻟﺠﺔ ﺍﻟﺴﺭﻁﺎﻥ ﻓﻲ ﺍﻟﺘﺠﺎﻭﻴﻑ ﺍﻟﺩﺍﺨﻠﻴﺔ.‬ ‫• ﻏﺭﺱ ﺍﻟﻤﻁﺒﻘﺎﺕ ﻓﻲ ﺍﻟﻌﻴﻥ ‪.eye plaque‬‬ ‫• ﺍﻟﺘﻁﺒﻴﻘﺎﺕ ﺍﻟﻤﻭﻀﻌﻴﺔ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 71‬ ‫א‬ ‫1102/30/51‬ ‫א‬ ‫:‬ ‫ﺘﺴﺘﻌﻤل ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﺸﻌﺔ ﺍﻟﺘﺎﻟﻴﺔ ﻓﻲ ﺍﻟﺘﻁﺒﻴﻘﺎﺕ ﺍﻟﺭﻭﺘﻴﻨﻴﺔ:‬ ‫‪60Co‬‬ ‫ﻤﺼﺎﺩﺭ ﺍﻟﺴﻴﺯﻴﻭﻡ ‪137Cs‬ﻭﺍﻟﻜﻭﺒﺎﻟﺕ‬ ‫ﺇﺒﺭ ﺃﻭ ﻤﻁﺒﻘﺎﺕ.‬ ‫‪ 192Ir‬ﺒﺫﻭﺭ ﺃﻭ ﺃﺴﻼﻙ ﻤﻐﻠﻔﺔ ﺒﻨﺎﻴﻠﻭﻥ ﻤﻁﺎﻁﻲ.‬ ‫ﺍﻟﺫﻫﺏ ‪ 198Au‬ﻭﺍﻟﻴﻭﺩ ‪125I‬ﻭﺍﻟﺒﻼﺩﻴﻭﻡ ‪ 103Pd‬ﻜﻤﺼﺎﺩﺭ ﻤﺨﺘﻭﻤﺔ ﻋﻠﻰ‬ ‫ﺸﻜل ﺒﺫﻭﺭ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 81‬ ‫9‬ ‫ﻜﻤﺼﺎﺩﺭ ﻤﺨﺘﻭﻤﺔ ﻋﻠﻰ ﺸﻜل‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫א :‬ ‫א‬ ‫ﺘﺴﺘﻌﻤل ﺍﻟﻤﺼﺎﺩﺭﺍﻟﺘﺎﻟﻴﺔ:‬ ‫ﻤﺼﺎﺩﺭ ﺍﻟﺴﻴﺯﻴﻭﻡ ‪137Cs‬ﻭﺍﻟﻜﻭﺒﺎﻟﺕ‬ ‫ﺸﻜل ﺇﺒﺭ ﺃﻭ ﻤﻁﺒﻘﺎﺕ.‬ ‫‪90Sr‬‬ ‫‪60Co‬‬ ‫ﻜﻤﺼﺎﺩﺭ ﻤﺨﺘﻭﻤﺔ ﻋﻠﻰ‬ ‫ﻤﺼﺩﺭ ﻤﺨﺘﻭﻡ ﻀﻤﻥ ﺍﻟﻤﻁﺒﻘﺎﺕ ﻟﻠﻤﻌﺎﻟﺠﺔ ﺍﻟﺴﻁﺤﻴﺔ ﻟﻠﻌﻴﻥ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 91‬ ‫1102/30/51‬ ‫א‬ ‫‪Eye Applicators‬‬ ‫• ﺘﺘﺎﻟﻑ ﻤﻁﺒﻘﺎﺕ ﺍﻟﻌﻴﻥ ﺤﺸﻭﺓ ﻤﻥ ﺍﻟﺒﻼﺴﺘﻴﻙ ﺍﻟﻨﺎﻋﻡ ﻗﻭﺴﻴﺔ‬ ‫ﺍﻟﺸﻜل ﻋﻠﻴﻬﺎ ﻋﺩﺩ ﻤﻥ ﺍﻷﺨﺎﺩﻴﺩ ﺘﺜﺒﺕ ﻀﻤﻨﻬﺎ ﺍﻟﻤﺎﺩﺓ ﺍﻟﻤﺸﻌﺔ ﺜﻡ‬ ‫ﺘﻐﻁﻰ ﺒﺴﻁﺢ ﻤﺤﺩﺏ ﺫﻭ ﺸﻜل ﻤﻨﺴﺠﻡ ﻤﻊ ﺍﻟﺘﻘﻭﺱ.‬ ‫• ﺒﻤﺎ ﺍﻟﻤﻁﺒﻕ ﻴﻭﻀﻊ ﻋﻠﻰ ﻤﺤﺠﺭ )ﻤﺩﺍﺭ( ﺍﻟﻌﻴﻥ ﻓﻭﻕ ﻤﻭﻀﻊ‬ ‫ﺍﻟﻭﺭﻡ ﻭﻴﺘﻡ ﺘﺜﺒﻴﺘﻪ ﺠﺭﺍﺤﻴﺎ )ﺨﻴﺎﻁﺔ( ﻤﻊ ﻏﺸﺎﺀ ﺍﻟﺠﻔﻥ ﻟﺫﻟﻙ‬ ‫ﹰ‬ ‫ﺘﻌﺘﺒﺭ ﻫﺫﻩ ﺍﻟﺘﻘﻨﻴﺔ ﻤﻥ ﺘﻘﻨﻴﺎﺕ ﺍﻟﺯﺭﻉ ﺍﻟﺨﻼﻟﻲ ﺃﻱ ﻟﻴﺴﺕ ﻤﻌﺎﻟﺠﺔ‬ ‫ﺴﻁﺤﻴﺔ ﻋﺎﺩﻴﺔ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 02‬ ‫01‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺎﺕ ﺍﻟﻤﻭﻀﻌﻴﺔ )ﺍﻟﺴﻁﺤﻴﺔ(‬ ‫ﺒﺸﻜل ﺭﻭﺘﻴﻨﻲ ﺘﺴﺘﻌﻤل ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﺘﺎﻟﻴﺔ :‬ ‫• ‪ 90Sr‬ﻤﺼﺩﺭ ﻤﺨﺘﻭﻡ ﻀﻤﻥ ﺍﻟﻤﻁﺒﻘﺎﺕ ﻟﻠﻤﻌﺎﻟﺠﺔ‬ ‫ﺍﻟﺴﻁﺤﻴﺔ ﻟﻠﻌﻴﻥ.‬ ‫• ﻤﺼﺎﺩﺭ ﺍﻟﺴﻴﺯﻴﻭﻡ ‪137Cs‬ﻭﺍﻟﻜﻭﺒﺎﻟﺕ ‪ 60Co‬ﻜﻤﺼﺎﺩﺭ‬ ‫ﻤﺨﺘﻭﻤﺔ ﻋﻠﻰ ﺸﻜل ﺇﺒﺭ ﺃﻭ ﻓﻲ ﺨﻼﻴﺎ ﺍﻟﻤﻁﺒﻘﺎﺕ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 12‬ ‫1102/30/51‬ ‫ﻤﻁﺒﻕ ﺴﻁﺤﻲ ﻤﻊ ﺘﻭﺯﻉ‬ ‫ﻋﺸﻭﺍﺌﻲ ﻟﻤﻨﺎﺒﻊ ﺍﻟﺭﺍﺩﻴﻭﻡ‬ ‫ﻋﻠﻰ ﺴﻁﺢ ﺍﻟﻤﻁ ‪‬ﻕ‬ ‫ﺒ‬ ‫)3391 ‪(Murdoch, Brussels‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 22‬ ‫11‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫א‬ ‫ﻤﻌﺎﻟﺠﺔ ﺍﻵﻓﺎﺕ ﺍﻟﺴﻁﺤﻴﺔ ﺒﻤﻨﺎﺒﻊ ﻤﺸﻌﺔ ﺒﺘﻤﺎﺱ ﻤﺒﺎﺸﺭ ﻤﻊ‬ ‫ﺍﻟﺠﻠﺩ‬ ‫ﻗﺎﻟﺏ ﺨﻠﻑ ﺍﻟﻴﺩ ﻤﻊ ﺘﺩﺭﻴﻊ ﻤﺼﻤﻡ‬ ‫ﻟﻭﻗﺎﻴﺔ ﺍﻟﻤﺭﻴﺽ ﺨﻼل ﺍﻟﻤﻌﺎﻟﺠﺔ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 32‬ ‫א‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫)‬ ‫(‬ ‫ﻤﻌﺎﻟﺠﺔ ﺍﻵﻓﺎﺕ ﺍﻟﺴﻁﺤﻴﺔ ﺒﺎﺴﺘﻌﻤﺎل ﻤﺼﺎﺩﺭ ﻤﺸﻌﺔ‬ ‫ﺘﻭﻀﻊ ﻋﻠﻰ ﺘﻤﺎﺱ ﻤﻊ ﺍﻟﺠﻠﺩ‬ ‫ﻗﺎﻟﺏ ﻟﻤﻌﺎﻟﺠﺔ ﺨﻼﻴﺎ ﺴﺭﻁﺎﻨﻴﺔ ﻗﺸﺭﻴﺔ‬ ‫) ‪(squamous cell carcinoma‬‬ ‫ﻓﻲ ﻤﻨﻁﻘﺔ ﺍﻟﺠﺒﻴﻥ.‬ ‫ﻴﻼﺤﻅ ﻓﻲ ﺍﻟﺸﻜل ﺍﻟﻘﺜﺎﻁﺭ ﻟﺘﻭﻀﻴﻊ‬ ‫ﺍﻟﻤﺼﺎﺩﺭ ﺍﺍﻟﻤﺸﻌﺔ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 42‬ ‫21‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫)‬ ‫א‬ ‫(‬ ‫ﻤﻌﺎﻟﺠﺔ ﺍﻵﻓﺎﺕ ﺍﻟﺴﻁﺤﻴﺔ ﺒﺎﺴﺘﻌﻤﺎل ﻤﺼﺎﺩﺭ ﻤﺸﻌﺔ‬ ‫ﺘﻭﻀﻊ ﻋﻠﻰ ﺘﻤﺎﺱ ﻤﻊ ﺍﻟﺠﻠﺩ‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 52‬ ‫א‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫)‬ ‫(‬ ‫ﺍﻟﻤﺤﺎﺴﻥ:‬ ‫ﺘﻨﺎﻗﺹ ﺴﺭﻴﻊ ﻟﻠﺠﺭﻋﺔ ﻀﻤﻥ ﺍﻟﻨﺴﺞ ﺒﺴﺒﺏ ﻗﺎﻨﻭﻥ ﺍﻟﺘﺭﺒﻴﻊ‬ ‫ﺍﻟﻌﻜﺴﻲ، ﻭﻴﻤﻜﻥ ﻤﻁﺎﺒﻘﺔ ﺍﻟﻨﺸﺎﻁ ﺍﻹﺸﻌﺎﻋﻲ ﻷﻱ ﺴﻁﺢ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 62‬ ‫31‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫א‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 72‬ ‫1102/30/51‬ ‫א‬ ‫ﻴﺠﺏ ﺃﻥ ﻴﺅﻤﻥ ﻤﺴﺘﻭﺩﻉ ﺍﻟﻤﺼﺎﺩﺭ‬ ‫ﺍﻟﻤﺸﻌﺔ ﻤﺎ ﻴﻠﻲ:‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫ﻴﺅﻤﻥ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺘﺄﺜﻴﺭ ﺍﻟﻅﺭﻭﻑ ﺍﻟﺒﻴﺌﻴﺔ‬ ‫ﺍﻟﻤﺤﻴﻁﺔ.