局部晚期食管癌放射治疗两种固定方式的锁骨上区动度比较分析

目的比较使用胸腹平架和颈胸一体架固定装置的局部晚期食管癌放射治疗患者锁骨上区的摆位误差的差异,分析两种装置固定效果的优劣。方法回顾性分析50例局部晚期食管癌含锁骨上区放射治疗的患者锥形束计算机断层(CBCT)图像,分别使用胸腹平架(A组)和颈胸一体架(B组)固定,两组均含25例病例,其中A组获取175次CBCT图像,B组获取230次CBCT图像。分别分析两组病例摆位误差的大小,并分别测量肩锁关节的移动幅度和三维空间位移。结果胸腹平架组(A组)和颈胸一体架组(B组)的摆位误差的差异明显,尤其平移误差X(左右方向)和Z(腹背方向)(P<0.001);旋转误差Rx(矢状面)(P<0.001);Ry(横断面)(P<0.05)。胸腹平架组和颈胸一体架组的肩锁关节动度ΔX、ΔY、ΔZ,分别是(0.10±0.10)cm和(0.08±0.08)cm、(0.14±0.13)cm和(0.11±0.11)cm、(0.16±0.12)cm和(0.11±0.12)cm。肩锁关节的三维空间位移是(0.27±0.14)cm和(0.20±0.14)cm(P<0.001)。结论在控制旋转角度对靶...

Comparative analysis of supraclavicular area mobility in locally advanced esophageal cancer radiation therapy with two different fixed ways

Objective To compare the setup errors provided by the chest and abdomen flat frame fixation device and integral cervico-thoracic fixation device in supraclavicular regions of locally advanced esophageal cancer patients.Methods The cone beam computed tomography(CBCT)images of 50 patients with locally advanced esophageal cancer and received radiotherapy in supraclavicular region were retrospectively analyzed.The chest and abdomen flat frame fixation device(group A)or the integral cervicothoracic fixation device(group B)were used respectively with 25 in each.There were 175 CBCT images in group A and 230 CBCT images in group B.The setup errors of the two groups were analyzed,and the movement and displacement of acromioclavicular joint in three-dimensions were measured.The differences were compared by independent sample t test and rank sum test.Results The setup errors were significantly different between group A and group B.The P value in X axis(left-right)and Z axis(anterior-posterior)were both less than 0.001(P<0.001);The P value in pitch was less than 0.001(P<0.001)androll was less than 0.05(P<0.05).The movement amplitude of acromioclavicular joint(ΔX,ΔY,ΔZ)of groups A and B were(0.10±0.10)cm and(0.08±0.08)cm in X axis,(0.14±0.13)cm and(0.11±0.11)cm in Y axis,(0.16±0.12)cm and(0.11±0.12)cm in Z axis.The three-dimensional displacement of groups A and B were(0.27±0.14)cm and(0.20±0.14)cm,(P<0.001).Conclusions If the influence of rotation angle is well controlled,the application of the integral cervicothoracic fixation device is better to immobilize the acromioclavicular joint and reproduce the setup position for locally advanced esophageal cancer patients.Special attention should be paid for the influence of rotation angle on the location accuracy of target.