CBCT X射线图像引导技术在胸上段食管癌容积旋转调强放疗中的应用价值  

Application value of CBCT X-ray image-guided technique in volumetric modulated arc therapy for upper thoracic esophageal carcinoma

作　　者：谢红亮[1] 曹洋森[1] 张火俊[1] 吴婷[1] XIE Hongliang;CAO Yangsen;ZHANG Huojun;WU Ting(Radiotherapy Department,Changhai Hospital of Shanghai,Shanghai 200433,China)

机构地区：[1]上海长海医院放疗科,上海200433

出　　处：《临床医学研究与实践》2023年第22期129-132,共4页Clinical Research and Practice

基　　金：海军军医大学第一附属医院“234学科攀峰计划”资助项目(No.2019YPT004)。

摘　　要：目的探讨锥体束计算机断层扫描(CBCT)X射线图像引导技术在胸上段食管癌容积旋转调强放疗(VMAT)中的应用价值。方法回顾性分析2021年1月至12月于我院放疗科行VMAT治疗的22例胸上段食管癌患者临床资料。摆位完成后采用CBCT X射线图像引导获得扫描图像,与数字重建放射影像(DRR)进行匹配,得到3个方向的平移摆位误差和3个方向的旋转摆位误差,并进行误差纠正,纠正后再次扫描6个方向的摆位误差。比较纠正前、后的摆位误差。结果纠正前,平移方向摆位误差最大值从大到小依次为Z(胸、背)、Y(头、脚)、X(左、右)方向,旋转方向摆位误差最大值从大到小依次为RX(左、右)、RY(头、脚)、RZ(胸、背)方向;纠正后,平移方向摆位误差最大值从大到小依次为Z(胸、背)、Y(头、脚)、X(左、右)方向,旋转方向摆位误差最大值从大到小依次为RX(左、右)、RZ(胸、背)、RY(头、脚)方向,均很小;纠正后,各方向平移摆位误差、旋转摆位误差均小于纠正前,差异具有统计学意义(P<0.05)。结论CBCT X射线图像引导技术运用于胸上段食管癌VMAT的摆位验证中可以明显减小摆位误差,提高放疗的精确度。Objective To explore the application value of cone beam computed tomography(CBCT)X-ray image-guided technique in volumetric modulated arc therapy(VMAT)for upper thoracic esophageal carcinoma.Methods The clinical data of 22 patients with upper thoracic esophageal carcinoma who underwent VMAT in the radiotherapy department of our hospital from January to December 2021 were retrospectively analyzed.After the setup was completed,the CBCT X-ray image-guided was used to obtain the scanning image,which was matched with the digitally reconstructed radiograph(DRR)to obtain the translational setup errors in 3 directions and the rotational setup errors in 3 directions.The errors were corrected,and the setup errors in 6 directions were scanned again after correction.The setup errors before and after correction were compared.Results Before correction,the maximum value of setup error in translational direction from large to small was Z(chest,back),Y(head,foot),X(left,right)direction,and the maximum value of setup error in rotational direction from large to small was RX(left,right),RY(head,foot),RZ(chest,back)direction;after correction,the maximum value of the setup error in the translational direction from large to small is Z(chest,back),Y(head,foot),X(left,right)direction,and the maximum value of the setup error in the rotational direction from large to small is RX(left,right),RZ(chest,back),RY(head,foot)direction,all of which are very small;after correction,the translational setup errors and rotational setup errors in all directions were less than those before correction,and the differences were statistically significant(P<0.05).Conclusion CBCT X-ray image-guided technology application in the setup verification of VMAT for upper thoracic esophageal carcinoma can significantly reduce the setup error and improve the accuracy of radiotherapy.

关 键 词：容积旋转调强放疗 锥体束计算机断层扫描 X射线图像引导 胸上段食管癌 

分 类 号：R735.1[医药卫生—肿瘤]