‬ ‫ﻤﺨﺼﺹ ﻟﻭﻀﻊ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﺸﻌﺔ ﻓﻘﻁ‬ ‫ﻴﺅﻤﻥ ﻭﻗﺎﻴﺔ ﺇﺸﻌﺎﻋﻴﺔ ﻜﺎﻓﻴﺔ.‬ ‫ﻤﻘﺎﻭﻡ ﻟﻠﺤﺭﺍﺌﻕ.‬ ‫ﻤﺯﻭﺩ ﺒﻘﻔل ﺃﻤﺎﻥ ﻭﻏﻴﺭ ﻗﺎﺒل ﻟﻠﺴﺭﻗﺔ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 82‬ ‫41‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫א‬ ‫מ ‪137Cs‬‬ ‫ﻤﺯﻭﺩﺓ ﺒﺩﺭﻭﺝ ﻤﺭﻗﻤﺔ ﻭﻤﻌﻠﻤﺔ‬ ‫ﺒﺈﺸﺎﺭﺍﺕ ﻤﺨﺘﻠﻔﺔ ﺍﻷﻟﻭﺍﻥ ﺘﺅﻤﻥ‬ ‫ﺴﻬﻠﺔ ﺍﻟﺘﻌﺭﻑ ﻋﻠﻰ ﺍﻟﻤﺼﺎﺩﺭ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 92‬ ‫1102/30/51‬ ‫ﺁﻤﺎﻥ ﺍﻟﻤﺼﺩﺭ‬ ‫ﻴﺠﺏ ﺘﺨﺯﻴﻥ ﺍﻟﻤﺼﺩﺭ ﺍﻟﻤﺸﻊ:‬ ‫• ﺒﺸﻜل ﺁﻤﻥ ﻴﻤﻨﻊ ﺍﻷﺸﺨﺎﺹ ﻏﻴﺭ ﺍﻟﻤﺭﺨﺹ ﻟﻬﻡ ﻤﻥ‬ ‫ﺍﻟﻭﺼﻭل ﺇﻟﻴﻪ.‬ ‫• ﻴﺠﺏ ﺍﻟﺘﺩﻗﻴﻕ ﺒﺼﻭﺭﺓ ﺩﻭﺭﻴﺔ ﻟﻤﻁﺎﺒﻘﺔ ﺴﺠﻼﺕ ﺠﺭﺩ‬ ‫ﺍﻟﻤﺼﺎﺩﺭ ﻤﻊ ﻤﺘﻁﻠﺒﺎﺕ ﺍﻟﺴﻠﻁﺔ ﺍﻟﺭﻗﺎﺒﻴﺔ.‬ ‫ﻴﺠﺏ ﺃﻥ ﺘﻌﺭﻑ ﺴﺠﻼﺕ ﺍﻟﺠﺭﺩ ﻤﺎ ﻴﻠﻲ:‬ ‫• ﺍﻟﻨﻜﻠﻴﺩﺍﺕ ﺍﻟﻤﺸﻌﺔ ﻭﺍﻟﻨﺸﺎﻁ ﺍﻹﺸﻌﺎﻋﻲ ﻟﻠﻤﺼﺩﺭ.‬ ‫• ﺍﻟﻤﻭﻀﻊ ﻭﻤﻭﺍﺼﻔﺎﺕ ﺍﻟﻤﺼﺎﺩﺭ.‬ ‫• ﺘﻔﺎﺼﻴل ﺍﻟﺘﺨﻠﺹ ﻤﻥ ﺍﻟﻤﺼﺎﺩﺭ )ﺒﻤﺎ ﻓﻴﻬﺎ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﺘﻲ‬ ‫ﺘﻐﺭﺱ ﺒﺼﻭﺭﺓ ﺩﺍﺌﻤﺔ ﻓﻲ ﺍﻟﻤﺭﻀﻰ(.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 03‬ ‫51‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

Barchytherapy Equipment and Protection Brachytherapy Afterloading 15/03/2011 ‫א‬ ‫א‬ 31 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 15/03/2011 Brachytherapy Afterloading ‫א‬ ‫א‬ ‫ﻴﻌﻤل ﺠﻬﺎﺯ ﺍﻟﺤﺎﻗﻥ ﺍﻵﻟﻲ ﻋﻠﻰ ﻨﻘل ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﺸﻌﺔ ﺁﻟﻴﺎ ﻤﻥ ﻤﻜﺎﻥ ﺍﻟﺘﺨﺯﻴﻥ‬ .‫)ﺍﻟﺤﺎﻭﻴﺔ( ﺇﻟﻰ ﺠﺴﻡ ﺍﻟﻤﺭﻴﺽ ﻭﺒﺴﺭﻋﺔ ﻋﺎﻟﻴﺔ ﻭﻟﻤﺩﺓ ﻤﺤﺩﺩﺓ ﻤﺴﺒﻘﺎ‬ ‫ﹰ‬ 15/03/2011 Ossama Anjak, oanjak@yahoo.com, Damascus, SYRIA 32 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 16

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א א‬ ‫א‬ ‫) ‪( LDR HDR‬‬ ‫‪ :HDR‬ﻤﻌﺩل ﺠﺭﻋﺔ ﻋﺎﻟﻲ ‪High Dose Rate‬‬ ‫‪ :LDR‬ﻤﻌﺩل ﺠﺭﻋﺔ ﻤﻨﺨﻔﺽ ‪Low Dose Rate‬‬ ‫• ﺁﻟﻴﺔ ﺍﻟﺘﺤﻤﻴل ﺍﻵﻟﻲ: ﻫﻲ ﺘﻠﻙ ﺍﻟﺘﻘﻨﻴﺔ ﺍﻟﺘﻲ ﻴﺘﻡ ﻓﻴﻬﺎ ﻭﻀﻊ‬ ‫ﺍﻟﻤﻁﺒﻘﺎﺕ ﻏﻴﺭ ﺍﻟﻤﺸﻌﺔ ﻭﺍﻷﻨﺎﺒﻴﺏ ﻓﻲ ﺍﻟﻤﺭﻴﺽ ﻭﻤﻥ ﺜﻡ ﻴﺘﻡ‬ ‫ﺘﺤﻤﻴل ﺍﻟﻤﺼﺎﺩﺭ ﺇﻟﻰ ﺘﻠﻙ ﺍﻟﻤﻁﺒﻘﺎﺕ .‬ ‫ﻫﺫﻩ ﺍﻵﻟﻴﺔ ﺘﻌﺘﻤﺩ ﻋﻠﻰ ﺍﻟﺸﺭﻜﺔ ﺍﻟﺼﺎﻨﻌﺔ ﻭﻤﻭﺩﻴل ﺍﻟﺠﻬﺎﺯ‬ ‫ﻭﺘﻁﺒﻕ ﻓﻲ ﺤﺎل ﺍﺴﺘﺨﺩﺍﻡ ﻤﺼﺎﺩﺭ ‪192Ir, 60Co or‬‬ ‫‪.137Cs‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 33‬ ‫1102/30/51‬ ‫א א‬ ‫א‬ ‫) ‪( LDR HDR‬‬ ‫• ﺒﺘﻘﻨﻴﺔ ‪ HDR‬ﻋﺎﺩﺓ ﻴﺴﺘﻌﻤل ﻤﺼﺩﺭ ﻭﺍﺤﺩ ﻭﺍﻟﻨﺸﺎﻁ ﺍﻹﺸﻌﺎﻋﻲ‬ ‫ﻟﻠﻤﺼﺩﺭ ﻀﻤﻥ ﺍﻟﻤﺠﺎل ‪180 GBq‬ﺇﻟﻰ ‪.740 GBq‬‬ ‫• ﺒﺘﻘﻨﻴﺔ ‪ LDR‬ﺭﺒﻤﺎ ﻴﺴﺘﻌﻤل ﻤﺼﺩﺭ ﻭﺍﺤﺩ ﺃﻭ ﻋ ‪‬ﺓ ﻤﺼﺎﺩﺭ ﻭﺍﻟﻨﺸﺎﻁ‬ ‫ﺩ‬ ‫ﺍﻹﺸﻌﺎﻋﻲ ﻟﻠﻤﺼﺩﺭ ﻀﻤﻥ ﺍﻟﻤﺠﺎل ‪ ~370 MBq‬ﺇﻟﻰ 055~‬ ‫‪.MBq‬‬ ‫• ﺒﺴﺒﺏ ﺍﻟﻨﺸﺎﻁ ﺍﻹﺸﻌﺎﻋﻲ ﺍﻟﻌﺎﻟﻲ ﻓﻲ ﺘﻘﻨﻴﺔ ‪ HDR‬ﻓﺄﻨﻨﺎ ﻨﺤﺘﺎﺝ ﺇﻟﻰ‬ ‫ﺘﺩﺭﻴﻊ ﺃﻜﺜﺭ ﻤﻨﻪ ﻓﻲ ﺘﺠﻬﻴﺯﺍﺕ ‪LDR‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 43‬ ‫71‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א א‬ ‫א‬ ‫) ‪( LDR HDR‬‬ ‫• ﺒﺴﺒﺏ ﺍﻟﻨﺸﺎﻁ ﺍﻹﺸﻌﺎﻋﻲ ﺍﻟﻌﺎﻟﻲ ﻓﻲ ﺘﻘﻨﻴﺔ ‪ HDR‬ﻓﺄﻨﻨﺎ ﻨﺤﺘﺎﺝ‬ ‫ﺇﻟﻰ ﺘﺩﺭﻴﻊ ﺃﻜﺜﺭ ﻤﻨﻪ ﻓﻲ ﺘﺠﻬﻴﺯﺍﺕ ‪LDR‬‬ ‫• ﻓﻲ ﺒﺘﻘﻨﻴﺔ ‪ HDR‬ﻴﺘﻡ ﻋﺎﺩﺓ ﺘﺤﺭﻴﻙ ﺍﻟﻤﺼﺩﺭ ﺍﻟﻭﺍﺤﺩ ﺇﻟﻰ ﻋ ‪‬ﺓ‬ ‫ﺩ‬ ‫ﻤﻭﺍﻀﻊ ﺒﻴﻨﻤﺎ ﻓﻲ ﺘﻘﻨﻴﺔ ‪ LDR‬ﻻ ﻴﺘﻡ ﺘﺤﺭﻴﻙ ﺍﻟﻤﺼﺩﺭ ﺤﻴﺙ‬ ‫ﻴﻭﺠﺩ ﻋ ‪‬ﺓ ﻤﺼﺎﺩﺭ ﺘﺸﺤﻥ ﺇﻟﻰ ﺩﺍﺨل ﺠﺴﻡ ﺍﻟﻤﺭﻴﺽ.