改良型体膜固定板在宫颈癌调强放射治疗中的应用  

Application of modified body membrane fixation plate in intensity modulated radiotherapy for cervical cancer

作　　者：商在春 葛彬彬[1] 李明[1] 储开岳[1] 金建华[1] SHANG Zai-chun;GE Bin-bin;LI Ming;CHU Kai-yue;JIN Jian-hua(Department of Radiotherapy,Nantong Tumor lospital,Nantong 226006,Jiangsu,China)

机构地区：[1]南通市肿瘤医院放疗科,江苏南通226006

出　　处：《生物医学工程与临床》2023年第3期331-336,共6页Biomedical Engineering and Clinical Medicine

基　　金：南通市科技计划指导性项目(MSZ20209)。

摘　　要：目的探讨改良型体膜固定板与传统型体膜固定板在宫颈癌调强放射治疗中的应用及身体质量指数(BMI)对宫颈癌患者摆位误差的影响。方法选择2019年3月至2021年7月在南通市肿瘤医院经病理确诊的宫颈癌患者128例,年龄33~77岁,中位年龄49岁;临床肿瘤分期(TNM)ⅡA~ⅡB期34例,ⅢA~ⅢC期94例;BMI 18~29 kg/m^(2),中位BMI 24.5 kg/m^(2)。将患者随机分为A组(改良型体膜固定板)60例和B组(传统型体膜固定板)68例。两组患者在进行放射治疗前,行锥形束CT扫描,采用自动灰度线性+旋转匹配(Grey+Tine),得出三维方向线性摆位误差及旋转误差。比较不同体膜固定板之间的摆位误差。以BMI 24 kg/m^(2)为分界点,将BMI<24 kg/m^(2)为1(非肥胖)组,≥24 kg/m^(2)为2(肥胖)组。分析BMI对两组患者的摆位误差影响。结果A组患者在X(左右)、Y(头脚)、Z(腹背)方向的平移误差分别为(0.18±0.14)cm、(0.25±0.18)cm、(0.17±0.13)cm,旋转误差R_(X)(绕X轴角度)、R_(Y)(绕Y轴角度)、R_(Z)(绕Z轴角度)分别为(0.50±0.50)°、(0.61±0.57)°、(0.93±0.80)°;B组分别为(0.22±0.15)cm、(0.37±0.28)cm、(0.20±0.14)cm和(1.30±0.76)°、(1.08±0.58)°、(1.08±0.68)°。结果可见A组患者在Y方向、R_(X)方向、R_(Y)方向小于B组,差异有统计学意义(P<0.05)。按BMI分组:A1组患者在X、Y、Z方向的平移误差分别为(0.15±0.13)cm、(0.25±0.13)cm、(0.14±0.11)cm,旋转误差R_(X)、R_(Y)、R_(Z)分别为(0.53±0.45)°、(0.59±0.48)°、(1.10±0.76)°;A2组患者分别为(0.25±0.16)cm、(0.24±0.25)cm、(0.17±0.14)cm和(0.46±0.52)°、(0.64±0.66)°、(0.85±0.84)°;B1组患者分别为(0.16±0.14)cm、(0.24±0.14)cm、(0.16±0.12)cm和(0.91±0.55)°、(0.86±0.40)°、(0.83±0.52)°;B2组分别为(0.23±0.21)cm、(0.47±0.33)cm、(0.24±0.14)cm和(1.75±0.72)°、(1.32±0.65)°、(1.33±0.73)°。从结果中可见,A1组在X方向上小于A2组,在R_(X)、R_(Y)方向上小于B1组,差异有统计学意义(P<0.05)。A2组与BObjective To investigate the application of modified body membrane fixation plate and conventional body membrane fixation plate in intensity-modulated radiotherapy for cervical cancer and the effect of body mass index(BMI)on the set-up error of patients with cervical cancer.Methods From March 2019 to July 2021,128 patients with cervical cancer diagnosed by pathology in Nantong Cancer Hospital were enrolled,aged 33-77 years old with median age of 49 years old,clinical tumor node metastasis classification TNM stage IIA-IIB in 34 cases and stage IIIA-IIIC in 94 cases,BMI index 18-29 kg/m?with median BMI of 24.5 kg/m².All of them were randomly divided into group A(modified body membrane fixation plate,60 cases)and group B(traditional body membrane fixation plate,68 cases).In both groups,cone-beam CT scans were performed before radiation treatment,and automatic grayscale linear+rotational matching(Grey+Tine)was used to derive linear positional errors and rotational errors in three-dimensional direction.The positioning errors of different body membrane fixation plates were compared.BMI 24 kg/m^(2)was used as the cut-off point,and BMI<24 kg/m²was considered as group 1(non-obese)and BMI≥24 kg/m^(2)as group 2(obese).The effect of BMI on the set-up error of patients in 2 groups was analyzed.Results The translation errors of patients in group A were(0.18±0.14)cm,(0.25±0.18)cm and(0.17±0.13)cm in the X(left and right),Y(head and feet)and Z(abdominal and dorsal)directions,respectively,and the rotation errors R_(x)(angle around the X axis),R_(y)(angle around the Y axis)and R(angle around the Z axis)were(0.50±0.50)°,(0.61±0.57)°and(0.93±0.80),respectively.The translation errors in the X,Y,and Z directions of group B patients were(0.22±0.15)cm,(0.37±0.28)cm,and(0.20±0.14)cm,respectively,and the rotational errors of R_(x),R_(y),and R_(z)were(1.30±0.76),(1.08±0.58)°,and(1.08±O.68)°.The results showed that the error in Y direction,R_(x)and R_(y)direction of group A were statistically significantly smaller than t

关 键 词：宫颈癌 改良体膜固定板 传统体膜固定板 摆位误差 身体质量指数 调强放射治疗 

分 类 号：R730.55[医药卫生—肿瘤] R737.33[医药卫生—临床医学]