研究体板结合真空垫及热塑膜技术与传统臂部支撑固定技术在胸部肿瘤放疗摆位中的误差

发布时间：2018-05-12 16:44

本文选题：体位固定 + 摆位误差　；参考：《中国癌症杂志》2017年05期

【摘要】：背景与目的:放射治疗已进入了精确放疗的时代,摆位误差成为影响放疗效果的重要因素。通过采用两种不同体位固定方式,即自行改装后的体板结合真空垫及热塑膜的固定装置和臂部支撑装置,讨论分析胸部肿瘤放疗中的摆位误差。方法:选择肺及食管胸部肿瘤患者19例,随机分成两组,分别采用体板+真空垫+体部热塑膜固定(A组)、臂部支撑装置固定(B组)进行摆位和治疗。A组利用二次摆位技术,即先使患者头脚方向的激光线与真空垫上的定位标记一致,再根据患者体表定位标记进行摆位(第一次摆位),最后覆上热塑膜固定,再根据热塑膜上的定位标记移床至治疗位置(第二次摆位);B组利用一次摆位技术,即直接根据体表标记进行摆位。A、B组均利用千伏级锥形束CT(kilo-voltage cone beam computed tomography,KVCBCT)采集治疗前后的图像,并与计划CT图像配准,得到治疗前及治疗后的体位误差并进行统计分析。结果:对于两种不同固定方式,A组和B组治疗前误差分别为:X轴(左右方向)(1.06±0.58)和(1.82±0.82)mm,Y轴(头脚方向)(1.31±0.40)和(2.18±1.20)mm,Z轴(腹背方向)(1.28±0.66)和(2.94±1.81)mm。治疗后误差分别为:X轴(0.86±0.54)和(1.29±0.58)mm,Y轴(1.07±0.58)和(1.08±0.45)mm,Z轴(0.98±0.53)和(1.56±0.63)mm。结论:A组误差均小于B组,采用体板结合真空垫及热塑膜固定装置并应用二次摆位技术的患者,在放疗过程中不仅摆位的精确度得以提高,同时也保证了体位的重复性及稳定性。
[Abstract]:Background & objective: radiotherapy has entered the era of accurate radiotherapy. By using two different methods of body position fixation, that is, self-modified body plate combined with vacuum pad, thermoplastic film fixation device and brachial support device, the positioning error in radiotherapy of chest tumor was discussed and analyzed. Methods: nineteen patients with thoracic tumor of lung and esophagus were randomly divided into two groups: group A was fixed with thermoplastic film in body with vacuum pad, group B was fixed with brachial support device, and group A was treated with second swing technique. That is, the laser line in the direction of the patient's head and foot is first consistent with the positioning mark on the vacuum pad, and then according to the positioning mark of the patient's body surface, the position is carried out (the first time the position is placed, the last is fixed with a thermoplastic film, Then according to the positioning marks on the thermoplastic membrane, the bed was moved to the therapeutic position (the second pendulum group B used the single swing technique, that is, directly according to the body surface marking, all the groups were collected before the treatment by using the KV conical beam CT(kilo-voltage cone beam computed tomphography (KVCBCTs). The postural errors before and after treatment were obtained and analyzed statistically. Results: for two different fixation methods, the errors before treatment in group A and group B were: 1. X axis (left and right), 1. 82 卤0. 82 卤0. 82 mm ~ (-1) y axis (head and foot) and 2. 18 卤1. 20 mm ~ (-1) m ~ + Z axis (ventral dorsal direction, 1. 28 卤0. 66) and 2. 94 卤1. 81 mmm. respectively. After treatment, the errors were 0.86 卤0.54) and 1.29 卤0.58 卤0.58 卤1.07 卤0.58) and 1.08 卤0.45 卤0.45 卤0.98 卤0.53) and 1.56 卤0.63 mm2 respectively. Conclusion the errors in group A are all smaller than those in group B. the accuracy of body plate combined with vacuum pad and thermoplastic film fixation and secondary pendulum technique can be improved during radiotherapy. At the same time, it also ensures the repeatability and stability of posture.
【作者单位】：复旦大学附属肿瘤医院放射治疗科复旦大学上海医学院肿瘤学系;
【分类号】：R730.55

【参考文献】