‬ ‫ﺩ‬ ‫• ﻓﻲ ﺒﺘﻘﻨﻴﺔ ‪ HDR‬ﻴﻁﺒﻕ ﺯﻤﻥ )ﺍﻟﺘﻌﺭﺽ ﻟﻺﺸﻌﺎﻉ( ﻤﻊ ﻤﻌﺩل‬ ‫ﺠﺭﻋﺔ ﻋﺎﻟﻲ ﺃﻗﺼﺭ ﺒﻜﺜﻴﺭ ﻤﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺒﺘﻘﻨﻴﺔ ‪LDR‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 53‬ ‫א‬ ‫1102/30/51‬ ‫א‬ ‫‪HDR‬‬ ‫• ﻋﺎﺩﺓ ﺘﻜﻭﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻤﺠﺯﺌﺔ ﻋﻠﻰ ﻋ ‪‬ﺓ ﺠﺭﻋﺎﺕ )ﻋﻠﻰ‬ ‫ﺩ‬ ‫ﺴﺒﻴل ﺍﻟﻤﺜﺎل: 6 ﺠﻠﺴﺎﺕ ﻋﻼﺠﻴﺔ ﻭﺍﻟﺠﺭﻋﺔ ‪.(6 Gy‬‬ ‫• ﻓﻲ ﻜل ﻤﺭﺓ ﻴﺩﺨل ﺍﻟﻤﺭﻴﺽ ﺇﻟﻰ ﺍﻟﻤﺴﺘﺸﻔﻰ ﻴﺘﻡ ﺘﺤﻤﻴل‬ ‫ﺍﻟﻤﺼﺎﺩﺭ ﺇﻟﻰ ﺍﻟﻤﺭﻴﺽ ﻤﻥ ﺃﺠل ﺍﻟﻤﻌﺎﻟﺠﺔ.‬ ‫• ﺍﻟﻔﺘﺭﺓ ﺍﻟﻔﺎﺼﻠﺔ ﻤﺎ ﺒﻴﻥ ﺠﻠﺴﺘﻲ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻴﺠﺏ ﺃﻥ ﻻ ﺘﻘل‬ ‫ﻋﻥ 6 ﺴﺎﻋﺎﺕ ﻭﺫﻟﻙ ﻜﻲ ﺘﺴﺘﻁﻴﻊ ﺍﻟﻨﺴﺞ ﺍﻟﺴﻠﻴﻤﺔ ﺇﻋﺎﺩﺓ‬ ‫ﺘﺭﻤﻴﻡ ﺠﺯﺀ ﻤﻨﻬﺎ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 63‬ ‫81‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫‪) HDR‬‬ ‫א‬ ‫מ‬ ‫א‬ ‫א‬ ‫(‬ ‫.‬ ‫ﺼﻨﻊ ﺸﺭﻜﺔ ﻓﺎﺭﻴﻥ ‪Varian‬‬ ‫ﻗﺴﺎﻁﺭ ﻨﻘل ﺍﻟﻤﺼﺎﺩﺭ ﻤﻭﺼﻭﻟﺔ ﺒﺄﻤﺎﻜﻨﻬﺎ ﺨﻼل‬ ‫ﺘﻁﺒﻴﻕ ﺍﻟﻤﻌﺎﻟﺠﺔ. ﻴﺩل ﺍﻟﻤﺼﺒﺎﺡ ﺍﻷﺨﻀﺭ ﻋﻠﻰ‬ ‫ﺃﻥ ﺃﻨﺎﺒﻴﺏ ﺍﻟﻘﺴﻁﺭﺓ ﻓﻲ ﺤﺎﻟﺔ ﺍﻟﻌﻤل.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 73‬ ‫א‬ ‫1102/30/51‬ ‫‪) HDR‬‬ ‫א‬ ‫(‬ ‫‪HDR‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 83‬ ‫91‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

Barchytherapy Equipment and Protection 15/03/2011 ‫א‬ LDR HDR ‫א‬ ‫א‬ ‫א‬ :‫ ﺒﻌﻨﻕ ﺍﻟﺭﺤﻡ‬LDR (137Cs) ‫ﺇﺩﺨﺎل‬ 10 pellets each 550 MBq = 5.5 GBq total • ~ 0.2 mSv/h at 1 m • ~ 5 days for 1 mSv • 39 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 15/03/2011 LDR HDR ‫א‬ ‫א‬ ‫א‬ ‫א‬ HDR (192Ir) ‫ﻤﻌﺎﻟﺠﺔ ﺒﺎﺴﺘﺨﺩﺍﻡ ﺍﻹﻴﺭﻴﺩﻴﻭﻡ‬ 370 GBq source • ~ 47 mSv/h at 1 m • ~1.3 minutes for 1 mSv • ‫ﺒﺎﺏ ﻏﺭﻓﺔ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻴﺠﺏ ﺃﻥ ﻴﻜﻭﻥ ﻤﻘﻔل‬ 15/03/2011 Ossama Anjak, oanjak@yahoo.com, Damascus, SYRIA 40 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 20

Barchytherapy Equipment and Protection 15/03/2011 Image Guided Brachytherapy ‫ ﻓﻲ ﻤﻌﺎﻟﺠﺔ‬ultrasound ‫ﺘﺴﺘﺨﺩﻡ ﺍﻷﻤﻭﺍﺝ ﻓﻭﻕ ﺍﻟﺼﻭﺘﻴﺔ‬ (125-‫ﺍﻟﺒﺭﻭﺴﺘﺎﺕ )ﺯﺭﻉ ﺒﺫﻭﺭ ﺍﻟﻴﻭﺩ‬ guidance plate 41 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 15/03/2011 ‫א‬ ‫ﻁﺎﻭﻟﺔ ﺍﻟﻤﺭﻴﺽ‬ ‫ﻤﺴﺩﺩ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﺸﻌﺔ ﻀﻤﻥ ﺍﻟﺒﺭﻭﺴﺘﺎﺕ‬ 15/03/2011 Ossama Anjak, oanjak@yahoo.com, Damascus, SYRIA ‫ﻜﺎﺸﻑ ﺇﺸﻌﺎﻋﻲ‬ 42 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 21

Barchytherapy Equipment and Protection ‫מא‬ 15/03/2011 ‫א‬ ‫א‬ ‫א א‬ 43 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 15/03/2011 ‫א‬ Ossama Anjak, oanjak@yahoo.com, Damascus, SYRIA ‫א‬ Brachytherapy Accessories (Prostate Treatment). ‫א‬ 22

