乳腺癌胸壁野结合锁骨上野放疗时头部固定的重要性研究  

Study of significance of head fixation in the chest wall field combined with supraclavicular field radiotherapy for breast cancer

作　　者：谢涛 许青[1] 彭佳元[1] 孟怡然 贯士阔 杨昭志 梅欣 俞晓立[1] 

机构地区：[1]复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院放射治疗科,上海200032

出　　处：《中华放射肿瘤学杂志》2018年第5期500-503,共4页Chinese Journal of Radiation Oncology

摘　　要：目的通过比较多功能体板对头部进行固定的体位固定方式和乳腺托架体位固定方式在位移误差及其引起的剂量学差异，研究乳腺癌行胸壁野结合锁骨上野放疗时头部固定的重要性。方法选取2017年年内乳腺癌患者30例，随机分成A、B两组，A组使用多功能体板结合头部热塑膜固定，B组采用乳腺托架固定。每例患者在放疗前后均行CBCT扫描。计算两组患者在z、y、x轴向的摆位误差和分次内位移以及V100、V95，并行独立样本t检验差异。结果A组和B两组患者在x、y、z轴向摆位误差分别为（1．24±0．42）、（1．71±0．61）、（2．25±1．04）mm和（3．67±2．05）、（3．78±1．74）、（4．65±2．66）mm（P=0．033、0．027、0．020）；分次内位移分别为（1．10±0．66）、（1．13±0．59）、（1．1l±0．62）mm和（2．48±0．88）、（2．21±0．98）、（3．53±2．01）mm（P=0．030、0．021、0．013）；Vloo分另0为（94．27±3．20）％和（99．08±0．60）％（P=0．065），V95为（89．48±4．70）％和（96．53±2．50）％（P=0．002）。结论使用多功能体板对头部进行固定较乳腺托架固定方式产生的位移误差明显减小．使胸壁野及锁骨上野剂量的准确性更高。Objective To explore the importance of head fixation in chest wall field combined with supraclavicular field radiotherapy for breast cancer by comparing the displacement error and dosimetric differences caused by multi-functional body board and breast bracket. Methods Thirty patients with breast cancer were randomly divided into groups A and B. In group A, patients were fixed with multi-functional body board and head thermoplastic film. In group B, patients were fixed with traditional breast brackets. Each patient received CBCT scan before and after radiotherapy. Both setup errors and intra-fractional displacements in the x-,y-and z-axis, V100 and V95 were calculated. Statistical analyses were performed using the independent sample t-test. Results The displacement errors in groups A and B before and after radiotherapy were （ 1.24± 0. 42）, （ 1.71 ± 0. 61 ） and （ 2.25 ± 1.04 ） mm vs. （ 3.67±2. 05 ）, （ 3.78± 1.74 ）, （4.65±2.66） mm in the x-, y-and z-axis, respectively （ P= 0. 033,0. 027, 0. 020）. The intra-fractional displacements in groups A and B were （ 1.10±0. 66） , （ 1.13±0. 59） , （ 1.11＋_0. 62） mm vs. （ 2.48±0. 88） , （2.21±0. 98）, （3.53±2.01） mm in the x-,y-and z-axis, respectively （P=O. 030,0. 021,0. 013）.The Vt0o in groups A and B were （ 94.27±3.20） % and （ 99.08±0. 60） % （ P = 0. 065 ）, and （ 89.48±4. 70） % and （96.53±2. 50 ） % for V95 （ P= 0. 002 ）, respectively. Conclusion The risk of displacement error is significantly reduced using muhi-funetional body board, which enhances the accuracy of radiation dose in chest wall and supraclavieular fields of breast cancer patients.

关 键 词：头部固定 多功能体板 摆位误差 乳腺肿瘤/放射疗法 

分 类 号：R730.55[医药卫生—肿瘤] R737.9[医药卫生—临床医学]