自制可调角度楔形垫板在精确放疗摆位中的应用

目的 比较自制可调角度楔形垫板（楔形垫板组）、负压真空垫（负压真空垫组）、普通软枕（普通软枕组）分别联合热塑头颈肩膜体位固定技术，在脊柱后凸畸形头颈部位肿瘤（含原发和继发）患者精确放疗摆位中的重复性。方法 选择2014年6月—2016年4月期间入住本院的48例头颈部肿瘤患者，随机数字表法均分为3组，分别联合热塑头颈肩膜体位固定，以颅骨右茎突尖足方向末层中心点为参考点，对左茎突尖足方向末层中心点、定位坐标系原点在患者左右、头足、腹背（x、y、z）方向位置变化测量分析。结果 与负压真空垫组相比，楔形垫板组摆位误差与坐标系转移误差结果差异无统计学意义（P>0.05）；与普通软枕组相比，其他两组的三维摆位误差均有统计学意义（t=-6.99~-2.69，P<0.05）；与普通软枕组相比，其他两组的三维坐标系转移误差均有统计学意义（t=-5.13~-2.71，P<0.05）。结论 自制可调角度楔形垫板在脊柱后凸畸形头颈部位肿瘤患者放疗摆位中简便且重复性好。

The application of self-made adjustable wedge plate in radiotherapy positioning

Objective To investigate the repeatability of precise radiotherapy placement of self-made adjustable angle wedge plate, negative pressure vacuum pad and common soft pillow, corresponding to 3 groups. The study is demonstrated with a thermoplastic membrane immobilization technology in kyphotic deformity patients with head and neck cancer (including primary and secondary), respectively. Methods From Jun 2014 to Apr 2016, 48 cases of severe head and neck cancer patients received radiotherapy humpback who were randomly divided into 3 groups. Combined with thermoplastic head and neck shoulder film position fixation, the right foot direction at the end of the skull styloid process layer center was set as a reference point. On the left foot at the end of the direction of styloid process layer center, localization of the origin of the coordinate system in patients around the head and foot, dorsoventrally (x, y, z) analysis of the direction change of position measurement was performed. ResultsThere was no significant difference between the adjustable angle wedge plate and negative pressure vacuum pad groups of the coordinate system (P>0.05). Compared with common soft pillow group, three dimensional positioning errors and three dimensional coordinate system transfer errors of the adjustable angle wedge plate and negative pressure vacuum pad groups were statistically significantly different (t=-6.99 to -2.69, -5.13 to -2.71, P<0.05). Conclusions The self-made adjustable angle wedge plate has good repeatability, saves time and money, is simple and durable on precise radiotherapy positioning of kyphotic deformity patients with head and neck cancer.