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫ﻤﻌﺎﻟﺠﺔ ﺒﻌﺽ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻘﻠﺒﻴﺔ‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 54‬ ‫1102/30/51‬ ‫א‬ ‫א‬ ‫• ﻴﺴﺘﺨﺩﻡ ﻓﻲ ﻫﺫﻩ ﺍﻟﺘﻘﻨﻴﺔ ﻗﺴﺎﻁﺭ ﺃﻭ ﻜﺭﺍﺕ ﺃﻭ ﻗﻭﺍﻟﺏ ﻤﻥ ﻤﻭﺍﺩ‬ ‫ﻤﺸﻌﺔ ﻟﻤﻌﺎﻟﺠﺔ ﻤﺸﺎﻜل ﺍﻷﻭﻋﻴﺔ ﺍﻹﻜﻠﻴﻠﻴﺔ ﺃﻭ ﺍﻷﻭﻋﻴﺔ ﺍﻟﺨﺎﺭﺠﻴﺔ.‬ ‫• ﻴﻤﻜﻥ ﺯﺭﻉ ﺍﻟﻤﺼﺩﺭ ﺍﻟﻤﺸﻊ ﺃﻭ ﻁﻼﺀﻩ ﺃﻭ ﻭﻀﻌﺔ ﻀﻤﻥ ﻜﺒﺴﻭﻟﺔ‬ ‫ﻋﻠﻰ ﺸﻜل ﻤﺼﺩﺭ ﻤﺨﺘﻭﻡ ﻤﻭﺼﻭل ﺇﻟﻰ ﺴﻠﻙ ﺘﻭﺠﻴﻪ )ﺩﻟﻴل(‬ ‫ﻟﻼﺴﺘﻌﻤﺎل ﻓﻲ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﻘﻭﻴﻡ ﺍﻟﻭﻋﺎﺌﻲ.‬ ‫• ﻴﻤﻜﻥ ﺯﺭﻉ ﺍﻟﻤﺎﺩﺓ ﺍﻟﻤﺸﻌﺔ ﺒﺼﻭﺭﺓ‬ ‫ﺩﺍﺌﻤﺔ ﺃﻭ ﻨﺯﻋﻬﺎ ﺒﻭﺍﺴﻁﺔ ﺍﻟﺴﻠﻙ ﻋﻘﺏ‬ ‫ﺍﻟﺘﺄﺜﺭ ﻋﻠﻰ ﺠﺩﺍﺭ ﺍﻟﻭﻋﺎﺀ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 64‬ ‫32‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫א‬ ‫)‬ ‫א‬ ‫(:‬ ‫ﺍﻟﻐﺎﻴﺔ ﻤﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫• ﻋﻘﺏ ﻓﺘﺢ ﺍﻟﻭﻋﺎﺀ ﺍﻟﻤﻐﻠﻕ ﻤﻥ ﺨﻼل ﺇﺠﺭﺍﺀ ﺍﻟﻘﺴﻁﺭﺓ‬ ‫ﺍﻟﻭﻋﺎﺌﻴﺔ ﻫﻨﺎﻙ ﺍﺤﺘﻤﺎل ﻗﻭﻱ ﻹﻋﺎﺩﺓ ﺍﻨﺴﺩﺍﺩ ﺍﻟﻭﻋﺎﺀ‬ ‫)+%06 ( ﺃﻱ ﻤﻌﺎﻭﺩﺓ ﺤﺩﻭﺙ ﺘﻀﻴﻕ ﻭﻋﺎﺌﻲ.‬ ‫• ﻟﻭﺤﻅ ﺃﻥ ﺍﻹﺸﻌﺎﻉ ﻴﺴﺎﻋﺩ ﻓﻲ ﺍﻟﺤﺩ ﻤﻥ ﻨﻤﻭ ﺍﻟﺨﻼﻴﺎ‬ ‫ﻭﺒﺎﻟﺘﺎﻟﻲ ﻟﻪ ﺘﺄﺜﻴﺭ ﻗﻭﻱ ﻋﻠﻰ‬ ‫.‬ ‫• ﺘﺴﺘﺨﺩﻡ ﻤﻨﺎﺒﻊ ﻏﺎﻤﺎ ﻤﺜل‬ ‫‪.90Sr/Y, 188Re‬‬ ‫ﺃﻭ ﻤﻨﺎﺒﻊ ﺒﻴﺘﺎ ﻤﺜل‬ ‫‪192Ir‬‬ ‫,‪32P‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 74‬ ‫א‬ ‫1102/30/51‬ ‫א‬ ‫ﻤﺼﺎﺩﺭ ﺒﻴﺘﺎ:‬ ‫)‬ ‫(:‬ ‫• ﻟﻬﺎ ﻤﺠﺎل ﻤﺤﺩﻭﺩ ﻀﻤﻥ ﺍﻟﻨﺴﺞ.‬ ‫ﺃﺩﺍﺓ ﻫﻴﺩﺭﻭﻟﻴﻜﻴﺔ‬ ‫• ﺃﻜﺜﺭ ﺃﻤﺎﻨﺎ ﻤﻥ ﺠﻬﺔ ﺍﻟﻭﻗﺎﻴﺔ‬ ‫ﹰ‬ ‫ﺍﻹﺸﻌﺎﻋﻴﺔ.‬ ‫• ﺫﺍﺕ ﺤﺠﻡ ﺼﻐﻴﺭ.‬ ‫ﻤﺴﺎﺭ ﻟﻤﺼﺩﺭ )‪(90Sr‬‬ ‫ﻗﺴﻁﺎﺭ ﻨﻘل ﺍﻟﻤﺼﺩﺭ ﺍﻟﻤﺸﻊ‬ ‫)‪Beta-Cath™ System (Novoste‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 84‬ ‫42‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

Barchytherapy Equipment and Protection :( 15/03/2011 ) ‫א‬ ‫א‬ ‫ﺨﻼل ﺍﻟﻤﻌﺎﻟﺠﺔ‬ Pre-PTCA ‫6 ﺃﺸﻬﺭ ﺒﻌﺩ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ Post-PTCA 49 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 15/03/2011 :‫ﺿﺒﻂ ﺍﳉﻮﺩﺓ ﰲ ﺍﳌﻌﺎﳉﺔ ﻋﻦ ﻗﺮﺏ‬ Ossama Anjak, oanjak@yahoo.com, Damascus, SYRIA 25

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫ﺍﺨﺘﺒﺎﺭ ﻤﺼﺎﺩﺭ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻥ ﻗﺭﺏ:‬ ‫ﻋﻨﺩ ﺍﺴﺘﻼﻡ ﺍﻟﻤﺼﺎﺩﺭ ﻴﺠﺏ ﺍﻟﻘﻴﺎﻡ ﺒﺎﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺎﻟﻴﺔ‬ ‫ﻭﺘﻭﺜﻴﻘﻬﺎ:‬ ‫• ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺍﻟﺸﻜل ﺍﻟﻔﻴﺯﻴﺎﺌﻲ ﻭﺍﻟﻜﻴﻤﻴﺎﺌﻲ.‬ ‫• ﻜﺒﺴﻭﻟﺔ ﺍﻟﻤﺼﺩﺭ، ﺍﺨﺘﺒﺎﺭ ﺍﻟﻤﺴﺢ .‬ ‫• ﺘﻭﺯﻉ ﺍﻟﻤﺎﺩﺓ ﺍﻟﻤﺸﻌﺔ ﻭﺍﻟﺘﺠﺎﻨﺱ:‬ ‫ﺘﺼﻭﻴﺭ ﺍﻟﻤﺼﺩﺭ ‪.Autoradiograph‬‬ ‫ﺘﺠﺎﻨﺱ ﺍﻟﻨﺸﺎﻁ ﺍﻹﺸﻌﺎﻋﻲ ﻓﻴﻤﺎ ﺒﻴﻥ ﺍﻟﺒﺫﻭﺭ.‬ ‫ﺇﺠﺭﺍﺀ ﻓﺤﺹ ﻋﻴﺎﻨﻲ ﻟﻠﺒﺫﻭﺭ ﻀﻤﻥ ﺍﻷﺸﺭﻁﺔ ‪.ribbons‬‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 15‬ ‫1102/30/51‬ ‫ﺍﺨﺘﺒﺎﺭ ﻤﺼﺎﺩﺭ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻥ ﻗﺭﺏ )ﺘﺘﻤﺔ(:‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫ﻴﺠﺏ ﺍﺨﺘﺒﺎﺭ ﻭﻤﻌﺎﻴﺭﺓ ﻜﺎﻓﺔ ﺍﻟﻤﺼﺎﺩﺭ ﻋﻨﺩ ﺍﻻﺴﺘﻼﻡ.‬ ‫ﻤﻥ ﺃﺠل ﻋﺩﺩ ﻜﺒﻴﺭ ﻤﻥ ﺍﻟﻤﺼﺎﺩﺭ ﺫﺍﺕ ﻋﻤﺭ ﻨﺼﻑ ﻗﺼﻴﺭ‬ ‫ﻴﻜﻔﻲ ﺍﺨﺘﺒﺎﺭ ﻭﻤﻌﺎﻴﺭﺓ ﻋﻴﻨﺔ ﺤﻭﺍﻟﻲ )%01~( ﻤﻥ ﺍﻟﻤﺼﺎﺩﺭ‬ ‫ﺍﻟﻤﻭﺭﺩﺓ .