放疗中皮肤弹性与摆位误差随年龄变化的相关性研究  

The effect of age on skin elasticity and setup error in optical surface image-guided radiotherapy

作　　者：何阳 雷金艳 彭海燕 罗焕丽 毛开金 王登彦 彭立锋 朱羿羽 闵庆宏 王雪纯 唐欢 肖鹏 肖强 王颖[1] 靳富[1] He Yang;Lei Jinyan;Peng Haiyan;Luo Huanli;Mao Kaijin;Wang Dengyan;Peng Lifeng;Zhu Yiyu;Min Qinghong;Wang Xuechun;Tang Huan;Xiao Peng;Xiao Qiang;Wang Ying;Jin Fu(Department of Radiation Oncology,Chongqing Cancer University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital,Chongqing 400030,China)

机构地区：[1]重庆市肿瘤医院/重庆市肿瘤研究所/重庆大学附属肿瘤医院放疗科,400030

出　　处：《中华放射肿瘤学杂志》2020年第1期47-51,共5页Chinese Journal of Radiation Oncology

基　　金：国家自然科学基金(11575038,11805025);重庆市科委科研院所绩效激励引导专项(cstc2017jxjl130017);重庆市社会民生科技创新专项项目(cstc2016shms-ztzx10002,cstc2016shmszx130033)。

摘　　要：目的探讨光学表面引导放疗中摆位误差与皮肤弹性的相关性。方法对文献中头、胸、腹部皮肤弹性参数R7进行数据提取并分析其与年龄相关性,另外选取重庆市肿瘤医院收治的鼻咽癌、乳腺癌、宫颈癌患者共54例进行研究。首次治疗时常规摆位后进行OBI验证,利用Catalyst分别获取有无膜时体表影像作为参考影像;非首次治疗均用Catalyst辅助摆位,并进行每周两次CBCT验证。记录3个方向上Catalyst摆位误差,Pearson法分析其与年龄相关性。结果3个部位R7随年龄变化均呈负相关(P<0.01)。无膜时男性头颈部的Catalyst随机误差与年龄在3个方向上均呈正相关(左右0.866、腹背0.645、头脚0.624,P<0.05),女性则较弱。头颈部系统误差与年龄相关性在男性左右方向、女性腹背方向上呈正相关(P<0.05)。女性胸腹部摆位误差与年龄相关性较弱。摆位误差与皮肤弹性关联主要表现在男性头颈部,关联系数绝对值左右>头脚>腹背。结论在光学表面引导的头颈部放疗中,皮肤弹性或许可成为评估男性摆位误差的一个重要指标。Objective To investigate the correlation between skin elasticity and setup error in optical surface image-guided radiotherapy.Methods The skin elasticity(R7)data of the head,chest and abdomen were extracted and analyzed its correlation with age by systematic literature review.Fifty-four patients diagnosed with nasopharyngeal carcinoma,breast cancer and cervical cancer were recruited in this study.Firstly,the patients were positioned based on the room laser and markers.Subsequently,the patient position was verified by the Varian On-Board Imager,and then C-Rad Catalyst was adopted to obtain surface images in two states(mask or non-mask)as reference images.In the subsequent fraction treatment,after initial positioning,the local calibration was performed by Catalyst,and setup errors in three directions were recorded.Meanwhile,the patient setup was verified by CBCT twice a week.The Pearson correlation analysis was performed to analyze the correlation between setup error and age.Results The skin elasticity was negatively correlated with aging(P<0.01).The correlation coefficient between random error and age in head-and-neck cancer were 0.645,0.624 and 0.866 in the AP,SI and LR directions(all P<0.05)for male patients without mask,respectively.The system error was significantly correlated with age in the LR direction(P<0.05)for male patients,and in the AP direction(P<0.05)for female patients with head-and-neck cancer without mask.The setup error had a significant correlation with skin elasticity in male patients with head-and-neck cancer,and the sequence of absolute value of correlation coefficient was LR>SI>AP.Conclusion In optical surface-guided radiotherapy of head and neck cancer,skin elasticity may be a significant index for assessing the setup errors in male patients.

关 键 词：皮肤弹性 表面图像引导放疗 摆位误差 

分 类 号：R730[医药卫生—肿瘤]