基于CBCT的两种体位固定方式在乳腺癌保乳术后调强放疗的摆位误差比较  

Error comparison of two body position fixation methods for breast cancer after breast conserving surgery based on CBCT

作　　者：唐成琼 王翠翠[2] 刘浩[1] 曹耀峰[1] 刘江平[1] 艾秀清[3] TANG Chengqiong;WANG Cuicui;Liu Hao;CAO Yaofeng;LIU Jiangping;AI Xiuqing(Department of Radiophysics,Xinjiang Hui Autonomous Region 830011,China;Department of Pathology,Xinjiang Hui Autonomous Region 830011,China;Department of Breast Radiotherapy,Oncology Hospital Affiliated to Xinjiang Medical University,Urumqi,Xinjiang Hui Autonomous Region 830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院放射物理技术科,乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院病理科,乌鲁木齐830011 [3]新疆医科大学附属肿瘤医院乳腺放疗科,乌鲁木齐830011

出　　处：《重庆医学》2019年第23期3994-3996,4000,共4页Chongqing medicine

基　　金：新疆维吾尔自治区科技支疆项目（2017E0260）

摘　　要：目的 比较基于直线加速器机载锥形束CT(CBCT)下热塑膜联合乳腺托架固定和真空垫联合乳腺托架固定两种体位固定方式在乳腺癌保乳术后调强放疗中的摆位误差。方法 选取该院乳腺放疗科2017年11月至2019年2月30例乳腺癌保乳术后行调强放疗的患者,采取随机数字表法分为热塑膜联合乳腺托架组(A组,15例)和真空垫联合乳腺托架组(B组,15例),两组患者均应用CBCT在第1次治疗前及以后的每周进行1次摆位验证,比较两组摆位误差的差异。结果 A组左右(X)、头脚(Y)、腹背(Z)方向误差值分别为(1.07±1.66)、(0.51±1.74)、(0.68±1.70)mm,B组分别为(1.95±2.27)、(2.03±2.72)、(1.61±2.44)mm。A组在X、Y、Z三个方向的误差值均小于B组,差异均有统计学意义(t=-2.71,P=0.008;t=-4.08,P=0.001;t=-2.72,P=0.007)。结论 基于CBCT的乳腺癌保乳术后放疗中,使用热塑膜联合乳腺托架体位固定技术摆位精度更高。Objective To compare the placement error between two body position fixation methods,thermoplastic membrane combined with breast bracket fixation and vacuum pad combined with breast bracket fixation,based on the cone-beam computerized tomography(CBCT)after breast conserving surgery.Methods Thirty patients with breast cancer who underwent intensity modulated radiation therapy after breast conserving surgery from the Department of Breast Radiotherapy of this hospital from November 2017 to February 2019 were selected and randomly divided into the thermoplastic membrane combined with breast bracket group(group A,15 cases)and the vacuum bag combined with breast bracket group(group B,15 cases).Both groups were treated with CBCT with linear accelerator before and after the first treatment once a week,and the placement error between the two groups was compared.Results The error values of left and right(X),head and foot(Y)and abdomen and back(Z)directions were(1.07±1.66),(0.51±1.74),(0.68±1.70)mm in group A,and(1.95±2.27),(2.03±2.72),(1.61±2.44)mm in group B,respectively.The error values of group A in X,Y and Z directions were less than those of group B,and the differences were statistically significant(t=-2.71,P=0.008;t=-4.08,P=0.001;t=-2.72,P=0.007).Conclusion In the radiotherapy of breast conserving surgery based on CBCT,the positioning accuracy of thermoplastic film combined with breast bracket is higher than that of vacuum bag combined with breast bracket.

关 键 词：乳腺肿瘤 乳房切除术 区段 直线加速器机载锥形束CT 放射疗法 调强适形 体位 偏差 

分 类 号：R737.9[医药卫生—肿瘤]