‬ ‫ﻴﺠﺏ ﺘﻭﺜﻴﻕ )ﺘﺴﺠل( ﻨﺘﺎﺌﺞ ﺍﻟﻤﻌﺎﻴﺭﺓ‬ ‫ﻤﻘﺩﺍﺭ ﺍﻟﺨﻁﺄ ﺍﻟﻤﺴﻤﻭﺡ ﺒﻪ ﺍﻟﻤﻘﺘﺭﺡ:‬ ‫ﻤﺘﻭﺴﻁ ﺍﻟﻜﻤﻴﺔ )%3(.‬ ‫ﺍﻹﻨﺤﺭﺍﻑ ﻋﻥ ﺍﻟﻤﺘﻭﺴﻁ )5%(.‬ ‫ﻤﻥ ﺃﺠل ﻤﻌﺭﻓﺔ ﻤﻘﺩﺍﺭ ﺍﻟﺴﻤﺎﺤﻴﺔ ﺭﺍﺠﻊ ﺍﻟﻭﺜﺎﺌﻕ ﺍﻟﻭﺍﺭﺩﺓ ﻤﻥ‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 25‬ ‫ﺍﻟﺸﺭﻜﺔ ﺍﻟ ﺎﻨ ﺔ‬ ‫62‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫اﻟﻤﻌﺎﻳﺮة ‪Calibration‬‬ ‫• ﻳﺘﻢ إﺟﺮاء اﻟﻤﻌﺎﻳﺮة ﻋﻨﺪ اﺳﺘﻼم اﻟﻤﻨﺎﺑﻊ واﻟﻮﺛﺎﺋﻖ اﻟﻌﺎﺋﺪة ﻟﻬﺎ.‬ ‫• ﺗﺘﻢ اﻟﻤﻌﺎﻳﺮة ﻟﻜﻞ ﻣﻨﺒﻊ ﻣﻦ اﻟﻤﻨﺎﺑﻊ اﻟﻤﺴﺘﻠﻤﺔ.‬ ‫– اﻟﻤﻨﺎﺑﻊ ذات ﻧﺼﻒ اﻟﻌﻤﺮ اﻟﻄﻮﻳﻞ )731 ‪: (eg Cs‬‬ ‫• آﺎﻓﺔ اﻟﻤﻨﺎﺑﻊ.‬ ‫‪Nucletron‬‬ ‫• ﻣﻨﺎﺑﻊ ذات ﻧﺼﻒ ﻋﻤﺮ ﻗﺼﻴﺮ )521-‪.( ...... Ir-193, I‬‬ ‫– إذا آﺎن ﻋﺪد اﻟﻤﻨﺎﺑﻊ ﻗﻠﻴﻞ ﺗﺘﻢ اﻟﻤﻌﺎﻳﺮة ﻟﻜﺎﻓﺔ اﻟﻤﻨﺎﺑﻊ.‬ ‫– إذا آﺎن ﻋﺪد اﻟﻤﻨﺎﺑﻊ آﺒﻴﺮ )ﺑﺬور 521-‪ I‬ﻟﻤﻌﺎﻟﺠﺔ اﻟﺒﺮوﺳﺘﺎت( ﺗﺠﺮى‬ ‫اﻟﻤﻌﺎﻳﺮة ﻟﻌﻴﻨﺔ ﻣﻦ اﻟﻤﻨﺎﺑﻊ ) 01% ﻋﻠﻰ اﻷﻗﻞ(.‬ ‫35‬ ‫‪Ossama Anjak‬‬ ‫1102/30/51‬ ‫ﺿﻤﺎن اﻟﺠﻮدة ﻟﻠﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ اﻟﻤﺴﺘﺨﺪﻣﺔ‬ ‫ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ ﻋﻦ ﻗﺮب‬ ‫• ﻳﺠﺐ إﺟﺮاء اﺧﺘﺒﺎرات ﺿﻤﺎن اﻟﺠﻮدة اﻟﺘﺎﻟﻴﺔ ﻋﻨﺪ اﺳﺘﻼم اﻟﻤﻨﺎﺑﻊ‬ ‫اﻟﻤﺸﻌﺔ:‬ ‫– اﻟﺸﻜﻞ اﻟﻔﻴﺰﻳﺎﺋﻲ واﻟﻜﻴﻤﻴﺎﺋﻲ ﻟﻠﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ.‬ ‫– اﻟﺘﺄآﺪ ﻣﻦ ﻏﻼف اﻟﻤﻨﺎﺑﻊ.‬ ‫‪Mentor‬‬ ‫– ﺗﻮزع اﻟﻨﻜﻠﻴﺪ اﻟﻤﺸﻊ واﻟﺘﺠﺎﻧﺲ. ‪Radionuclide distribution‬‬ ‫‪.and uniformity‬‬ ‫• ﺗﺼﻮﻳﺮ اﻟﻤﻨﺒﻊ ‪.Autoradiograph‬‬ ‫45‬ ‫72‬ ‫‪Ossama Anjak‬‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫ﺿﻤﺎن اﻟﺠﻮدة ﻟﻮﺣﺪات اﻟﺘﺤﻤﻴﻞ اﻵﻟﻲ اﻟﻤﺴﺘﺨﺪﻣﺔ‬ ‫ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ ﻋﻦ ﻗﺮب‬ ‫• ﻗﺒﻞ اﻟﺒﺪء ﺑﺎﻟﻤﻌﺎﻟﺠﺔ ﻳﺠﺐ اﻟﺘﺄآﺪ ﻣﻤﺎ ﻳﻠﻲ:‬ ‫– ﻧﻈﻢ اﻵﻣﺎن ﻓﻲ اﻟﻐﺮﻓﺔ وﻗﻔﻞ اﻟﺒﺎب اﻟﻤﺘﺮاﺑﻂ ﻣﻊ ﺁﻟﻴﺔ اﻟﺘﺸﻌﻴﻊ ‪door‬‬ ‫‪interlocks‬‬ ‫– اﻹﺿﺎءة وﺁﻟﻴﺔ اﻹﻧﺬار‪Lights and alarms‬‬ ‫– ﺟﻬﺎز ﻣﺮاﻗﺒﺔ اﻹﺷﻌﺎع ‪Radiation monitor‬‬ ‫– ﻋﻤﻞ وﺣﺪة اﻟﺘﺤﻜﻢ ‪Console functions‬‬ ‫– ﻓﺤﺺ ﻋﻴﺎﻧﻲ ﻟﺪﻟﻴﻞ اﻟﻤﻨﺒﻊ ‪source guides‬‬ ‫‪Gamma Sonics‬‬ ‫‪Ossama Anjak‬‬ ‫55‬ ‫1102/30/51‬ ‫ﺿﻤﺎن اﻟﺠﻮدة ﻟﻮﺣﺪات اﻟﺘﺤﻤﻴﻞ اﻵﻟﻲ اﻟﻤﺴﺘﺨﺪﻣﺔ‬ ‫ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ ﻋﻦ ﻗﺮب‬ ‫• أﺳﺒﻮﻋﻴﺎ:‬ ‫ً‬ ‫– اﻟﺪﻗﺔ ﻓﻲ ﺗﺤﻤﻴﻞ اﻟﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ ‪ source‬واﻟﻤﻨﺎﺑﻊ اﻟﻮهﻤﻴﺔ ‪dummy‬‬ ‫– اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﻮﺿﻊ اﻟﻤﻨﺎﺑﻊ ‪Source positioning‬‬ ‫• ﻋﻨﺪ ﺗﺒﺪﻳﻞ أو آﻞ 3 أﺷﻬﺮ:‬ ‫– إﺟﺮاء ﻣﻌﺎﻳﺮة ‪Calibration‬‬ ‫– أداء اﻟﻤﺆﻗﺖ اﻟﺰﻣﻨﻲ ‪.Timer function‬‬ ‫– اﻟﺪﻗﺔ ﻓﻲ أﻧﺎﺑﻴﻦ ﻧﻘﻞ اﻟﻤﻨﺒﻊ ‪ source guides‬واﻟﻮﺻﻼت.‬ ‫65‬ ‫82‬ ‫‪Ossama Anjak‬‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫ﺿﻤﺎن اﻟﺠﻮدة ﻟﻮﺣﺪات اﻟﺘﺤﻤﻴﻞ اﻵﻟﻲ اﻟﻤﺴﺘﺨﺪﻣﺔ‬ ‫ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ ﻋﻦ ﻗﺮب‬ ‫• ﺳﻨﻮﻳﺎ:‬ ‫ً‬ ‫– ﺧﻮارزﻣﻴﺔ ﺣﺴﺎب اﻟﺠﺮﻋﺔ ‪Dose calculation algorithm‬‬ ‫– إﺟﺮاء ﻣﺤﺎآﺎة ﻟﺤﺎﻟﺔ اﻟﻄﻮارئ ‪Simulate emergency‬‬ ‫‪conditions‬‬ ‫– اﻟﺘﺤﻘﻖ ﻣﻦ ﺗﺨﺰﻳﻦ اﻟﻤﻨﺎﺑﻊ ‪Verify source inventory‬‬ ‫75‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫ﺿﻤﺎن اﻟﺠﻮدة ﻟﻮﺣﺪات اﻟﺘﺤﻤﻴﻞ اﻵﻟﻲ اﻟﻤﺴﺘﺨﺪﻣﺔ‬ ‫ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ ﻋﻦ ﻗﺮب‬ ‫اﺧﺘﺒﺎرات اﻵﻣﺎن اﻹﺷﻌﺎﻋﻲ.