塑形垫固定技术能提高鼻咽癌患者调强放疗摆位精度  

Customized Cushion Immobilization System Improves Positioning Accuracy for Radiation Therapy of Nasopharyngeal Carcinoma

作　　者：周方正[1] 陈洁[1] 高琳[1] 张东升[1] 丑红宇[1] 王小聪[1] 聂龙[1] 潘东风[1] 

机构地区：[1]湖北医药学院附属随州医院肿瘤科,湖北随州441300

出　　处：《湖北医药学院学报》2017年第2期104-107,共4页Journal of Hubei University of Medicine

基　　金：湖北省卫计委2015年一般项目(WJ2015MB294)

摘　　要：目的:将"塑形垫+头颈肩热塑膜"与"头颈肩热塑膜"固定技术对比,以介绍一种更加方便、安全的鼻咽癌调强适形放疗(IMRT)体位固定技术。方法:选取40例鼻咽癌患者随机分成2组(头颈肩热塑膜固定组,"塑形垫+头颈肩热塑膜"固定组),对比两种固定方式的适形性、舒适性及固定性;利用EPID拍摄正侧位片,统计X、Y、Z轴3个方向上的摆位误差值。结果:塑形垫组舒适性、适形性及固定性均优于头颈肩热塑膜组。塑形垫组摆位后拍摄电子射野影像系统(EPID)验证片配准误差均值为:X方向(0.21±0.53)mm、Y方向(0.18±0.41)mm、Z方向(0.20±0.43)mm;头颈肩热塑膜组为:X方向(0.54±0.61)mm、Y方向(0.47±0.59)mm、Z方向(0.45±0.41)mm,两组各个方向误差数据差异均有统计学意义(P<0.05)。结论:"塑形垫+头颈肩面罩"固定技术能够提高鼻咽癌放射治疗摆位的可重复性、精确度及患者舒适度。Objective The purpose of this study was to analyze the set-up errors detected by the electronic portal imaging device （EPID） using 2 kinds of different immobilization techniques （head neck shoulder mask and custom Clarity Accu Cushion ＋ head neck shoulder mask） for the patients with nasopharyngeal carcinoma （NPC）. Methods A total number of 40 NPC patients were randomly assigned into 2 groups （ head neck shoulder mask group and custom Clarity Accu Cushion ＋ head neck shoulder mask group）. We matched the EPID images with the DRRs and acquired the set-up errors in x, y, and z axis.Results In the custom Clarity Accu Cushion＋head neck shoulder mask group, the errors of EPID were X （0.21±0. 53 ） mm, Y （0.18±0.41） mm, and Z （0.20±0.43） mm ; The errors of EPID in the head neck shoulder mask group were X （ 0.54±0.61 ） ram, Y （0.47 ±0.59） ram, and Z （ 0.45±0.41 ） mm, respectively （P〈0.05）. Conclusion the custom Clarity Accu Cushion＋head neck shoulder mask fixation technique was more accurate than the head neck shoulder mask fixation method.

关 键 词：鼻咽癌 兆伏级电子射野影像系统 摆位误差 

分 类 号：R739.63[医药卫生—肿瘤]