乳腺托架辅助装置设计及其在放射治疗摆位中的验证研究  

Study on the application value of auxiliary device of breast bracket in the positioning of radiotherapy

作　　者：杨海芳[1] 刘建平[1] 姜斌[1] 黄钰霖 迟子锋[2] YANG Hai-fang;LIU Jian-ping;JIANG Bin(Center of Radiotherapy,Tangshan People’s Hospital,Tangshan 063001,China;不详)

机构地区：[1]唐山市人民医院放疗中心,河北唐山063001 [2]河北医科大学第四医院放疗科,河北石家庄050011

出　　处：《中国医学装备》2023年第1期32-36,共5页China Medical Equipment

基　　金：河北省医学科学研究课题计划(20211398)“放射治疗摆位辅助装置改进和验证的研究”。

摘　　要：目的:设计乳腺托架辅助装置,探讨其在左侧乳腺癌保乳术后全乳及锁骨上下区放射治疗中的应用价值。方法:选取医院收治的24例左侧乳腺癌保乳术后行放射治疗患者,按照随机数表法将其分为两种定位方式的乳腺托架组和乳腺托架辅助装置组,每组12例。两组患者均采用一体化静态调强放射治疗,统计分析两组患者主要危及器官(OAR)剂量学指标2%、50%靶区体积的受照剂量(D2、D50)、最大剂量(Dmax)、平均剂量(Dmean)、适形指数(CI)和均匀性指数(HI),使用锥形束CT(CBCT)测算患者摆位误差绝对值,并记录摆位时间。结果:两组患者剂量学指标D2、D50、CI及HI比较,差异无统计学意义;OAR左肺(V20、V30、Dmean)、心脏(V30、Dmean)、右乳腺Dmean、脊髓Dmax、肱骨头(Dmax、Dmean)和甲状腺Dmean比较,差异均无统计学意义。两组患者左右方向、头脚方向和腹背方向的摆位误差比较,差异均有统计学意义(Z=-2.112,Z=-8.061,Z=-2.228;P<0.035)。两组患者摆位时间比较,差异有统计学意义(t=5.181,P<0.001)。结论:乳腺托架辅助装置可提高摆位精度与效率,改造现有装备以适应技术的发展,提高放射治疗设备利用率,有较好的临床应用价值。Objective: To investigate the application value of auxiliary device of breast bracket in radiotherapy of whole breast and “up and down region” of clavicle after left breast conserving surgery. Methods: A total of 24 patients who underwent radiotherapy after left breast conserving surgery were selected and they were randomly divided into breast bracket group and breast bracket with auxiliary device group, with 12 patients in each group. Both two groups adopted integrated static intensity-modulated radiotherapy, and the exposure doses(D2, D50) of 2% and 50%target volumes, the maximum dose(Dmax), the average dose(Dmean), conformal index(CI) and homogeneity index(HI) of dosimetry indicators of organ at risk(OAR) of two groups were analyzed as statistical method. The cone beam computed tomography(CBCT) was used to measure the absolute value of positioning error of patients, and the time of positioning was recorded. Results: The differences of D2, D50, CI and HI of dosimetry indicators between two groups were not significant, and the differences of OAR left lung(V20, V30, Dmean), heart(V50, Dmean), right breast Dmean, caput humerus(Dmax, Dmean) and thyroid(Dmean) between two groups were also not significant. The positioning errors of left-right direction, head-foot direction and abdomen – back direction between two groups were significant(Z=-2.112, Z=-8.061, Z=-2.228, P<0.035). The difference of the time of positioning between two groups was not significant(t=5.181, P<0.001).Conclusion: The auxiliary device of breast bracket can improve positioning accuracy and efficiency, and the remolding of existing equipment for adapting the development of technique can increase the utilization rate of radiotherapy equipment, which has favorable clinical application value.

关 键 词：乳腺癌 乳腺托架 辅助装置 体位固定 摆位误差 

分 类 号：R812[医药卫生—放射医学]