國際上硼中子捕獲治療(Boron neutron capture therapy,BNCT)的中子源，從過去的反應器(reactor-based)逐步邁向加速器(accelerator-based)型態，此趨勢提升了BNCT建構於醫療院所的可能性，也增加了在國際上的能見度。針對國內而言，以清華大學水池式反應器(Tsing-Hua open-pool reactor,THOR)的BNCT也已通過政府核可進行恩慈療法(compassionate therapy)，提供癌症病患治療的新選擇。面對硼中子捕獲治療的日益普及，輻射安全的議題也逐步受到重視，因此本研究選擇成本相對低廉且已廣泛運用於光子治療品保的EBT3膠片，建構BNCT射束品質控制程序，應用於中子的射束品保與劑量品保上，除此之外，本研究也將針對治療後病患的輻射安全議題，建立病患的外釋標準與評估工作人員於執行醫療的過程中所接受的輻射劑量。
EBT3膠片應用於射束品質控制的研究議題上，須建立兩套測量系統進行比對，第一套系統為目前國際上用於中子射束品保的活化分析系統，透過高純度鍺偵檢器測量推論中子射束的反應率，此系統在研究中作為參考的標準值。第二套系統為本研究建立的EBT3膠片量測系統，此系統的建立用於量測中子混合場下的等效加馬劑量，經實驗證實，在熱中子佔九成以上的深度處，等效加馬劑量率與金箔片的反應率呈線性正比關係，除此之外，等效加馬劑量率與銅箔片的反應率亦呈現線性正比之趨勢，由此證明EBT3膠片為良好的熱中子偵檢器，能應用於熱中子的射束品保量測上。除此之外，透過蒙特卡羅的模擬計算，鑑別混合場下的光子劑量，建立各深度中子與光子對於輻射膠片等效加馬劑量的比值，經實驗證實，此比值隨著深度的增加呈線性遞減，因此EBT3輻射膠片亦能應用於BNCT的劑量品保測量上。
針對治療後病患的輻射安全議題，主要為中子的活化反應導致病患在治療後具有暫時的放射性。基於輻射防護的考量，建立病患的外釋標準，針對工作人員因醫療行為導致的職業曝露，進行輻射劑量之評估。由結果得知，以目前國際放射防護委員會第103號報告對於公眾曝露的輻防建議，病患離開BNCT中心的外釋標準為距離病患一公尺的周圍等效劑量率低於40 μSv/h，在過去接受恩慈療法的病患測量值皆遠低於此標準。工作人員於20分鐘的執行醫療期間，假設距離為極貼近病患治療部位，超過80%的病患因活化所造成的工作人員職業曝露不超過10 μSv，最大值為20 μSv。由此可知，病人活化所造成輻射工作人員的輻射劑量，遠低於國際放射防護委員會第103號報告的建議。
本研究針對硼中子捕獲治療輻射安全進行探討，成功建立EBT3膠片應用於硼中子捕獲治療熱中子的射束品保與劑量品保上，提供硼中子捕獲治療中心能使用成本相對較低且與光子同一套的設備進行品保。在病患活化的輻射防護議題中，建立與醫院核子醫學科作法相似的病患外釋程序，亦同時評估工作人員的輻射曝露，此輻防數值的評估提供硼中子捕獲治療中心治療流程建立之參考。

The neutron source of boron neutron capture therapy in the world has gradually moved from the reactor to the accelerator. This trend has increased the possibility of BNCT being built in the hospital. In Taiwan, the BNCT, which is using the neutron source from Tsing-Hua open-pool reactor, has also been approved by the government for compassionate therapy. This policy provides new options for the treatment of cancer patients. In the face of the popularity of BNCT, the issue of radiation safety has gradually been attention. Therefore, this study chooses the EBT3 film with relatively low cost and widely used in photon therapy to establish the BNCT quality control procedure and apply it to the beam and dosimetry quality assurance. In addition, this study will also focus on the radiation safety issues which is related to the post-treatment patients to establish the patients’ release criteria and evaluate the radiation doses of BNCT staff during the treatment course.
EBT3 film is applied to the BNCT quality control; two sets of measurement systems must be established for comparison. The first system is the activation analysis system which is used for beam quality assurance currently. This system uses a high-purity germanium detector to measure the activity to infer the reaction rate of the neutron beam. In order to ensure the accuracy of the measurement, the measurement value of this system will be verified by calculation value. The second is the EBT3 film measurement system. The establishment of this system is used to measure the equivalent gamma dose in the mixed field. It has been experimentally confirmed that at a depth where thermal neutrons account for more than 90%, the equivalent gamma dose rate is linearly proportional to the reaction rate of the gold foil. In addition, the equivalent gamma dose rate and the reaction rate of the copper foil are also linearly proportional. Thus, the EBT3 film is a good thermal neutron detector. It can be applied to the measurement of the thermal neutron beam. In addition, through Monte Carlo simulation calculations, the photon dose in the mixed field can be identified and the ratio of neutron and photon response to the EBT3 film can be established at each depth. It has been experimentally confirmed that this ratio decreases linearly with depth. Therefore, EBT3 film can also be used for BNCT dose quality assurance measurement.
For the radiation safety issue of patients after treatment, the patients are temporarily radioactive owing to the neutron activation. Based on radiation protection considerations, the patients’ release criteria should be established. For occupational exposures of BNCT staff during a medical procedure, the measurement values are used for evaluation. According to the results of this study, the release criteria is 40 μSv/h at 1 meter from the patients. The criteria based on the recommendations of the ICRP Report No. 103. The patients of compassionate therapy are all far lower than the criteria. More than 80% of the occupational exposure caused by activation does not exceed 10 μSv and the maximum value is 20 μSv during the 20 minutes. Therefore, the radiation dose of radiation workers caused by the activation of patients is much lower than the recommendations of the ICRP Report No. 103.
This study successfully established the EBT3 film to be applied to the beam and dosimetry quality assurance of BNCT. This equipment with low cost can also be used for photon quality assurance. Besides, this study also established patients release criteria for the radioactive patients after BNCT treatment and evaluated the occupational exposure of BNCT staff. This evaluation of the radiation protection provides the reference of treatment protocol in the BNCT center.

摘要 i
Abstract iii
致謝 v
目錄 vi
表目錄 x
圖目錄 xi
第一章 緒論 1
1.1 引言 1
1.2 中子射束品質控制之文獻回顧 4
1.3 病患活化分析之國際文獻 5
1.4 研究目的與動機 6
1.5 名詞解釋 9
第二章 硼中子捕獲治療雙箔片品質保證系統 13
2.1 中子活化分析 13
2.2 活化偵檢器簡介 18
2.3 品質保證設備 24
2.4 品質保證標準建立 34
第三章 硼中子捕獲治療輻射膠片品保系統之建立 38
3.1 輻射自顯影膠片簡介 38
3.2 系統建立所需設備與軟體 42
3.3 掃描協議的建立 46
3.4 射束品保建立 51
3.5 劑量品保建立 62
第四章 病患外釋標準建立與工作人員輻射劑量評估 66
4.1 研究背景簡介 66
4.2 放射性核種分析 69
4.3 病患外釋條件的建立 74
4.4 周圍等效劑量率的測量 77
4.5 BNCT工作人員劑量評估 80
第五章 結論與未來工作 84
5.1 研究結論 84
5.2 未來工作 85
參考文獻 86
附錄 91

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