| 胸部肿瘤放射治疗三种体位固定方式的比较分析 |
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| 引用本文： | 姜树坤,姜伟娟,王俊杰,杨瑞杰,林 蕾,王 敏.胸部肿瘤放射治疗三种体位固定方式的比较分析[J].现代肿瘤医学,2019,0(16):2932-2935. |
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| 作者姓名： | 姜树坤 姜伟娟 王俊杰 杨瑞杰 林 蕾 王 敏 |
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| 作者单位： | 北京大学第三医院肿瘤放射治疗科，北京 100191 |
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| 摘 要： | 目的:利用图像引导设备研究三种固定装置对胸部肿瘤摆位误差大小的影响。方法:回顾性分析我科2015年3月1日至9月30日30例胸部肿瘤患者，三种体位固定方式各入组10例，应用Varian RapidArc Cone-Beam CT(CBCT)对所有入组胸部肿瘤患者进行图像验证，验证患者摆位误差，每例患者行CBCT 10次，共计300次，与原始定位CT图像进行比较，采取骨性配准，得出相应的摆位误差并记录。通过研究患者升降床方向（Vertical，Vrt），进出床方向（Longitudinal，Lng)，左右方向（Lateral，Lat)的系统误差值、随机误差值、靶区的偏移量及≤5 mm摆位次数进行比较得出哪种固定方式有较大的优势。结果:三组患者（A组:热塑体模组；B组:负压真空袋组；C组:翼型板联合负压真空垫组）的摆位误差,通过两两比较我们可以发现C组为最优。三组不同固定方式在Vrt(升降床方向)、 Lng(进出床方向)和Lat(左右方向)的摆位误差分别为A组（-0.12±0.42）cm、（-0.23±0.70)cm、(-0.04±0.39)cm；B组（0.23±0.31）cm、（-0.21±0.63)cm、(-0.03±0.37)cm；C组（0.23±0.33）cm、（0.05±0.41)cm、(0.06±0.33)cm。在Vrt方向的P值分别为A vs B:P=0.000、A vs C:P=0.000、B vs C:P=0.281；在Lng方向的P值分别为A vs B:P=0.007、A vs C:P=0.871、B vs C:P=0.004；在Lat方向的P值分别为A vs B:P=0.022、A vs C:P=0.489、B vs C:P=0.113。结论:胸部肿瘤放疗时不可避免存在一定程度摆位误差，为减少摆位误差影响，建议使用翼型板联合真空垫对胸部肿瘤患者进行固定。
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| 关 键 词： | 胸部肿瘤 摆位误差 Cone-Beam CT 固定方式 |
Comparative analysis of three kinds of fixed modes of radiotherapy for thoracic tumor patients |
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| Jiang Shukun,Jiang Weijuan,Wang Junjie,Yang Ruijie,Lin Lei,Wang Min.Comparative analysis of three kinds of fixed modes of radiotherapy for thoracic tumor patients[J].Journal of Modern Oncology,2019,0(16):2932-2935. |
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| Authors: | Jiang Shukun Jiang Weijuan Wang Junjie Yang Ruijie Lin Lei Wang Min |
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| Affiliation: | Department of Radiation Oncology,Peking University Third Hospital,Beijing 100191,China. |
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| Abstract: | Objective:To evaluate the influence of the setup errors of the thoracic tumor with three kinds of immobilization devices by image guiding equipment.Methods:A retrospective analysis was made on 30 patients with thoracic tumors in our department from March 1 to September 30,2015.Ten patients with thoracic tumors were enrolled in each group by three kinds of fixed methods.All patients with thoracic tumors were examined by Varian RapidArc Cone-Beam CT (CBCT),and the setup errors were verified.Each patient underwent CBCT 10 times,a total of 300 times.The results were compared with the original positioning CT images,and bone registration was adopted.The setup errors were obtained and recorded.By comparing the system error value,random error value,target displacement and<5 mm placement times of patients'ascending and descending bed direction (Vrt),longgitudinal direction (Lng),left and right direction (Lateral),we can find out which fixed method has greater advantages.Results:There were three groups of patients (group A:Thermoplastic model group.Group B:Negative pressure vacuum bag group.Group C:Airfoil plate combined with negative pressure vacuum cushion group).By comparing each group,we can find that group C was the best one.The setup errors of Vrt,Lng and Lat in the three groups:group A（-0.12±0.42）cm,（-0.23±0.70)cm,(-0.04±0.39)cm.group B（0.23±0.31）cm,（-0.21±0.63)cm,(-0.03±0.37)cm.group C（0.23±0.33）cm,（0.05±0.41)cm,(0.06±0.33)cm.respectively.The P values in the Vrt direction were A vs B:P=0.000,A vs C:P=0.000,B vs C:P=0.281.the P values in the Lng direction were A vs B:P=0.007,A vs C:P=0.871,B vs C:P=0.004.and the P values in the Lat direction were A vs B:P=0.022,A vs C:P=0.489,B vs C:P=0.113.Conclusion:Certain positioning errors are unavoidable in radiotherapy of thoracic tumors.In order to reduce the influence of setup errors,airfoil plate combined with vacuum pad is recommended for the fixation of patients with thoracic tumors. |
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| Keywords: | chest tumor setup errors Cone-Beam CT fixed mode |
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