Trajtimi i kancerit të lëkurës me elektrone dhe roli i Fizikanit Mjekësor në Radioterapi

Trajtimi me elektrone është një metodë efektive dhe e domosdoshme e radioterapisë që përdoret kryesisht për sëmundjet malinje sipërfaqësore siç është kanceri i lëkurësMsc. Fesal Selimi, PhDcEkspert i Fizikës Mjekësore & Ekspert për Mbrojtje nga Rrezatimi

Elektronet, ndryshe nga rrezet X (fotonet) që punojnë me energji të lartë, kanë një depërtueshmëri më të vogël në thellësi, që do të thotë se ato depërtojnë në shtresat e para të lëkurës dhe më pas ndalojnë, duke kursyer indet e shëndetshme në thellësi dhe duke shkatërruar qelizat kanceroze që janë në sipërfaqe.

Elektronet janë shumë efikase për lloje të ndryshme të kancerit të lëkurës, përfshirë karcinomën bazocelulare, karcinomat sklamoze, si dhe për lezionet prekanceroze apo rikthimet lokale pas kirurgjisë.

Si përparësi kryesore e trajtimit të pacientëve me elektrone janë: mbrojtja e indeve të shëndosha në thellësi te organit; precizitet i lartë dhe lokalizim i dozës vetëm në vendin ku duhet rrezatuar pacienti; aplikim relativisht i thjeshtë dhe toleranca shumë e mirë nga pacientët; aplikim pa metoda invazive etj.

Zakonisht për trajtimin e pacientëve me elektrone përdoren energji të ndryshme të elektroneve (prej 4 MeV deri ne 15 MeV) varësisht nga thellësia e lezioneve. Planifikimi bëhet në bazë të skanimit 3D CT-skan (CT-simulatorit), konturimit nga specialisti i Radioterapisë dhe planimetria nga Eksperti i Fizikës Mjekësore për shpërndarjen dhe optimizim të dozave, duke pasur parasysh gjithmonë ruajtjen e indeve te shëndosha.

Varësisht nga regjioni dhe organi ku gjendet lezione në aplikojmë doza prej 45deri 66 Gy të ndara në fraksione ditore prej 1.8 apo 2 Gy.

Trajtimi me elektrone në Radioterapi është shumë efikase sepse nuk ka shumë efekte anësore. Kryesisht si efekte të lokalizuara dhe të përkohshme janë irritimet e lëkurës, thatësia e lëkurës, apo djegiet e përkohshëm të një shtrese të lëkurës.

Kjo metodë është një opsion terapeutik i sigurt dhe efektiv për shumë raste të kancerit të lëkurës, veçanërisht kur kirurgjia nuk është e mundshme ose kur kërkohet ruajtja e integritetit estetik të lëkurës. Një planifikim i mirëfilltë fizik dhe bashkëpunimi ndërdisiplinor siguron sukses terapeutik të lartë me komplikime minimale.

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Ndihmon në zgjedhjen e metodës më të përshtatshme të trajtimit si:
- Radioterapia me elektrone për lezionet sipërfaqësore të lëkurës.
- Radioterapia me fotone me energji të ulët.
- Brahiterapia sipërfaqësore, në varësi të lokalizimit dhe thellësisë së tumorit.
▪ Përcakton fushën e trajtimitpërmes CT-simulimit ose matjeve fizike.
▪ Përdor Sistemin e Planifikimit të Trajtimit (TPS) për llogaritjen dhe shpërndarjen optimale të dozës në tumore, me qëllim minimizimin e ekspozimit te dozave në inde të shëndosha.
▪ Përdor boluse në trajtimet sipërfaqësore, për të sjellë pikën maksimale të dozës afër sipërfaqes së lëkurës.
▪ Verifikon saktësinë e dozës së llogariturpërmes pajisjeve dozimetrike dhe kryerjes së kontrollit të cilësisë (QA) para dhe gjata trajtimeve.
▪ Harton masat e mbrojtjespër personelin dhe pacientët.
▪ Zbaton standardet ndërkombëtare të sigurisë (IAEA, ICRP).
▪ Edukon stafin dhe pacientët në lidhje me efektet e mundshme anësore dhe menaxhimin e tyre.
▪ Bashkëpunon në analizën e imazheve pas-trajtimit, për të vlerësuar suksesin terapeutik.
▪ Përmirëson protokolleve klinike, bazuar në të dhënat dosimetrike dhe rezultatet klinike.

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