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Abstrak :
ABSTRAK
Tindakan terapi bertujuan untuk memperoleh hasil yang optimal berupa kematian jaringan kanker sebanyak mungkin dan kerusakan minimal pada jaringan sehat sehingga dilakukan upaya untuk mengoptimalkan hasil pengobatan radiasi. Dengan perkembangan teknologi, teknik radioterapi juga berkembang dari konvesional, 3D conformal ke Intensity Modulated Radiotherapy (IMRT). IMRT merupakan teknik meggunakan banyak lapangan radiasi dalam penyinarannya dengan intensitas yang tidak seragam pada setiap arah lapangan radiasi. Sebelum dilakukan penyinaran pada pasien perlu dilakukan verifikasi penyinaran IMRT antara perhitungan pada TPS dan pada keadaan sebenarnya dilapangan. Verifikasi dilakukan dengan mengguunakan film gafchromic EBT2. Pada penelitian ini dilakukan verifikasi penyinaran IMRT dengan klinis Glioblastoma Multiforme pada 5 pasien distribusi dosis akumulasi dan 3 pasien untuk distribusi dosis per lapangan penyinaran menggunakan film gafchromic EBT2. Didapatkan kesesuaian piksel untuk semua pasien dengan kriteria gamma ≤ 1 dengan 3% dose different dan 3 mm DTA. Hasil verifikasi untuk distribusi dosis akumulasi pada 5 pasien didapat kesesuaian piksel 100% pada 4 pasien dan hanya 1 pasien yang mempunyai kesesuaian 99,8%. Kesesuaian piksel gamma untuk verifikasi setiap lapangan penyinaran pasien pada pasien 1, 87%; 85,4%; 85,9%; 80,5%; 92,3%; 100%; pasien 2; 91,1%; 89,9%; 89,4%; 87,8%; 80,5%; 100%; pasien 3; 79,3%; 88,5%; 77,5%; 84,9%; 83,1%; 99,8%. Hasil kesesuaian piksel pada distribusi dosis perlapangan penyinaran kurang baik karena dosis perlapangan penyinaran rendah maka tingkat kehitaman film gafchromic EBT2 rendah. Film gafchromic EBT2 memberikan hasil yang baik pada lapangan penyinaran akumulasi. Evaluasi dose difference dengan kriteria 3% memberikan hasil banyak daerah yang tidak cocok (tidak lolos) sehingga kesesuaian piksel rendah karena dosis pada film disetiap piksel cukup fluktuatif dan adanya perbedaan resolusi film dengan dose matrix. Evaluasi menggunakan DTA saja tidak dapat digunakan untuk mengevaluasi verifikasi IMRT karena pada tiap pikselnya mempunyai kecocokan (lolos) pada kriteria 3mm sehingga mempunyai kesesuaian pixel yang baik. Sehingga untuk mengevaluasi verifikasi IMRT harus menggunakan gabungan DTA dan dose difference yaitu menggunakan evaluasi nilai gamma.

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ABSTRACT
Therapy aims is to obtain optimal results to kill cancer tissue with minimal damage in healthy tissue, so we need to optimize the radiation treatment. Technology has developed from conventional radiotherapy, 3D conformal to Intensity Modulated Radiotherapy (IMRT). IMRT is a technique which has many radiation field with non uniform intensity in every from many directions. Before the irradiation done in patients we need to verify the IMRT delivery between TPS and the calculations on the actual conditions the field using gafchromic EBT2 film. In this study IMRT verification were done on glioblastoma multiforme on 5 patients verification with are 2 patient verified using composite field 3 patients were verificed using per-field radiation using film gafchromic EBT2. Pixel passing level criteria for all patients using gamma criteria of 3% ≤ 1 with a different dose and 3 mm DTA. Verification for the distribution of the accumulated dose on 5 patients are 100% pixel passing on 4 patients and 1 patient 99.8%. Verification of each pixel passing gamma radiation field in patients 1 patient, 87%, 85.4%, 85.9%, 80.5%, 92.3%; patient 2; 91.1%, 89.9 %, 89.4%, 87.8%, 80.5%; patient 3; 79.3%, 88.5%, 77.5%, 84.9%, 83.1%. The results of passing pixel per field radiation distributions is not good because of low radiation doses per field. Gafchromic EBT2 film give good results in the accumulation of radiation field. Evaluation of dose difference with the criteria of 3% give the results of many areas that do not pass resolution between with the dose matrix from TPS. Evaluation using DTA can not be used to evaluate IMRT verification because at each pixel a pass on 3mm criteria so as to have a good fit pixel. So the evaluation should IMRT verification using a combined DTA and dose difference is using the evaluation value of gamma.

