发泡胶个体化体位固定技术在颈段及胸上段食管癌调强放射治疗中的应用价值研究  

Study on the application value of fixation technique with styrofoam of individual body position in IMRT for cervical and upper thoracic esophageal cancer

作　　者：吴云来[1] 孙谦[1] 韩洋 蔡汉飞[1] 徐全敬[1] 李文海[1] 吴先想 杨荣邦 WU Yun-lai;SUN Qian;HAN Yang(Department of Radiation Oncology,The First Affiliated Hospital of Bengbu Medical College and Tumor Hospital Affiliated to Bengbu Medical College,Bengbu 233004,China;不详)

机构地区：[1]安徽省蚌埠医学院第一附属医院暨蚌埠医学院附属肿瘤医院肿瘤放疗科,安徽蚌埠233004

出　　处：《中国医学装备》2022年第12期33-37,共5页China Medical Equipment

基　　金：蚌埠医学院科技项目(自然科学类)(2020byzd177)“发泡胶个体化体位固定技术在颈段及胸上段食管癌放疗中的应用价值研究”。

摘　　要：目的:探讨发泡胶个体化体位固定技术在颈段及胸上段食管癌调强放射治疗中的应用价值。方法:选取在医院肿瘤放疗中心接受调强放射治疗(IMRT)的80例颈段及胸上段食管癌患者,按不同体位固定方式将患者分为发泡胶组和头枕组,每组40例。发泡胶组采用个体化发泡胶联合头颈肩热塑膜固定体位,头枕组采用标准聚氨酯头枕联合头颈肩热塑膜固定体位。采集每例患者放射治疗前3次和治疗后每周1次的锥形束CT(CBCT)图像,并与计划CT图像进行配准后分别记录在左右、上下及前后方向上的重复摆位误差值,并根据3个方向的误差值计算出三维摆位误差。采用问卷调查形式评估患者对固定装置及技师操作的主观治疗舒适满意度。结果:发泡胶组和头枕组摆位误差左右方向分别为(0.76±0.97)mm和(1.78±1.33)mm;上下方向分别为(0.82±1.02)mm和(2.29±1.45)mm;三维摆位误差分别为(2.97±1.13)mm和(4.34±1.65)mm,差异均有统计学意义(t=8.78,t=11.89,t=1.74;P<0.05);前后方向分别为(0.97±0.82)mm和(1.10±0.97)mm;两者比较差异无统计学意义。发泡胶组和头枕组≥5 mm的三维摆位误差累积频率分别为11.9%和24.4%,其差异有统计学意义(x^(2)=16.73,P<0.05);发泡胶组和头枕组患者的主观舒适满意度分别为87.5%和57.5%,其差异有统计学意义(x^(2)=9.03,P<0.05);结论:发泡胶个体化体位固定技术在颈段及胸上段食管癌IMRT中,能够减少患者的摆位误差,提高患者摆位精度和舒适度,具有临床应用价值。Objective:To explore the application value of fixation technique with Styrofoam of individual body position in intensity modulated radiation therapy(IMRT)for cervical and upper thoracic esophageal cancer.Methods:80 patients with cervical and upper thoracic esophageal cancer who received IMRT in the center of tumor radiotherapy of hospital were selected,and they were divided into Styrofoam group and head pillow group according to different fixation method of body position,with 40 cases in each group.Styrofoam group adopted individual Styrofoam combined with headneck-shoulder thermoplastic film to fix the body position,and head pillow group adopted standard head pillow with polyurethane combined with head-neck-shoulder thermoplastic film to fix the body position.Conical beam computed tomography(CBCT)images of 3 times before radiotherapy and weekly 1 time after treatment of each patient were collected,and then,the error values of repetitive positioning on left and right direction,up and down direction and forward and backward direction were respectively recorded after these CBCT images were registered with CT images.Then,the three-dimensional(3D)positioning errors were calculated according to the error values of three directions.Questionnaire survey was used to assess the satisfactions of the subjective treatment comfort of patients for the fixed devices and the operation of technicians.Results:The positioning errors of left and right direction of Styrofoam group and head pillow group were respectively(0.76±0.97)mm and(1.78±1.33)mm,and that of up and down direction of two groups were respectively(0.82±1.02)mm and(2.29±1.45)mm,and that of 3D positioning errors of Styrofoam group and head pillow group were respectively(2.97±1.13)mm and(4.34±1.65)mm,and the differences of them between two groups were statistically significant(t=8.78,t=11.89,t=1.74,P<0.05),respectively.However,the positioning errors of forward and backward direction of two groups were respectively(0.97±0.82)mm and(1.10±0.97)mm,and the difference

关 键 词：颈段及胸上段食管癌 调强放射治疗(IMRT) 个体化发泡胶 体位固定 摆位误差 

分 类 号：R815[医药卫生—放射医学]