前列腺癌放疗时俯卧板与真空垫固定对膀胱和直肠体积变化影响  

Effects of prone board or vacuum pad in fixation on the bladder and rectal volume during radiotherapy for prostate cancer

作　　者：陈炫光 林志悦 何梦雪 林楚燕 方键蓝[1] 方涌文 林承光[1] 许森奎[1] 姚文燕[1] CHEN Xuan-guang;LIN Zhi-yue;HE Meng-xue;LIN Chu-yan;FANG Jian-lan;FANG Yong-wen;LIN Cheng-guang;XU Sen-kui;YAO Wen-yan(State Key Laboratory of Oncology in South China,Radiotherapy Department of Sun Yat-sen University Cancer Center,Guangzhou510060,China)

机构地区：[1]华南肿瘤学国家重点实验室,中山大学肿瘤防治中心放疗科,广东广州510060

出　　处：《中华肿瘤防治杂志》2022年第22期1624-1627,1635,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：广东省医学科学技术研究基金(A2020621,A2017613);中山大学肿瘤防治中心青年优创项目(PT21020101)。

摘　　要：目的分析放疗过程中不同体位固定对前列腺癌患者膀胱和直肠体积变化的影响,为前列腺癌靶区计划设计提供参考。方法选取2015-08-05-2020-11-19在中山大学肿瘤防治中心进行放疗的69例前列腺癌患者,其中32例使用俯卧板固定(俯卧板组),37例使用负压真空垫固定(真空垫组),每次治疗前行机载锥形束CT(CBCT)扫描。在CT模拟定位影像和CBCT影像上勾画膀胱和直肠轮廓,分析69例患者放疗过程中膀胱、直肠体积变化趋势,并对2组患者CBCT的膀胱和直肠体积变化百分比(与计划CT比较)进行非参数检验。结果俯卧板组计划CT影像的膀胱和直肠体积分别为362(172)和54(38)mL;CBCT影像的膀胱和直肠充盈体积分别为278(165)和55(31)mL,每日CBCT膀胱体积平均减少19%,直肠体积增加16%;真空垫组计划CT影像的膀胱和直肠体积分别为368(138)和55(54)mL;CBCT影像的膀胱和直肠充盈体积分别为249(169)和50(38)mL,每日CBCT膀胱体积平均减少33%,直肠体积减少12%。2组膀胱和直肠体积变化百分比差异均有统计学意义,均P<0.001。结论放疗过程中前列腺癌患者膀胱和直肠体积存在不同程度的变化,使用俯卧板时患者的膀胱一致性保持优于真空垫,直肠体积重复性俱佳。Objective To analyze the influence of different body position fixation on the volume change of the bladder and rectum in patients with prostate cancer during radiotherapy,so as to provide reference for the delineation of prostate cancer target area plan.Methods A total of 69 patients with prostate cancer who underwent radiotherapy in Sun Yat-sen University Cancer Center from August 5,2015 to November 19,2020 were selected as research objects,of whom 32 patients were fixed with a prone board(prone board group),and the other 37 patients were fixed with a negative pressure vacuum pad(vacuum pad group).Cone beam computed tomography(CBCT)scans were performed before each treatment.The contours of the bladder and rectum were delineated on CT simulated images and CBCT images,and the trends of bladder and rectal volume were analyzed in 69 patients during radiotherapy.The percentage of bladder and rectum changes in the two groups was analyzed by non-parametric test.Results In the prone board group,the median volumes(quartile spacing)of the bladder and rectum in planned CT images were 362(172)and 54(38)mL.The volumes of the bladder and rectum on CBCT images were 278(165)and 55(31)mL.The bladder volume decreased by 19%and rectal volume increased by 16%in the average daily CBCT.In the vacuum pad group,the median volumes(quartile spacing)of the bladder and rectum in planned CT images were 368(138)and 55(54)mL.The volumes of the bladder and rectum on CBCT images were 249(169)and 50(38)mL.The bladder volume decreased by 33%and rectal volume decreased by 12%in average daily CBCT.There was significant difference between the two groups in the volume change percentage of the bladder and rectum(both P<0.001).Conclusion The bladder and rectal volume changes in patients with prostate cancer in radiotherapy.The consistency of bladder volume using prone board was better than that using vacuum pad,while the repeatability of rectal volume was doing well in both groups.

关 键 词：前列腺癌 锥形束CT 图像引导放射治疗 膀胱体积 直肠体积 

分 类 号：R737.25[医药卫生—肿瘤]