Abstrak :
[ABSTRAK
Telah dilakukan verifikasi dosis organ target dan jaringan sehat di sekitar target dengan menempatkan TLD Rod LiF100 dan film Gafchromic EBT2 di lubang slab bagian pelvis dari phantom Rando Alderson untuk simulasi kanker prostat. TLD dievaluasi menggunakan TLD Reader Harshaw, sementara Film Gafchromic EBT2 dipindai menggunakan scanner Epson Perfection V700 dengan mode transmisi, red channel dan resolusi 72 dpi. Pengukuran dosis titik dilakukan dengan membandingkan antara dosis yang direncanakan TPS Eclipse ver. 11 dan dosis yang diukur pada target organ target dan organ beresiko menggunakan teknik IMRT dan VMAT. Hasilnya adalah deviasi dosis pada organ target menggunakan teknik IMRT dan VMAT adalah kurang dari 5%. Demikian pula, deviasi dosis pada bladder dan rectum untuk kedua teknik juga kurang dari 5% karena posisinya sangat dekat dengan target volume. Di sisi lain, deviasi dosis di femoral head lebih dari 5% untuk kedua teknik karena lokasinya pada gradien dosis rendah. Selanjutnya, deviasi dosis organ target untuk teknik IMRT cenderung lebih kecil dari teknik VMAT baik untuk TLD dan Film. Perbedaan dosis pada dosis titik organ target antara IMRT dan VMAT kurang dari 1% tetapi terjadi pada dosis yang random untuk organ beresiko. Adapun dosis permukaan pada teknik IMRT cenderung lebih kecil dari teknik VMAT jika kita menggunakan TLD, tetapi dosis pada film EBT2 cenderung sama antara teknik IMRT dan VMAT.

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ABSTRACT
Have been done the dose verification of the target and healthy tissues around by placing the TLD Rod LiF100 and EBT2 Gafchromic film at slab hole of pelvic part of the Alderson Rando phantom for prostate cancer simulation. The Exposed TLDs was evaluated using the TLD Reader Harshaw, while Gafchromic Film EBT2 was scanned using Epson Perfection V700 scanner with transmission mode, red channel and resolution 72 dpi. The point dose measurements were compared between planned dose TPS Eclipse ver. 11 and measured dose at target volume organ and organ at risk for IMRT and VMAT techniques. The result is the dose difference at target volume for IMRT and VMAT are less than 5%. Similarly, the dose difference at Bladder and Rectum for both techniques are also less than 5% due to the position of OAR is very close to target volume. On the other hand, the dose difference at Femoral head are more than 5% for both techniques because the location of OAR already in low gradient dose. Furthermore, the difference dose of the target volume for IMRT technique is tends to be smaller than VMAT either for TLD and film detectors. The dose difference at point dose of target volume between IMRT and VMAT techniqe are less than 1% but it occur in random number for organ at risk. More over, the surface dose of IMRT tend to be smaller than VMAT dose if we are using TLDs, but the dose of EBT2 films tend to be similar between IMRT and VMAT techniques, Have been done the dose verification of the target and healthy tissues around by placing the TLD Rod LiF100 and EBT2 Gafchromic film at slab hole of pelvic part of the Alderson Rando phantom for prostate cancer simulation. The Exposed TLDs was evaluated using the TLD Reader Harshaw, while Gafchromic Film EBT2 was scanned using Epson Perfection V700 scanner with transmission mode, red channel and resolution 72 dpi. The point dose measurements were compared between planned dose TPS Eclipse ver. 11 and measured dose at target volume organ and organ at risk for IMRT and VMAT techniques. The result is the dose difference at target volume for IMRT and VMAT are less than 5%. Similarly, the dose difference at Bladder and Rectum for both techniques are also less than 5% due to the position of OAR is very close to target volume. On the other hand, the dose difference at Femoral head are more than 5% for both techniques because the location of OAR already in low gradient dose. Furthermore, the difference dose of the target volume for IMRT technique is tends to be smaller than VMAT either for TLD and film detectors. The dose difference at point dose of target volume between IMRT and VMAT techniqe are less than 1% but it occur in random number for organ at risk. More over, the surface dose of IMRT tend to be smaller than VMAT dose if we are using TLDs, but the dose of EBT2 films tend to be similar between IMRT and VMAT techniques]