个体化乳腺癌放射治疗体位固定技术改进方法研究  

An improved method of individualized breast cancer radiotherapy immobilization technology

作　　者：谢秋英[1] 石锦平[1] 张利文[1] 滕建建[1] 刘翠英[1] 

机构地区：[1]佛山市第一人民医院肿瘤中心放疗科,广东省528000

出　　处：《中华临床医师杂志（电子版）》2014年第7期50-53,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探索个体化乳腺癌放疗体位固定技术的改进方法。方法乳腺癌患者40例,A组(20例)采用乳腺托架固定,B组(20例)采用真空袋、直肠癌体架和热塑体膜联合固定法固定。利用EPID拍摄患者治疗前位置验证片,比较两组摆位误差。结果 B组摆位误差明显优于A组,患者左右(X)、上下(Y)、前后(Z)方向和旋转(R)误差分别为,A组:X(2.90±1.77)mm、Y(3.85±1.98)mm、Z(3.25±1.94)mm,R(1.67±1.27)°;B组:X(1.80±0.70)mm、Y(2.30±1.17)mm、Z(1.75±1.02)mm,R(0.55±0.42)°。两组各项指标差异均有统计学意义(P<0.05)。X、Y、Z三方向摆位误差>5 mm的比例分别为A组15.0%、35%、25%,B组为0、5%、0。B组PTV外放边界由A组的7.04 mm、9.09 mm、7.86 mm缩小至4.09 mm、5.42 mm和4.21 mm。结论新方法整体摆位准确性明显提高,特别是摆位误差≥5 mm的发生率显著下降,PTV的外放边界进一步缩小,减少肺和心脏等正常组织照射体积。Objective To explore an improved method of individualized breast cancer radiotherapy immobilization technology. Methods 40 breast cancer patients for this study were divided into Group A and B. Each group contained 20 patients. The patients of group A were immobilized with mammary gland bracket, and the patients of group B were combined fixed with vacuum bag, colorectal cancer shelf and thermoplastic mask. The electronic portal imaging device（EPID） was used to screen imaging in pre-treatment, compared the setup errors of Group A and B. Results The setup errors in group B was significantly better than group A. The mean setup deviations in the left-right（X）, up-down（Y）, anterior-posterior（Z） and rotational（R） direction were X（2.90±1.77）mm, Y（3.85±1.98）mm, Z（3.25±1.94）mm, R（1.67±1.27）° respectively in Group A, and X（1.80±0.70）mm, Y（2.30±1.17）mm, Z（1.75±1.02）mm, R（0.55±0.42）° respectively in Group B. The P value of each assessment indicators is less than〈0.05 with a significant difference. The percentages of the setup errors over 5mm in X, Y, Z directions were 15.0%, 35%, 25% respectively in Group A and 0%, 5%, 0% respectively in Group B. The margin for PTV were reduced from 7.04 mm, 9.09 mm, 7.86 mm respectively in Group A to 4.09 mm, 5.42 mm, 4.21 mm in Group B respectively. Conclusions The overall positioning accuracy of the new method has been significantly improved, especially the incidence of ≥5 mm of setup errors decreased significantly. It can further reduce the margin of PTV and reduce irradiated volume of lung and heart.

关 键 词：乳腺肿瘤 摆位误差 乳腺托架 真空袋 热塑膜 

分 类 号：R737.9[医药卫生—肿瘤]