‬ ‫اﻟﺘﺤﻘﻖ ﻣﻦ ﺳﻼﻣﺔ اﻟﻤﺼﺎدر اﻟﻤﺸﻌﺔ.‬ ‫اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﻮﺿﻊ اﻟﻤﺼﺎدر ) ﻣﻮﺿﻊ اﻟﺴﻜﻦ ‪dwell‬‬ ‫‪.(position‬‬ ‫اﻟﺘﺤﻘﻖ ﻣﻦ زﻣﻦ اﻟﻤﻌﺎﻟﺠﺔ )زﻣﻦ اﻟﺒﻘﺎء(.‬ ‫85‬ ‫92‬ ‫‪Ossama Anjak‬‬ ‫1102/30/51‬ ‫‪Ossama Anjak‬‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﻮﺿﻊ اﻟﻤﺼﺪر اﻟﻤﺸﻊ‬ ‫‪Verification of source position‬‬ ‫• ﻳﻤﻜﻦ اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﻮﺿﻊ اﻟﻤﻨﺒﻊ ﺑﺎﺳﺘﺨﺪام أﻓﻼم اﻟﺘﺼﻮﻳﺮ‬ ‫95‬ ‫‪Ossama Anjak‬‬ ‫اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﻮﺿﻊ اﻟﻤﺼﺪر اﻟﻤﺸﻊ‬ ‫1102/30/51‬ ‫‪position check‬‬ ‫• ﻹﺟﺮاء هﺬا اﻻﺧﺘﺒﺎر ﻳﺴﺘﺨﺪم أﻓﻼم‬ ‫ﻣﻦ ﻧﻮع ‪ Auto-radiograph‬ﻣﻦ‬ ‫أﺟﻞ اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﻮﺿﻊ اﻟﻤﺼﺎدر‬ ‫اﻟﻤﺸﻌﺔ اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ ﻧﻤﻂ‬ ‫‪.HDR‬‬ ‫06‬ ‫03‬ ‫‪Ossama Anjak‬‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﻜﺎن اﻟﻤﻨﺎﺑﻊ ‪LDR‬‬ ‫‪LDR source position check‬‬ ‫‪Auto-radiograph‬‬ ‫16‬ ‫‪QA kit for LDR auto‬‬‫‪radiograph‬‬ ‫‪Ossama Anjak‬‬ ‫א‬ ‫‪LDR unit‬‬ ‫1102/30/51‬ ‫:‬ ‫ﻤﻌﺎﻴﺭﺓ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﺸﻌﺔ: ﻫﻲ ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺍﻟﻨﻜﻠﻴﺩ ﺍﻟﻤﺸﻊ‬ ‫ﻭﻤﻭﺍﺼﻔﺎﺕ ﺘﺼﻤﻴﻡ ﺍﻟﻤﺼﺩﺭ ﻭﻴﺠﺏ ﺃﻥ ﺘﺠﺭﻯ ﺍﻟﻤﻌﺎﻴﺭﺓ ﻤﻥ ﻗﺒل‬ ‫ﻫﻴﺌﺔ ﻤﺨﺘﺼﺔ ﻤﺭﺨﺹ ﻟﻬﺎ ﻤﻥ ﻗﺒل ﺍﻟﺴﻠﻁﺔ ﺍﻟﺭﻗﺎﺒﻴﺔ. ﻜﻤﺎ ﻴﺠﺏ‬ ‫ﻤﻼﺤﻅﺔ ﻤﺎ ﻴﻠﻲ:‬ ‫• ﺍﻟﺩﻗﺔ ﻓﻲ ﺍﻟﻤﻌﺎﻴﺭﺓ.‬ ‫• ﻤﻌﺎﻤﻼﺕ ﺍﻟﺘﺩﺭﻴﺞ ﻭﺍﻟﺨﻁﻴﺔ.‬ ‫• ﻜﻔﺎﺀﺓ ﺘﺠﻤﻴﻊ ﺍﻻﻴﻭﻨﺎﺕ.‬ ‫• ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺍﻟﺸﻜل ﺍﻟﻬﻨﺩﺴﻲ ﻭﻁﻭل ﺍﻟﻤﺼﺩﺭ.‬ ‫• ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺍﻟﻁﺎﻗﺔ.‬ ‫• ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﻏﻼﻑ ﺍﻟﻤﺼﺩﺭ.‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 26‬ ‫13‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫ﻤﻌﺎﻴﺭﺓ ﻤﺼﺎﺩﺭ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻥ ﻗﺭﺏ )ﺘﺘﻤﺔ(‬ ‫ﻤﻥ ﺃﺠل ﺍﻟﻤﻌﺎﻴﺭﺓ ﻴﺠﺏ ﺍﺴﺘﻌﻤﺎل ﻤﺼﺩﺭ ﻤﺨﺘﻭﻡ ﺫﻭ ﻋﻤﺭ ﺍﻟﻨﺼﻑ‬ ‫ﻁﻭﻴل ﻤﻊ ﺍﻷﺨﺫ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ:‬ ‫ﺍﻟﺜﻘﺔ ﻓﻲ ﺍﻵﻟﻴﺔ ﺍﻟﻤﻴﻜﺎﻨﻴﻜﻴﺔ ‪reliable mechanical‬‬ ‫‪.integrity‬‬ ‫ﺍﻟﻤﻌﺭﻓﺔ ﺍﻟﺩﻗﻴﻘﺔ ﻟﺜﺎﺒﺕ ﺍﻟﺘﻔﻜﻙ.‬ ‫ﺸﻬﺎﺩﺓ ﺍﻟﻤﻌﺎﻴﺭﺓ ﺍﻟﻤﺭﺴﻠﺔ ﻤﻥ ﺍﻟﺸﺭﻜﺔ ﺍﻟﺼﺎﻨﻌﺔ.‬ ‫ﻴﺠﺏ ﺃﻴﻀﺎ ﺃﻥ ﻨﻀﻊ ﺒﺎﻟﺤﺴﺒﺎﻥ ﺇﻤﻜﺎﻨﻴﺔ ﺇﺠﺭﺍﺀ ﺍﺨﺘﺒﺎﺭ ﺒﺎﺴﺘﺨﺩﺍﻡ‬ ‫ﹰ‬ ‫ﺠﻬﺎﺯ ﻤﻌﺎﻴﺭﺓ ﺁﺨﺭ‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 36‬ ‫1102/30/51‬ ‫اﻟﻤﻌﺎﻟﺠﺔ ﻋﻦ ﻗﺮب‬ ‫وإﺟﺮاءات اﻟﻮﻗﺎﻳﺔ واﻷﻣﺎن‬ ‫1102/51/3‬ ‫23‬ ‫‪Ossama Anjak‬‬ ‫46‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫ﺗﺨﺰﻳﻦ اﻟﻤﻨﺎﺑﻊ:‬ ‫ﻳﺠﺐ أن ﺗﺨﺰن اﻟﻤﻨﺎﺑﻊ ﻓﻲ ﺣﺎوﻳﺎت ﺧﺎﺻﺔ ذات‬ ‫ﺗﺪرﻳﻊ آﺎف ﻣﻦ أﺟﻞ اﻟﻮﻗﺎﻳﺔ اﻹﺷﻌﺎﻋﻴﺔ‬ ‫أن ﺗﻜﻮن أﻣﺎآﻦ اﻟﺘﺨﺰﻳﻦ ﻣﻌﺪة ﻣﺴﺒﻘﺎ ﻟﻬﺬﻩ‬ ‫ً‬ ‫اﻟﻐﺎﻳﺔ اﻋﺘﻤﺎدا ﻋﻠﻰ ﻧﻮﻋﻴﺔ وآﻤﻴﺔ اﻟﻤﻮاد‬ ‫ً‬ ‫اﻟﻤﺸﻌﺔ اﻟﺘﻲ ﺳﺘﺨﺰن ﺿﻤﻨﻪ.