头颈胸热塑模联合真空垫在中下段食管癌放射治疗体位固定中的运用  

Application of head-neck-chest thermoplastic mold combined with vacuum pad in immobilization of radiotherapy for middle-lower esophageal cancer

作　　者：魏伟 孙丽[1] 许俊 WEI Wei;SUN Li;XU Jun(Jiangsu Cancer Hospital·Jiangsu Institute of Cancer Research·The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,Jiangsu,China)

机构地区：[1]江苏省肿瘤医院·江苏省肿瘤防治研究所·南京医科大学附属肿瘤医院,江苏南京210009

出　　处：《生物医学工程与临床》2021年第4期430-433,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨头颈胸热塑模联合真空垫在中下段食管癌放射治疗中的运用。方法选择2018年3月至9月在江苏省肿瘤医院治疗的中下段食管癌患者36例,其中男性27例,女性9例;年龄31~83岁,中位年龄65岁。随机分为试验组和对照组,每组18例。试验组采用头颈胸热塑模联合真空垫,对照组采用头颈胸热塑模。运用锥形束CT(CBCT)记录两种不同固定方法的中下段食管癌患者在X轴(左右方向)、Y轴(头脚方向)、Z轴(腹背方向)方向和Pitch(绕X轴前后旋转)、Roll(绕Z轴旋转)、Rtn(绕Y轴旋转)角度的摆位误差数据。采取非参数检验分析两组数据差异。结果试验组在X轴、Y轴、Z轴方向和Pitch、Roll、Rtn角度的摆位误差,依据频数表计算出六维度的P25(第25百位分数)、P50(第50百位分数)和P75(第75百位分数)分别为(0.0,1.0,2.0)mm、(1.0,2.0,4.0)mm、(0.0,1.0,2.0)mm和(0.1,0.4,0.8)°、(0.1,0.6,1.1)°、(0.1,0.3,0.8)°,对照组分别为(1.0,2.0,4.0)mm、(1.0,2.0,3.0)mm、(1.0,1.0,2.0)mm和(0.1,0.4,0.8)°、(0.2,0.7,1.3)°、(0.2,0.5,1.1)°。X轴、Y轴和Z轴方向及Rtn角度的摆位误差两组比较,差异有统计学意义(P<0.05)。结论中下段食管癌放射治疗采用头颈胸热塑模联合真空垫固定,摆位误差更少,放射治疗精度相对更高。Objective To investigate the application of head-neck-chest thermoplastic mold combined with vacuum pad in immobilization of radiotherapy for middle-lower esophageal cancer.Methods From March to September in 2018,36 patients with middle-lower esophageal cancer were enrolled,which included 27 males and 9 females,aged 31-83 years old with median age of 65 years old.All of them were randomly divided into experimental group(n=18,immobilization with head-neckchest thermal mold combined with vacuum pad)and control group(n=18,immobilization with head-neck-chest thermal mold).The cone beam CT(CBCT)was used to analyze set-up errors of two immobilization methods in patients with middle-lower esophageal cancer at X-axis(left-right direction),Y-axis(superior-inferior direction),Z-axis(anterior-posterior direction)and Pitch(rotation around X-axis),Roll(rotate around Z-axis),Rtn(rotate around Y-axis),Non-parametric tests were used to analyze parameters between 2 groups.Results Based on frequency table,set-up errors of experimental group at X-axis,Y-axis,Zaxis and Pitch,Roll,Rtn calculated 6 dimensions of P25(25 th percentile),P50(50 th percentile)and P75(75 th percentile)were(0.0,1.0,2.0)mm,(1.0,2.0,4.0)mm,(0.0,1.0,2.0)mm and(0.1,0.4,0.8)°,(0.1,0.6,1.1)°,(0.1,0.3,0.8)°;and control group were(1.0,2.0,4.0)mm,(1.0,2.0,3.0)mm,(1.0,1.0,2.0)mm,and(0.1,0.4,0.8)°,(0.2,0.7,1.3)°,(0.2,0.5,1.1)°.There were statistically significant differences in set-up errors of X-axis,Y-axis,Z-axis and Rtn between 2 groups(P<0.05).Conclusion It is demonstrated that head-neck-chest immobilization combined with vacuum pad for radiotherapy of middle-lower esophageal cancer could achieve less set-up error and relatively higher radiotherapy accuracy.

关 键 词：食管癌 体位固定 热塑模 真空垫 联合应用 摆位误差 精确放射治疗 

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