3D打印头枕提高了鼻咽癌调强放疗体位重复性  

The 3D printed headrest improves the repeatability of the position of intensity-modulated radiotherapy for nasopharyngeal carcinoma

作　　者：闫昱萤 叶荣[1] 于路新 唐晓燕 黄发生 杨程凡 YAN Yuying;YE Rong;YU Luxin;TANG Xiaoyan;HUANG Fasheng;YANG Chengfan(Cancer Center,Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital,Sichuan Chengdu 610072,China.;3D Printing Center,Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital,Sichuan Chengdu 610072,China.)

机构地区：[1]四川省医学科学院·四川省人民医院肿瘤放疗中心,四川成都610072 [2]四川省医学科学院·四川省人民医院3D打印中心,四川成都610072

出　　处：《现代肿瘤医学》2023年第8期1485-1489,共5页Journal of Modern Oncology

摘　　要：目的:分析3D打印头枕对鼻咽癌调强放疗重复性的影响。方法:选取54例鼻咽癌放疗患者分为实验组27例和对照组27例。实验组采用3D打印头枕联合头颈肩热塑膜固定体位,对照组采取泡沫软头枕、碳纤维垫块联合头颈肩热塑膜固定体位。比较两组患者在腹背、头脚、左右三方向摆位误差及配准分析颅底、第2、4和第7颈椎四个感兴趣区的残余平移误差及残余旋转误差。结果:实验组患者首次治疗前需重新摆位的人次明显少于对照组,具有统计学意义(P<0.05)。实验组的腹背、头脚方向摆位误差均明显小于对照组,具有统计学意义(P<0.05),两组患者左右方向摆位误差差异不明显,无统计学意义(P>0.05)。实验组颅底和第2颈椎的腹背、头脚、左右三方向以及第4和第7颈椎腹背、左右两方向残余平移误差均明显小于对照组,具有统计学意义(P<0.05);第4和第7颈椎的头脚方向残余平移误差均与对照组差异不明显,无统计学意义(P>0.05);实验组颅底、第2、4和7颈椎的失状位、横断位、冠状位三截面残余旋转误差均明显小于对照组,具有统计学意义(P<0.05)。实验组颅底腹背方向及第2、4和7颈椎腹背、头脚、左右三方向残余平移误差绝对值>2 mm的频次明显少于对照组,具有统计学意义(P<0.05),颅底头脚、左右两方向残余平移误差绝对值>2 mm的频次与对照组差异不明显,无统计学意义(P>0.05);实验组颅底、第2、4和7颈椎的失状位、横断位、冠状位三截面残余旋转误差绝对值>2°的频次均明显少于对照组,具有显著统计学意义(P<0.05)。结论:在鼻咽癌调强放疗中运用3D打印头枕联合头颈肩膜固定体位减小了摆位误差、残余平移误差及残余旋转误差,有效提高调强放疗精度同时降低正常组织副反应,提高靶区疗效和患者生存质量。Objective:To analyze the effect of 3D printed headrest on the reproducibility of intensity modulated radiation therapy(IMRT)for nasopharyngeal carcinoma(NPC).Methods:54 patients with NPC were divided into experimental group(27 cases)and control group(27 cases).The experimental group was fixed with 3D printed headrest combined with head-neck-shoulder thermoplastic membrane,while the control group was fixed with foam soft headrest,carbon fiber pad and head-neck-shoulder thermoplastic membrane.The setup errors in the three directions of anterior-posterior(AP),superior-inferior(SI),left-right(LR)were retrospectively compared between the two groups,and the residual translation errors and residual rotation errors in the 4 regions of interest of basis cranial,cervical 2,cervical 4 and cervical 7 were analyzed by registration.Results:The number of patients needing repeated positioning before the first treatment in the experimental group was significantly less than that in the control group with statistical significance(P<0.05).The setup errors of AP and SI directions in the experimental group were significantly smaller than those in the control group(P<0.05),and there was no significant differencein the LR direction between the two groups(P>0.05).The residual translation errors of cranial base and cervical 2 in the AP,SI and LR directions and cervical 4 and cervical 7 in the AP,LR directions in the experimental group were significantly smaller than those in the control group(P<0.05).There was no significant difference in the residual translation errors in the SI direction of cervical 4 and cervical 7 compared with the control group(P>0.05).The residual rotation errors of cranial base,cervical 2,cervical 4 and cervical 7 in the sagittal,transverse,and coronal sections in the experimental group were significantly lower than those in the control group(P<0.05).In the experimental group,the frequency of absolute value of residual translation error>2 mm in the AP direction of cranial base and the AP,SI and LR directions of cer

关 键 词：3D打印头枕 鼻咽癌 调强放射治疗 摆位误差 残余平移误差 残余旋转误差 

分 类 号：R739.63[医药卫生—肿瘤]