‬ ‫ﻳﺠﺐ أن ﻳﻜﻮن اﻟﻤﺨﺰن ﻣﻘﺴﻤﺎ إﻟﻰ أﺟﺰاء‬ ‫ً‬ ‫ﻟﻠﺪﺧﻮل إﻟﻴﻪ ﺑﺴﻬﻮﻟﺔ وﻳﺴﻤﺢ أﻳﻀﺎ ﺑﺴﻬﻮﻟﺔ‬ ‫‪Ossama Anjak‬‬ ‫1102/51/3 اﻟﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ آﻞ ﻋﻠﻰ ﺣﺪة‬ ‫ﻣﺮاﻗﺒﺔ‬ ‫56‬ ‫ﻣﺘﻄﻠﺒﺎت اﻟﺴﻼﻣﺔ ﻟﻠﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ‬ ‫•ﻭﻓﻘﺎ ﻟﻤﻌﺎﻴﻴﺭ ﺍﻟﻤﻨﻅﻤﺔ ﺍﻟﺩﻭﻟﻴﺔ ﻟﻠﻤﻘﺎﻴﻴﺱ ‪ ISO‬ﻟﺘﺼﻨﻴﻑ ﺍﻟﻤﻨﺎﺒﻊ ﻭﻤﺘﻁﻠﺒﺎﺕ‬ ‫ﹰ‬ ‫ﺍﻟﺴﻼﻤﺔ ﻓﺈﻥ ﺍﻟﻤﻨﺎﺒﻊ ﺍﻟﻤﺸﻌﺔ ﺍﻟﻤﺴﺘﻌﻤﻠﺔ ﻓﻲ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻥ ﻗﺭﺏ:‬ ‫1. ﻴﺠﺏ ﺃﻥ ﺘﺯﻭﺩ ﺒﻭﺜﻴﻘﺔ )ﺸﻬﺎﺩﺓ( ﺘﻌﺭﻴﻑ ﻤﻥ ﺍﻟﺸﺭﻜﺔ ﺍﻟﺼﺎﻨﻌﺔ ﺘﺒﻴﻥ ﻓﻴﻬﺎ:‬ ‫•ﺃﻥ ﺘﻠﻙ ﺍﻟﻤﻨﺎﺒﻊ ﻤﺘﻁﺎﺒﻘﺔ ﻤﻊ ﺍﻟﻤﻌﺎﻴﻴﺭ ﺍﻟﻤﻌﺘﻤﺩﺓ.‬ ‫•ﺠﻤﻴﻊ ﺍﻟﻤﻨﺎﺒﻊ ﺍﻟﻤﺴﺘﺨﺩﻤﺔ ﻓﻲ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻥ ﻗﺭﺏ ﻫﻲ ﻤﻨﺎﺒﻊ ﻤﻐﻠﻘﺔ ﺃﻱ ﺃﻥ ﺍﻟﻤﺎﺩﺓ ﺍﻟﻤﺸﻌﺔ‬ ‫ﻤﻐﻠﻔﺔ ﺒﻤﻌﺩﻥ.‬ ‫•ﺍﻹﺭﻴﺩﻴﻭﻡ 291‪ Ir‬ﻋﻨﺩﻤﺎ ﻴﻜﻭﻥ ﻋﻠﻰ ﺸﻜل ﺃﺴﻼﻙ ﺃﻭ ﻤﺜل ﺩﺒﺎﺒﻴﺱ ﺍﻟﺸﻌﺭ ‪hair‬‬ ‫‪ pins‬ﻭﺘﺼﻨﻑ ﻫﺫﻩ ﺍﻟﻤﻨﺎﺒﻊ ﻋﻠﻰ ﺃﻨﻬﺎ ﻤﻨﺎﺒﻊ ﻤﻐﻠﻘﺔ ﻋﻠﻤﺎ ﺃﻥ ﻟﺏ ﺍﻟﻤﻨﺒﻊ ﺍﻟﻤﺸﻊ‬ ‫ﹰ‬ ‫ﺴﻴﻜﻭﻥ ﻤ ‪‬ﺭﺽ ﻭﻤﻜﺸﻭﻑ ﻋﻨﺩ ﻗﻁﻊ ﺍﻟﺴﻠﻙ ﺃﻭ ﺩﺒﻭﺱ ﺍﻟﺸﻌﺭ.‬ ‫ﻌ‬ ‫1102/51/3‬ ‫33‬ ‫‪Ossama Anjak‬‬ ‫66‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫ﺷﻬﺎدة ﻣﻌﺎﻳﺮة ﻟﻠﻤﻨﺒﻊ اﻟﻤﺸﻊ:‬ ‫اﺳﻢ اﻟﻨﻜﻠﻴﺪ اﻟﻤﺸﻊ.‬ ‫ﺷﻜﻞ اﻟﻤﻨﺒﻊ واﻟﻨﻤﻮذج.‬ ‫ﺷﺪة اﻟﻤﻨﺒﻊ اﻟﻤﺸﻊ.‬ ‫ﺗﺎرﻳﺦ اﻟﻤﻌﺎﻳﺮة.‬ ‫ﺗﺎرﻳﺦ اﻟﺸﺮاء واﻟﺮﻗﻢ اﻟﻤﺘﺴﻠﺴﻞ ﻟﻠﻤﻨﺒﻊ.‬ ‫اﻟﺸﺮآﺔ اﻟﺼﺎﻧﻌﺔ.‬ ‫اﺧﺘﺒﺎرات اﻟﻘﺒﻮل واﺧﺘﺒﺎرات اﻟﺘﺴﺮﻳﺐ اﻹﺷﻌﺎﻋﻲ.‬ ‫1102/51/3‬ ‫‪Ossama Anjak‬‬ ‫76‬ ‫ﻣﺘﻄﻠﺒﺎت اﻟﺴﻼﻣﺔ ﻟﻠﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ‬ ‫ﻴﺠﺏ ﺇﺠﺭﺍﺀ ﺍﺨﺘﺒﺎﺭ ﺍﻟﻤﺴﺢ ‪wipe test‬‬ ‫ﺍﺨﺘﺒﺎﺭ ﺍﻟﺘﺴﺭﻴﺏ ‪ leakage test‬ﻭﻓﻘﺎ ﻟﻠﻘﻭﺍﻨﻴﻥ ﺍﻟﻤﺤﻠﻴﺔ ﻟﻜل ﺩﻭﻟﺔ.‬ ‫ﹰ‬ ‫ﻴﺠﺏ ﺍﺠﺭﺍﺀ ﺍﺨﺘﺒﺎﺭ ﺍﻟﻤﺴﺢ ﺩﻭﺭﻴﺎ‬ ‫ﹰ‬ ‫1102/51/3‬ ‫43‬ ‫‪Ossama Anjak‬‬ ‫86‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫اﻻﺣﺘﻔﺎظ ﺑﺎﻟﺴﺠﻼت‬ ‫اﻟﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ اﻟﻤﺘﻮﻓﺮة ﻓﻲ اﻟﻘﺴﻢ.‬ ‫ﻳﺪون ﻓﻲ ﺗﻠﻚ اﻟﺴﺠﻼت ﺣﺮآﺔ اﻟﻤﻨﺎﺑﻊ وﻋﻤﻠﻴﺔ ﻧﻘﻠﻪ ﻣﻦ‬ ‫وإﻟﻰ اﻟﻤﺴﺘﻮدع.‬ ‫– آﻨﻘﻞ اﻟﻤﻨﺒﻊ ﻟﻼﺳﺘﻌﻤﺎل ﻓﻲ ﻏﺮﻓﺔ اﻟﻌﻤﻠﻴﺎت وﻣﻦ ﻏﺮﻓﺔ‬ ‫اﻟﻌﻤﻠﻴﺎت إﻟﻰ اﻷﺟﻨﺤﺔ )ﻣﻜﺎن إﻗﺎﻣﺔ اﻟﻤﺮﺿﻰ(‬ ‫1102/51/3‬ ‫‪Ossama Anjak‬‬ ‫96‬ ‫اﻻﺣﺘﻔﺎظ ﺑﺎﻟﺴﺠﻼت‬ ‫اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﺤﺘﻮﻳﺎت اﻟﻤﺴﺘﻮدع أﺳﺒﻮﻋﻴﺎ وﻣﻘﺎرﻧﺘﻬﺎ ﻣﻊ‬ ‫ً‬ ‫اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺪوﻧﺔ ﻓﻲ اﻟﺴﺠﻞ.‬ ‫ﻳﺠﺐ أن ﻳﻘﻮم ﺷﺨﺺ ﻣﺴﺘﻘﻞ ﻣﻦ ﺧﺎرج اﻟﻤﺸﻔﻰ ﺑﻜﺘﺎﺑﺔ‬ ‫ﺗﻘﺎرﻳﺮ ﺳﻨﻮﻳﺔ ﺗﻔﺼﻴﻠﻴﺔ ﻋﻦ اﻟﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ وﻣﻘﺎرﻧﺘﻬﺎ ﻣﻊ‬ ‫ﻗﺎﺋﻤﺔ اﻟﺠﺮد وﺷﻬﺎدة اﻟﻤﻨﺸﺄ‬ ‫1102/51/3‬ ‫53‬ ‫‪Ossama Anjak‬‬ ‫07‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫اﺧﺘﺒﺎر اﻟﻤﻨﺎﺑﻊ ﻋﻨﺪ اﻻﺳﺘﻼم:‬ ‫اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﻮاﺻﻔﺎت اﻟﻤﻨﺒﻊ اﻟﻤﺮﺳﻞ.‬ ‫اﻟﻤﻄﺎﺑﻘﺔ ﻣﻊ اﻟﺸﻬﺎدة اﻟﻤﺮﻓﻘﺔ ﺑﻪ.‬ ‫– اﻟﺘﺤﻘﻖ ﻣﻦ اﻟﻨﺸﺎط اﻹﺷﻌﺎﻋﻲ ﻟﻠﻤﻨﺒﻊ ﻋﻨﺪ اﻻﺳﺘﻼم.‬ ‫إﺟﺮاء ﻗﻴﺎس ﻟﺸﺪة اﻟﻤﻨﺒﻊ ﻗﺒﻞ اﻟﺒﺪء ﺑﺎﺳﺘﺨﺪاﻣﻪ.