双参考线摆位法在宫颈癌调强放射治疗中应用对摆位误差影响  

Effect of dual-reference-line setting method on setting error in intensity modulated radiation therapy for cervical cancer

作　　者：郝其洁 刘福友 王君辉 储开岳[1] 李明[1] HAO Qi-jie;LIU Fu-you;WANG Jun-hui;CHU Kai-yue;LI Ming(Department of Radiotherapy,Nantong Tumor Hospital Tumor&Hospital Affiliated to Nantong University,Nantong 226361,Jiangsu,China)

机构地区：[1]南通市肿瘤医院•南通大学附属肿瘤医院放疗科,江苏南通226361

出　　处：《生物医学工程与临床》2022年第3期321-325,共5页Biomedical Engineering and Clinical Medicine

基　　金：南通市科技计划指导性项目(MSZ20209)。

摘　　要：目的探讨采用双参考线配合热塑体膜固定对宫颈癌摆位误差影响。方法选择60例宫颈癌容积旋转调强放射治疗患者,年龄27~82岁,中位年龄57岁。其中腹部画单参考线体膜固定的患者(A组)与画双参考线体膜固定的患者(B组)各30例。两组患者均行容积旋转调强放射治疗,在治疗前行锥形束CT(CBCT)扫描,扫描结果与定位图像进行融合匹配,得出A、B两组患者的摆位平移误差(X、Y、Z轴平移误差记为T-X、T-Y、T-Z)和旋转误差(X、Y、Z轴旋转误差记为R-X、R-Y、R-Z)。结果A组T-X、T-Y、T-Z分别为(0.21±0.18)cm、(0.47±0.34)cm、(0.20±0.10)cm,B组T-X、T-Y、T-Z分别为(0.19±0.08)cm、(0.20±0.20)cm.(0.19±0.08)cm。A、B两组T-X、T-Z差异无统计学意义(P>0.05),T-Y差异有显著统计学意义(P<0.01)。A组摆位旋转误差在R-X、R-Y、R-Z轴分别为1.14°±0.839、0.65°±0.50°、0.87°±0.64°,B组R-X、R-Y、R-Z分别为1.02°±0.83°、0.80°±0.55°、0.95°±0.96°,但两组R-X、R-Y、R-Z比较,差异均无统计学意义(P>0.05)。结论双参考线法摆位在宫颈癌容积旋转放射治疗中应用,提高了热塑体膜与身体敷贴度,有效地减小Y轴方向平移误差,提高摆位的重复性。Objective To investigate the effect of dual-reference-line and thermoplastic body film fixation on the setting error of cervical cancer. Methods A total of 60 patients with cervical cancer radiotherapy were enrolled, which aged 27-82 years old with mean age of 57 years old. All of them were divided into abdominal membrane fixation with single-reference-line(group A) and body membrane fixation with dual-reference-line(group B), 30 cases in each group. All of them performed cone beam CT( CBCT) scanning before intensity-modulated radiation therapy. The scan results were fused and matched with localization images, the setting and translation errors(X, Y, Z axis translation error was recorded as T-X, T-Y, T-Z) as well as rotation error(X, Y, Z axis rotation error was recorded as R-X, R-Y, R-Z) of all patients were obtained. Results The T-X, T-Y and T-Z in group A was(0.21 ± 0.18) cm,(0.47 ± 0.34) cm and(0.20 ± 0.10) cm, the T-X, T-Y, T-Z in group B was(0.19 ± 0.08) cm,(0.20 ± 0.20) cm and(0.19 ± 0.08) cm, respectively. There was statistically significant difference in T-Y between 2 groups(P < 0.01) and no significant difference in T-X and T-Z between 2 groups(P > 0.05). The setting rotation error of group A was 1.14° ± 0.83°, 0.65° ± 0.50° and 0.87° ± 0.64° in R-X, R-Y and R-Z, respectively;group B was 1.02° ±0.83°, 0.80° ± 0.55° and 0.95° ± 0.96°, respectively, and there was no significant difference in R-X, R-Y and R-Z between2 groups(P > 0.05). Conclusion It is demonstrated that the application of dual-reference-line could improve adhesion between thermoplastic film and body in radiation therapy of cervical cancer, which effectively reduce Y-axis translation error and improve setting repeatability.

关 键 词：宫颈癌 调强放射治疗(IMRT) 热塑体膜 双参考线 摆位误差 

分 类 号：R730.55[医药卫生—肿瘤] R737.33[医药卫生—临床医学]