乳腺癌放疗时不同固定方式在分次内摆位误差分析  

Analysis of influence of different fixation technologies on the internal position error in radiotherapy for breast cancer

作　　者：黄家文[1] 张梅芳[1] 吴章桂[1] 傅万凯[1] 刘利彬[1] HAUNG Jia-wen(Fujian Tumor Hospital, Affiliated Tumor Hospital of Fujian Medical University, Fuzhou, Fufian, 350014, China.)

机构地区：[1]福建省肿瘤医院福建省医科大学附属肿瘤医院,350014

出　　处：《齐齐哈尔医学院学报》2018年第1期28-30,共3页Journal of Qiqihar Medical University

基　　金：福建省科技计划项目(2015Y0010);2013-2014年国家临床重点专科建设资助项目;2012年福建省临床重点专科(西医类别)建设资助项目

摘　　要：目的研究乳腺癌放疗时不同固定方式分次内摆位误差大小。方法收集本院68例施行VMAT技术放疗乳腺癌病例。将其分为两组,即:使用乳腺专用托架固定为实验组33例;使用真空固定垫及热塑网膜固定为对照组35例。实验组与对照组分别于放疗前、后进行CBCT扫描验证摆位误差,并计算出放疗前、后分次内摆位误差,并统计分析实验组与对照组的分次内摆位误差值。结果实验组X、Y、Z轴方向上放疗前、后摆位误差分别:(2.28±1.63)、(2.63±1.59)、(2.16±1.77)mm;(3.45±2.00)、(3.55±1.66)、(3.37±1.77)mm;经计算得到分次内误差分别:(1.29±0.63);(1.62±0.77);(1.78±0.94)mm;对照组X、Y、Z轴方向上放疗前、后摆位误差分别:(2.20±1.83)、(2.73±1.80)、(2.95±2.01)mm;(2.68±1.87)、(3.44±1.82)、(3.58±1.95)mm;经计算得到分次内误差分别为:(0.72±0.37)、(1.09±0.49)、(1.16±0.74)mm。通过对分次内摆位误差的统计分析得知实验组X、Y、Z轴方向上分次内摆位误差高于对照组,具有统计学意义(P<0.05)。结论乳腺癌放疗时使用真空固定垫及热塑网膜固定技术能显著减少分次内摆位误差,提高摆位稳定性,更加有利于提高放疗精确度。Objective To study the size of the internal error caused by different fixations in radiotherapy of breast cancer.Methods 68 cases of breast cancer patients treated by VMAT technique in our hospital were collected. They were divided into 2 groups. 33 cases in experimental group used special breast bracket for fixation.The 35 cases in control group were fixed by vacuum pad and thermoplastic mask. The experimental group and the control group were scanned with CBCT scan before and after radiotherapy to test the position error. The setup error was verified,and the internal set-up error before and after the radiotherapy was calculated. Results The setup error of the experimental group before and after radiotherapy in the direction of X,Y and Z axes：（ 2.28±1.63）,（ 2.63±1.59）,（ 2.16±1.77） mm.（ 3.45±2.00）,（ 3.55±1.66）,（ 3.37±1.77） mm. Calculation of the internal error：（ 1.29±0.63）,（ 1. 62 ± 0. 77）,（ 1. 78 ± 0. 94） mm. The setup error of the control group before and after radiotherapy in the direction of X,Y and Z axes：（ 2.20±1.83）,（ 2. 73 ± 1. 80）,（ 2. 95 ± 2. 01） mm：（ 2. 68 ± 1.87）,（ 3.44±1.82）,（ 3.58±1.95） mm. Calculation of the internal error：（ 0.72±0.37）,（ 1.09± 0.49）,（ 1.16±0.74 mm. Through the statistical analysis of the internal setup error,it was found that the errors in the X,Y and Z axes in the experimental group were higher than those in the control group,with statistical significance（ P〈0.05）.Conclusions Vacuum fixed cushion and thermoplastic mask fixation technology can significantly reduce the internal error,improve the stability of placement,and improve the accuracy of radiotherapy.

关 键 词：乳腺专用托架 热塑网膜 分次内摆位误差 CBCT 

分 类 号：R739[医药卫生—肿瘤]