乳腺癌改良根治术后放射治疗自制固定装置的临床应用  

Clinical application of a self-made fixed device of radiotherapy post modified radical mastectomy of breast cancer

作　　者：刘建平[1] 杨立志 杨海芳[1] 王志武[1] 张晓斌[1] 时秀菊 李国欢 徐寿平[3] 迟子锋[4] 

机构地区：[1]唐山市人民医院放疗中心,河北唐山063001 [2]唐山唐钢气体有限公司技术质量部,河北唐山063000 [3]解放军总医院放疗科,北京100853 [4]河北医科大学第四医院放疗科,河北石家庄050011

出　　处：《中国医学装备》2018年第1期15-18,共4页China Medical Equipment

基　　金：国家自然科学基金青年科学基金(H2902)“基于病症结合的放射性肺损伤早期预测模型的建立和验证”

摘　　要：目的:探讨乳腺癌改良根治术后放射治疗自制固定装置在临床应用中的可行性。方法:选取152例近期行乳腺癌改良根治术后接受放射治疗的患者,按照数表法将其随机分成对照组(75例)和观察组(77例),对照组采用传统乳腺托架固定;观察组采用自主研制的体位固定装置联合头部热塑膜及体部发泡胶膜固定。运用锥形束CT(CBCT)采集患者分次间与分次内摆位误差。结果:观察组患者分次间与分次内摆位误差相较对照组患者均有所下降。左右(X轴)、头脚(Y轴)和前后(Z轴)3个方向,分次间摆位误差对照组患者分别为(4.23±2.58)mm、(3.17±1.33)mm和(3.58±2.87)mm,观察组患者分别为(2.31±1.09)mm、(1.89±0.98)mm和(2.01±1.27)mm;分次内摆位误差对照组患者分别为(3.78±2.43)mm、(2.46±1.07)mm和(2.38±1.45)mm,观察组患者分别为(1.14±0.79)mm、(0.89±0.45)mm和(1.08±0.81)mm。结论:自主研制的乳腺固定改进装置联合发泡胶垫与热塑头模,在乳腺癌改良根治术后放射治疗应用中体位固定性好、精确度高且重复性更好。Objective： To investigate the feasibility of self-made fixed device of radiotherapy post modified radical mastectomy of breast cancer in clinical application. Methods： 152 patients received radiotherapy post modified radical mastectomy of breast cancer were divided into the control group（75 cases） and observation group （77cases） as random number table. The patients of control group adopted treatment with routine breast bracket. In the control group, 77 patients were treated by using a self-made fixed device combined with body styrofoam and head thermoplastic mask. The intra-fractional and inter-fractional setup errors were measured by using cone-beam computed tomography（CBCT）. Results： The intra fractional setup errors and inter fractional setup errors of observation group were slightly lower than those of control group. In three directions that included left-right （X-axis）, head-foot （Y-axis） and front-back （Z-axis）, the inter fractional setup errors of control group were（4.23±2.58）, （3.17±1.33） and （3.58±2.87）mm while they were （2.31±1.09）, （1.89±0.98） and （2.01±1.27）mm in observation group, respectively. On the other hand, the intra fractional setup errors of control group were （3.78±2.43）, （2.46±1.07） and （2.38±1.45） mm, respectively, and they were （1.14±0.79）, （0.89±0.45） and （1.08±0.81）mm in observation group, respectively. Conclusion： The self-made modified fixed device that combined with body styrofoam and head thermoplastic mask has good body position stationarity, high accuracy and better repeatability in the application of radiotherapy post modified radical mastectomy of breast cancer.

关 键 词：乳腺癌改良根治术 乳腺托架 自制固定装置 摆位误差 医用直线加速器 模拟定位仪 锥形束CT 

分 类 号：R197.39[医药卫生—卫生事业管理]