不同位置摆位参考线对中上段食管癌放射治疗摆位误差影响  

Effects of different reference line on set-up errors in radiotherapy for middle-upper esophageal cancer

作　　者：商在春 储开岳[1] 王君辉 冯进进[1] 曹旻昱[1] 李明[1] SHANG Zai-chun;CHU Kai-yue;WANG Jun-hui;FENG Jin-jin;CAO Min-yu;LI Ming(Department of Radiotherapy,Nantong Tumor Hospital,Nantong 226361,Jiangsu,China)

机构地区：[1]南通市肿瘤医院放疗科,江苏南通226361

出　　处：《生物医学工程与临床》2020年第4期393-397,共5页Biomedical Engineering and Clinical Medicine

基　　金：南通市科学技术局计划项目(GJZ17043)。

摘　　要：目的研究在中上段食管癌放射治疗中摆位参考线位置的选择对摆位误差产生的影响。方法选择2018年1月至2019年6月102例接受放射治疗的食管癌患者,其中男性62例,女性40例;年龄50~75岁,中位年龄65岁;肿瘤位于胸上段34例,胸中段68例,TNM分期ⅡA~ⅡB期44例,ⅢA~ⅢC期58例。随机分为A、B两组,A组以胸骨柄中线水平画摆位参考线;B组以剑突下水平画摆位参考线。通过锥形束CT(CBCT)对两组患者线性摆位误差、旋转误差进行测量,并对测量结果进行统计学分析。结果A组患者线性摆位误差在左右(X)、头脚(Y)、腹背(Z)方向分别为(1.43±1.07)mm、(1.82±1.58)mm、(1.70±1.39)mm;旋转误差分别为0.80°±0.63°、0.72°±0.60°、0.68°±0.51°。B组患者线性摆位误差在X、Y、Z方向分别为(2.40±1.57)mm、(3.48±1.93)mm、(1.74±1.38)mm;旋转误差分别为0.81°±0.59°、0.56°±0.49°、0.74°±0.65°。统计学分析可见在X、Y方向上的线性摆位误差比较,A组小于B组,差异有显著统计学意义(P=0.001、0.000);其余方向线性误差及旋转误差差异均无统计学意义(P>0.05)。结论对中上段食管癌患者进行放射治疗时,胸骨柄中线水平画摆位参考线能够明显减少患者在X、Y方向上的线性摆位误差,具有广泛的临床应用价值。Objective To study the effect of reference line on set-up error in radiotherapy for middle-upper esophageal cancer.Methods From January 2018 to June 2019,a total of 102 patients with esophageal cancer who received radiotherapy were enrolled,which included 62 males and 40 females,aged 50-75 years old with median age of 65 years old.The tumors were located at upper thoracic in 34 cases and at middle thoracic in 68 cases,TNM stageⅡA-ⅡB in 44 cases and stageⅢA-ⅢC in 58 cases.All of the patients were randomly divided into group A and group B.In group A,the reference line was drawn horizontally at manubrium midline,and in group B the reference line was drawn below xiphoid.Linear positioning error and rotation error by cone beam CT(CBCT)of 2 groups were measured and statistical analyzed.Results In group A,the linear set-up errors were(1.43±1.07)mm,(1.82±1.58)mm,(1.70±1.39)mm in left-right-direction(X),top-down-direction(Y)and front-back-direction(Z),respectively,and rotation errors were 0.80°±0.63°,0.72°±0.60°,0.68°±0.51°,respectively.In group B,the linear set-up errors were(2.40±1.57)mm,(3.48±1.93)mm,(1.74±1.38)mm in X,Y and Z,and rotation errors were 0.81°±0.59°,0.56°±0.49°,and 0.74°±0.65°,respectively.Statistical analysis showed that the linear positioning errors in X and Y directions were less in group A than that in group B,and the difference was statistically significant(P=0.001,0.000),while no statistically significant differences of linear error and rotation error were observed in other directions(P>0.05).Conclusion It is demonstrated that manubrium midline horizontal reference line can significantly reduce linear set-up error at X and Y direction of radiotherapy in patients with upper-middle esophageal cancer.

关 键 词：食管癌 放射治疗 摆位参考线 胸骨柄中线 剑突下水平 摆位误差 

分 类 号：R730.55[医药卫生—肿瘤] R735.1[医药卫生—临床医学]