应用CBCT技术测量分析鼻咽癌VMAT治疗期间每周分次间及不同部位的摆位误差  

CBCT Technique in the Measurement of the Setup Errors Between Different Times and Different Parts of Nasopharyngeal Carcinoma During VMAT Treatment

作　　者：熊文敏 谢琛[1] 罗晗 龚晓昌[1] 龚巧英[1] 邱杨[1] 王小平[1] 张云[1] 袁承浪[1] 刘全全 XIONG Wenmin;XIE Chen;LUO Han(Jiangxi Cancer Hospital,Nanchang,330029)

机构地区：[1]江西省肿瘤医院,330029 [2]江西省永修县人民医院,330300

出　　处：《实用癌症杂志》2021年第11期1894-1897,共4页The Practical Journal of Cancer

摘　　要：目的通过CBCT测量鼻咽癌摆位误差,观察放射治疗期间、头部区域与颈部区域摆位误差,寻找适合VMAT技术的靶区边界,为提高放射治疗的精度提供临床依据。方法选择30例鼻咽癌患者,在放射治疗前进行CBCT扫描,将扫描图像与放疗定位影像匹配,记录放疗期间每周分次间的误差及头部、上颈部及下颈部的摆位误差。结果鼻咽癌放疗治疗期间平均摆位误差X(0.96±0.77)mm,Y(0.88±0.76)mm,Z(0.94±0.79)mm。治疗期间第4周起,各方的摆位误差较首次治疗有统计学差异。不同部位摆位误差,头部摆位误差与整体相当,无统计学差异;上颈部及下颈部摆位误差明显大于整体摆位误差。在整体结构中、MPTV在三维方向外扩范围分别为2.62 mm、2.50 mm、2.63 mm。结论在治疗的第4周开始摆位误差出现明显变化,需要通过在线校正或者计划修正减少治疗误差。同时头部区域摆位误差小于颈部区域摆位误差,因此在临床工作中必须核对配准图像。Objective To measure setup error of nasopharyngeal carcinoma by CBCT,setup errors of different registration such as head and neck were observed to found the boundary of target region suitable for VMAT technology,and provides clinical application for improving the accuracy of radiotherapy.Methods A total of 30 patients with nasopharyngeal carcinoma were enrolled.CBCT scans were performed before radiotherapy every week.The errors in the weekly sessions of the head,the upper neck and lower neck during radiotherapy were recorded.Results The average setup error during radiotherapy for nasopharyngeal carcinoma was X(0.96±0.77)mm,Y(0.88±0.76)mm,and Z(0.94±0.79)mm.From the 4th week of treatment,the setup error of the parties was statistically different from the first treatment.The setup error of different parts,the head setup error was equivalent to the whole error,and there was no statistical difference.The setup error of the upper neck and lower neck was significantly larger than the overall placement error.In the whole part the MPTV's external expansion range in the three-dimensional direction is 2.62mm,2.50mm,and 2.63mm,respectively.Conclusion There is a significant change in the setup error at the 4th week of treatment,and it is necessary to reduce the treatment error by online correction or planned correction.At the same time,the head area setup error is smaller than the neck area setuperror,so the registration image must be checked in clinical work.

关 键 词：鼻咽癌 容积旋转调强放射治疗 摆位误差 CBCT 

分 类 号：R739.63[医药卫生—肿瘤]