头颈肩热塑膜联合发泡胶固定在颈胸部肿瘤放射治疗中的应用  

Application of head-neck-shoulders thermoplastic film combined with styrofoam fixation in radiotherapy on neck and thoracic tumors

作　　者：吴艳[1] 肖杨 李恒 黄顺平[1] WU Yan;XIAO Yang;LI Heng(Department of Oncology,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400064,China)

机构地区：[1]重庆医科大学附属第二医院肿瘤科,重庆400064

出　　处：《中国医学装备》2022年第10期23-27,共5页China Medical Equipment

基　　金：国家自然科学基金(81972851)“pre-miRNA甲基化调控基因BCDIN3D在NSCLC淋巴分期中的作用及机制研究”。

摘　　要：目的:探讨头颈肩热塑膜联合发泡胶固定在颈胸部肿瘤放射治疗中的应用价值。方法:选取在医院接受调强放射治疗(IMRT)的91例颈胸部肿瘤患者,根据体位固定方式不同将采用头颈肩热塑膜固定的患者纳入热塑膜固定组(44例),采用头颈肩热塑膜联合发泡胶固定的患者纳入联合发泡胶固定组(47例)。所有患者均采用大孔径CT扫描定位并执行IMRT计划。每周行5次放射治疗,对患者行锥形束CT(CBCT)扫描位置验证。比较两组腹背、左右和头脚3个方向上的摆位误差及其分布情况。结果:91例患者总共进行1 765次放射治疗摆位,热塑膜固定组和热塑膜联合发泡胶固定组分别进行了172次和163次CBCT位置验证,所有摆位误差均符合临床治疗要求≤5 mm。热塑膜固定组在腹背、左右和头脚3个方向的平均摆位误差分别为(0.06±0.15)cm、(0.02±0.19)cm和(0.10±0.23)cm;联合发泡胶固定组平均摆位误差分别为(0.04±0.17)cm、(0.01±0.18)cm和(0.03±0.24)cm,联合发泡胶固定组在3个方向误差均小于热塑膜固定组,其中在头脚方向上差异具有统计学意义(t=2.791,P<0.05)。结论:头颈肩热塑膜联合发泡胶固定能够提高患者舒适性和配合度,同时减少颈胸部肿瘤放射治疗的摆位误差,在腹背和头脚方向的稳定性优于单纯头颈肩热塑膜固定。Objective: To investigate the application value of head-neck-shoulder thermoplastic film combined with styrofoam fixation in radiotherapy on neck and thoracic tumors. Methods: 91 patients with neck and thoracic tumors who underwent intensity modulated radiation therapy(IMRT) were selected. According to the difference of fixation mode of position, patients who adopted head-neck-shoulder thermoplastic film fixation were divided into thermoplastic film fixation group(44 cases), and patients who adopted head-neck-shoulder thermoplastic film combined with styrofoam fixation were divided into combined styrofoam fixation group(47 cases). All patients adopted computed tomography(CT) scan location with large aperture and performed IMRT plan. They underwent radiotherapy as 5 times per week, and they underwent cone beam CT(CBCT) scan for verifying position. And then, the setup error and the distribution of that on 3 directions included abdomen-back, left-right and head-foot between two groups were compared. Results: A total of 1765 positions of radiotherapy were performed on 91 patients. Two groups underwent respectively 172 times and 163times of CBCT position verification, and all setup errors were less than or equal to 5 mm that met to the requirement of clinical treatment. The setup errors on three directions of abdomen-back, left-right and head-foot of thermoplastic film fixation group were respectively(0.06 cm±0.15) cm,(0.02 cm±0.19) cm and(0.10 cm±0.23) cm. And those of combined styrofoam fixation group were(0.04±0.17) cm,(0.01±0.18) cm and(0.03±0.24) cm, respectively. The errors of three directions of combined styrofoam fixation group were less than those of thermoplastic film fixation group, and the difference of the error on head-foot direction between two groups were significant(t=2.791, P<0.05). Conclusion:The head-neck-shoulders thermoplastic film combined with styrofoam fixation can improve the comfort and adaptability of patients, and reduce the setup errors of radiotherapy for neck and thoracic tumors.

关 键 词：头颈肩热塑膜 发泡胶固定 肿瘤放射治疗 摆位误差 

分 类 号：R816[医药卫生—放射医学]