乳腺托架与举臂支架对乳腺癌放射治疗摆位误差的对比研究  

Comparative research of breast bracket and lifting arm bracket on positioning error of radiotherapy for breast cancer

作　　者：肖嘉宁 孙显松 杨志伟 姜斐 王忆君 张福泉[1] 邱杰 XIAO Jia-ning;SUN Xian-song;YANG Zhi-wei(Department of Radiotherapy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100005,China;不详)

机构地区：[1]中国医学科学院北京协和医院放射治疗科,北京100005

出　　处：《中国医学装备》2023年第1期37-41,共5页China Medical Equipment

摘　　要：目的:分析比较乳腺托架与举臂支架对乳腺癌患者放射治疗摆位误差的差异性,指导临床乳腺癌放射治疗中固定方式的正确选择。方法:选取医院收治的41例乳腺癌患者临床资料,其中21例患者在放射治疗中采用乳腺托架(7.5°)固定,20例患者采用举臂支架固定。所有患者共纳入锥形束CT(CBCT)治疗配准数据126组,摆位误差通过治疗前的CBCT验证获得,并进行误差修正后治疗。对比分析患者的不同年龄、接受不同乳腺癌治疗方式及不同肿瘤位置等因素对摆位误差的影响。结果:21例使用乳腺托架(7.5°)固定的患者在三维方向的升降方向(VRT)、进出方向(LNG)和左右方向(LAT)摆位误差分别为(0.41±0.32)cm、(0.43±0.53)cm和(0.22±0.17)cm;20例使用举臂支架定位的患者在三维方向VRT、LNG和LAT摆位误差分别为(0.34±0.22)cm、(0.37±0.27)cm和(0.31±0.25)cm。两种固定方法在3个方向的摆位误差差异均无显著统计学意义;右侧乳腺癌的患者在LAT方向乳腺托架(7.5°)均低于举臂支架摆放误差,差异有统计学意义(t=2.033,P<0.05)。举臂支架定位者的VRT方向年龄≥45岁的患者摆位误差小于年龄<45岁的患者,差异有统计学意义(t=2.8527,P<0.05);改良根治术后摆位误差小于保乳术者,差异有统计学意义(t=-2.3283,P≤0.05)。结论:在乳腺癌患者放射治疗中,乳腺托架(7.5°)与举臂支架两种定位方式摆位误差无显著差异,临床中可以根据设备的需求和患者的舒适度感受合理选择应用。Objective: To analyze and compare the difference of positioning error between breast bracket and lifting arm bracket in the radiotherapy for patients with breast cancer, so as to guide the correct choice of fixation mode in clinical radiotherapy for breast cancer. Methods: The clinical data of 41 patients with breast cancer who admitted to hospital were selected, 21 cases of them adopted breast bracket(7.5 °) for fixation, and other 20 cases of them adopted lifting arm bracket for fixation. A total of 126 groups of treatment data of cone beam computed tomography(CBCT) were included, and the positioning errors were obtained through CBCT verification before treatment, and the treatment was conducted after the error was corrected. And then, the influences of the factors included different ages,different treatment methods of breast cancer that were performed and the different positions of tumors on positioning errors were compared and analyzed. Results: The mean ± SD of positioning errors of 21 patients who used breast bracket(7.5°) for fixation on rise and fall direction(VRT), in and out direction(LNG) and left and right direction(LAT) of three dimensional(3D) direction were(0.41±0.32) cm,(0.43±0.53) cm and(0.22±0.17) cm, respectively.The mean ± SD of positioning errors of 20 patients who used lifting arm bracket for fixation on above three directions were 0.34±0.22 cm, 0.37±0.27 cm and 0.31±0.25 cm, respectively. There were no statistically significant difference in the positioning errors on three directions between two fixation methods. For patients with right side of breast cancer, the positioning error on LAT direction of breast bracket(7.5°) was significantly lower than that of lifting arm bracket(t=2.033, P<0.05). For patients who adopted lifting arm bracket, the positioning error on VRT direction of patients who were ≥ 45 years of age was significantly less than that of patients who were <45 years of age(t=2.8527,P<0.05). In addition, the positioning error of patients after modified radical maste

关 键 词：乳腺癌 乳腺托架 举臂支架 放射治疗 摆位误差 

分 类 号：R812[医药卫生—放射医学]