‬ ‫1102/51/3‬ ‫‪Ossama Anjak‬‬ ‫17‬ ‫إﺟﺮاءات اﻟﻮﻗﺎﻳﺔ‬ ‫واﻷﻣﺎن)1(‬ ‫ﻳﺠﺐ ﻧﻘﻞ اﻟﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ إﻟﻰ اﻟﺤﺎوﻳﺔ ﺑﺴﺮﻋﺔ‬ ‫1102/51/3‬ ‫63‬ ‫‪Ossama Anjak‬‬ ‫27‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫إﺟﺮاءات اﻟﻮﻗﺎﻳﺔ‬ ‫واﻷﻣﺎن)2(‬ ‫ﻋﻨﺪ اﻟﺘﺤﺪث ﻣﻊ اﻟﻤﺮﻳﺾ ﻳﺠﺐ اﻟﻮﻗﻮف ﺧﻠﻒ ﺣﺎﺟﺰ ﺧﺎص‬ ‫ﻳﺆﻣﻦ اﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻹﺷﻌﺎع‬ ‫1102/51/3‬ ‫‪Ossama Anjak‬‬ ‫37‬ ‫إﺟﺮاءات اﻟﻮﻗﺎﻳﺔ‬ ‫واﻷﻣﺎن)3(‬ ‫ﻳﺠﺐ وﺿﻊ إﺷﺎرة ﺗﺤﺬر ﻋﻠﻰ ﺑﺎب اﻟﻐﺮﻓﺔ ﻋﻘﺐ ﺗﺤﻤﻴﻞ اﻟﻤﻨﺎﺑﻊ‬ ‫داﺧﻞ ﺟﺴﻢ اﻟﻤﺮﻳﺾ.‬ ‫1102/51/3‬ ‫73‬ ‫‪Ossama Anjak‬‬ ‫47‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫إﺟﺮاءات اﻟﻮﻗﺎﻳﺔ‬ ‫واﻷﻣﺎن)4(‬ ‫ﻋﻨﺪ ﻧﺰع اﻟﻤﻨﺎﺑﻊ ﻣﻦ اﻟﻤﺮﻳﺾ ﻳﺠﺐ اﻟﺘﺄآﺪ:‬ ‫– ﻣﻦ ﻋﺪد اﻟﻤﻨﺎﺑﻊ وﻳﺠﺐ أن ﻳﻜﻮن ﻣﻄﺎﺑﻘﺎ ﻟﻌﺪد اﻟﻤﻨﺎﺑﻊ‬ ‫ً‬ ‫اﻟﻤﺰروﻋﺔ.‬ ‫– ﻳﺠﺐ إﻋﺎدﺗﻬﺎ ﻣﺒﺎﺷﺮة إﻟﻰ اﻟﺤﺎوﻳﺔ.‬ ‫– ﻳﺠﺐ اﺳﺘﻌﻤﺎل أدوات اﻟﻮﻗﺎﻳﺔ.‬ ‫1102/51/3‬ ‫‪Ossama Anjak‬‬ ‫57‬ ‫إﺟﺮاءات اﻟﻮﻗﺎﻳﺔ‬ ‫واﻷﻣﺎن)5(‬ ‫ﻋﻨﺪ ﻧﺰع اﻟﻤﻨﺎﺑﻊ ﻣﻦ اﻟﻤﺮﻳﺾ ﻳﺠﺐ اﻟﺘﺄآﺪ ﻣﻦ ﻧﺰع‬ ‫آﺎﻓﺔ اﻟﻤﻨﺎﺑﻊ وإﻋﺎدﺗﻬﺎ ﻟﻠﺤﺎوﻳﺔ.‬ ‫– ﻳﺠﺐ إﺟﺮاء ﻣﺴﺢ إﺷﻌﺎﻋﻲ ﻟﻠﻐﺮﻓﺔ واﻟﻤﺮﻳﻀﺔ ﺑﻌﺪ ﻧﻘﻞ‬ ‫اﻟﻤﻨﺎﺑﻊ ﻣﻦ اﻟﻐﺮﻓﺔ‬ ‫1102/51/3‬ ‫83‬ ‫‪Ossama Anjak‬‬ ‫67‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

‫‪Barchytherapy Equipment and Protection‬‬ ‫1102/30/51‬ ‫إﺟﺮاءات اﻟﻮﻗﺎﻳﺔ‬ ‫واﻷﻣﺎن)6(‬ ‫– ﻳﺠﺐ ارﺳﺎل اﻟﻤﻨﺎﺑﻊ إﻟﻰ اﻟﻐﺴﻴﻞ‬ ‫واﻟﺘﻌﻘﻴﻢ ﺑﻌﺪ آﻞ اﺳﺘﻌﻤﺎل.‬ ‫– ﻏﺎﻟﺒﺎ ﻻ ﺗﺤﺘﺎج اﻟﻤﻨﺎﺑﻊ اﻟﻤﺸﻌﺔ‬ ‫ً‬ ‫إﻟﻰ ﺗﻌﻘﻴﻢ إذا اﺳﺘﻌﻤﻞ ﺿﻤﻦ‬ ‫ﻣﻄﺒﻘﺎت ﻣﻐﻠﻘﺔ‬ ‫‪Ossama Anjak‬‬ ‫1102/51/3‬ ‫א‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫:‬ ‫ﻴﻌﺩ ﺘﺨﻁﻴﻁ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺃﻜﺜﺭ ﺍﻟﻤﺭﺍﺤل ﺃﻫﻤﻴﺔ ﻓﻲ ﻤﺠﺎل‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺔ ﻭﻴﺤﺘﺎﺝ ﻜل ﻤﺭﻴﺽ ﻴﺠﺘﺎﺝ ﺍﻟﻰ ﻤﺨﻁﻁ ﺨﺎﺹ‬ ‫ﻴﺘﻨﺎﺴﺏ ﻤﻊ ﺤﺎﻟﺘﻪ. ﻭﻫﺫﺍ ﺍﻟﺘﺨﻁﻴﻁ ﻤﻔﻴﺩ ﻓﻲ ﻭﻗﺎﻴﺔ ﺍﻟﻤﺭﻴﺽ‬ ‫ﺤﺴﺏ ﻤﺎ ﻭﺭﺩ ﻓﻲ ‪،BSS‬‬ ‫ﻴﺘﻁﻭﺭ ﺘﺨﻁﻴﻁ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻟﻴﺼﺒﺢ ﺃﻜﺜﺭ ﺘﻌﻘﻴﺩﺍ ﻭﺒﺎﻟﺘﺎﻟﻲ ﻴﺠﺏ‬ ‫ﹰ‬ ‫ﺃﻥ ﻴﺅﺨﺫ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ ﺍﻟﺯﻤﻥ ﺍﻟﺫﻱ ﻴﺴﺘﻐﺭﻗﻪ ﺇﺠﺭﺍﺀ‬ ‫ﺍﻟﺘﺨﻁﻴﻁ.‬ ‫ﻓﻬﻡ ﻭﺍﺴﺘﻴﻌﺎﺏ ﻤﺭﺍﺤل ﺍﻟﺘﻁﺒﻴﻕ ﻴﻔﻴﺩ ﻓﻲ ﺍﻟﻭﺼﻭل ﺇﻟﻰ ﻨﺘﺎﺌﺞ‬ ‫ﺃﻓﻀل.‬ ‫ﺃﻴﻀﺎ ﺇﺠﺭﺍﺀﺍﺕ ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ‪ QA‬ﻤﻔﻴﺩﺓ.‬ ‫ﹰ‬ ‫ﺍﻟﺸﺭﻴﺤﺔ 87‬ ‫93‬ ‫77‬ ‫1102/30/51‬ ‫,‪Ossama Anjak, oanjak@yahoo.com‬‬ ‫‪Damascus, SYRIA‬‬

Barchytherapy Equipment and Protection 15/03/2011 ‫ﺍﻟﻤﺭﺍﺠﻊ‬ • Johns H E and Cunningham J R 1983 The Physics of Radiology, 4th edition (Springfield: C Thomas) • Khan F M 1994 The Physics of Radiation Therapy, 2nd edition (Williams & Wilkins, Baltimore) • Williams J R and Thwaites D I 1993 Radiotherapy Physics in Practice (Oxford: Oxford University Press) • 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 ICRU 55, Bethesda. Prescribing, recording, and reporting interstitial brachytherapy. 1993. 15/03/2011 Ossama Anjak, oanjak@yahoo.com, Damascus, SYRIA 80 ‫ﺍﻟﺸﺭﻴﺤﺔ‬ 40

Barchytherapy Equipment and Protection 15/03/2011 ‫ﺷﻜﺮا ﻟﺤﻀﻮرآﻢ‬ ً ‫ﻣﻊ‬ ‫أﻃﻴﺐ اﻷﻣﻨﻴﺎت‬ Ossama Anjak, oanjak@yahoo.com, Damascus, SYRIA 41

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