发泡胶+头颈肩热塑膜在鼻咽癌螺旋断层调强放射治疗体位固定中的应用价值

目的探讨发泡胶+头颈肩热塑膜在鼻咽癌螺旋断层放射治疗体位固定中的应用价值。方法收集行螺旋断层放射治疗的鼻咽癌病人20例，随机分为对照组10例和观察组10例，对照组的固定方式是常规头枕+头颈肩热塑膜；观察组的固定方式是发泡胶+头颈肩热塑膜固定。将治疗前行MVCT扫描获取的图像与模拟CT的图像进行配准，记录X（左右）、Y（头脚）、Z（腹背）以及ROLL（沿横截面旋转）轴方向的摆位误差并对其分析。结果对照组在X轴、Y轴、Z轴及ROLL轴方向的摆位误差分别为（1.58±1.14）mm、（1.44±1.29）mm、（3.19±1.26）mm、（1.16±1.09）°，观察组分别为（1.06±0.89）mm、（1.02±0.73）mm、（2.71±1.37）mm、（1.31±1.12）°；2组在X、Y、Z轴方向的摆位误差比较，差异均有统计学意义（P < 0.01），在ROLL轴方向的摆位误差差异无统计学意义（P>0.05）。不同方向的摆位误差显示，对照组X轴、Y轴和Z轴方向的摆位误差主要集中在0~6 mm；观察组X轴、Y轴和Z轴方向的摆位误差主要集中在0~4 mm；观察组横断面旋转误差分布在区间0°~、1.1°~和2.1°~的频数分别为134（48.2%）、89（32.0%）和55（19.8%）；对照组横断面旋转误差分布在区间0°~、1.1°~和2.1°~的频数分别为177（59.8%）、60（20.3%）和59（19.9%）。结论鼻咽癌病人进行螺旋断层放射治疗时，为降低摆位误差，建议采用发泡胶+头颈肩热塑膜作为体位固定方式。

Application value of styrofoam combined with head and neck shoulder thermoplastic film in position fixation of nasopharyngeal carcinoma treated with helical tomography intensity modulated radiotherapy

ObjectiveTo investigate the application value of styrofoam combined with head and neck shoulder thermoplastic film in position fixation of nasopharyngeal carcinoma treated with helical tomography intensity modulated radiotherapy.MethodsTwenty nasopharyngeal carcinoma patients treated with CT radiotherapy were randomly divided into the control group and observation group(10 cases in each group).The control group was fixed with regular headrest combined with head and neck shoulder thermoplstic film, and the observation group was fixed with styrofoam combined with head and neck shoulder thermoplastic film.The image was obtained by MVCT scan before treatment, and registered with the image of simulated CT, the pendulum errors of X(left and right), Y(corner), Z(ventral dorsal) and ROLL(rotation along cross section) axis were recorded and analyzed.ResultsThe pendulum errors of the direction of X, Y, Z and ROLL axises in the control group were(1.58±1.14)mm, (1.44±1.29)mm, (3.19±1.26)mm and(1.16±1.09)°, respectively.The pendulum errors of the direction of X, Y, Z and ROLL axises were(1.06±0.89)mm, (1.02±0.73)mm, (2.71±1.37) mm and(1.31±1.12)°, respectively.The differences of pendulum errors in X, Y and Z axis directions between the two groups were statistically significant(P < 0.01), and the difference of the pendulum error in ROLL axis direction between the two groups was not statistically significant(P>0.05).The pendulum error in the direction of X, Y and Z axis in the control group and observation group mainly concentrated in 0-6 mm and 0-4 mm, respectively.The cross-sectional rotation error distribution at the interval of 0°~, 1.1°~and 2.1°~in observation group was 134(48.2%), 89(32.0%) and 55(19.8%), respectively.The cross-sectional rotation error distribution at the interval of 0°~, 1.1°~and 2.1°~in control group was 177(59.8%), 60(20.3%), and 59(19.9%), respectively.ConclusionsIn order to reduce the pendulum error, it is recommended to use styrofoam combined with thermoplastic film for the fixation of nasopharyngeal carcinoma patients.