Skin markings methods and guidelines: A reality in image guidance radiotherapy era.
Skin markings methods and guidelines: A reality in image guidance radiotherapy era.
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DOI：
10.4103/2278-330x.96502
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发表时间：
2012-07
影响因子：
0.5
通讯作者：
Agarwal J
中科院分区：
文献类型：
--
作者：
Rathod S;Munshi A;Agarwal J
放射治疗部位准备是放射治疗计划中的一个重要过程，在放射治疗过程中起着至关重要的作用，以实现重复性的设置和治疗输送的准确性。治疗区域的准备通过标记射野中心、射野边缘或计划射野的其他参考点来完成。非侵入性（记号笔，指甲花）和侵入性方法（纹身）均可用于标记，但各有局限性。纹身用针以30°的角度刺入1-2 mm的深度，以创建2-3 mm直径的纹身是一个理想的程序。可见性、永久性、社会宗教信仰和皮肤的流动性是纹身的主要问题之一。如果患者愿意，可以通过各种现代方式进行纹身去除，这将是美观的。磨皮术、冷冻疗法、手术、QSRL（Q开关红宝石激光）是去除纹身的常用方法。美学不满意、过敏、皮肤病、瘢痕疙瘩、感染、纹身扇形/褪色是相关问题。在IMRT和IGRT治疗中，对纹身的递送依赖性降低，并且替代标记物的使用正在增加，包括特别是用于骨设置和用于肿瘤定位和治疗验证的植入标记物（例如金种子）。然而，这些都是复杂的程序，需要专业知识。与外部或内部标记设置相比，设置容易和纹身所需的时间更少是纹身的主要优点之一。纹身仍然是一种重要的定位方法，特别是在发展中国家和姑息治疗环境中。
Preparation of site of radiation delivery is an important process in radiation treatment planning and plays a crucial role during a course of radiotherapy to achieve reproducibility of set-up and accuracy of treatment delivery. The preparation of treatment area is done by markings of field center, field edge or other reference point of planned field. Both non-invasive (marker pen, henna) and invasive methods (tattoo) are available for marking with limitations of each. Tattoo with a needle pricked at angle of 30° to 1-2 mm depth to create tattoo 2-3 mm diameter in size is an ideal procedure. Visibility, permanent nature, social-religious belief, and mobility of skin are one of the main concerns about tattoo. Tattoo removal can be done performed if desirable by patients by various modern ways, which will be esthetically available. Dermabrasion, cryotherapy, surgery, QSRL (Q-switched ruby laser) are common methods of tattoo removal. Esthetic dissatisfaction, allergy, dermatoses, keloids, infection, fanning/fading of tattoo are associated problems. In IMRT and IGRT treatment, delivery dependence on tattoo in reduced and use of surrogate markers including particularly for bony set-up and implanted markers (e.g. gold seeds) for tumor localization and treatment verification is increasing. However, these are complex procedures and require an expertise. Ease of set-up and less time required for tattooing are one of the main advantages of tattoo as compared to external or internal marker set-up. Tattoo still remains a crucial method of positioning, especially in developing countries and in palliative treatment settings.