基于CBCT分析三种体位固定技术在盆腔肿瘤放疗中的应用比较  

Comparison of the application of three postural fixation techniques in pelvic tumor radiotherapy based on CBCT

作　　者：王宇留[1] 方涌文 林晓生 姚文燕[1] 方键蓝 肖亮杰 WANG Yuliu;FANG Yongwen;LIN Xiaosheng;YAO Wenyan;FANG Jianlan;XIAO Liangjie(Radiotherapy Department,Sun Yat-sen University Cancer Center,Guangdong Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤防治中心放疗科,广东广州510060

出　　处：《现代肿瘤医学》2023年第17期3237-3242,共6页Journal of Modern Oncology

基　　金：广东省医学科学技术研究基金项目(编号:A2020621)。

摘　　要：目的:比较三种体位固定技术在盆腔肿瘤患者放疗中六维方向的摆位误差,探讨盆腔肿瘤患者放疗的理想体位,供临床参考。方法:选取2019年03月至2021年12月在我院放疗的盆腔肿瘤患者,根据不同固定技术,分为真空袋、orfit架和改良式个体化俯卧装置,共3组,每组各25例,放疗前均先行CBCT扫描,将CBCT图像与计划CT图像进行骨性配准,获得头脚方向(SI)、左右方向(LR)、前后方向(AP)、绕Z轴旋转(RTN)、绕X轴旋转(PITCH)、绕Y轴旋转(ROLL)6个方向的摆位误差,记录数据,进行单项方差分析和Games-Howell(A)多重比较。结果:三组线性误差绝对值>0.5 cm次数,差异均有统计学意义(P<0.05);三组旋转角度绝对值>3°次数,差异无统计学意义(P>0.05),两两比较三组在SI、LR、AP方向上摆位误差,差异均有统计学意义(P<0.05),在SI方向,第二组低于第一组及第三组,在LR方向,第三组低于第一组及第二组;在AP方向,第一组低于第二组及第三组;两两比较三组在PITCH、ROLL方向的旋转误差,差异有统计学意义(P<0.05),在PICTH方向,第一组/第二组存在差异(P<0.05);在ROLL方向,第一组/第二组、第二组/第三组存在明显差异(P<0.001)。结论:在盆腔肿瘤放疗中,三种体位固定技术各有优势,相对于orfit架,传统真空袋以及改良式个体化俯卧装置在LR、AP、ROLL三个方向上,降低摆位误差,提高放疗的精确度,但在SI、PITCH方向上的摆位误差还需要进一步提高。Objective:To compare the positional errors of three techniques of postural fixation in the six-dimensional direction in radiotherapy of pelvic tumor patients and to explore the ideal body position for radiotherapy of pelvic tumor patients for clinical reference.Methods:Patients with pelvic tumors treated with radiotherapy in our hospital from March 2019 to December 2021 were selected and divided into 3 groups according to different fixation techniques,including vacuum bag,orfit frame and modified individualized prone device,with 25 cases in each group,all of which were scanned by CBCT before radiotherapy,and the CBCT images were aligned bony with the planned CT images to obtain the positional errors in the head-foot direction(SI),left-right direction(LR),anterior-posterior direction(AP),rotation around Z axis(RTN),rotation around X axis(PITCH),rotation around Y axis(ROLL)in 6 directions,and the data were recorded by single ANOVA and Games-Howell(A)multiple comparisons.Results:The differences were statistically significant(P<0.05)for the number of times the absolute value of linear error was>0.5 cm in all three groups.The differences were not statistically significant(P>0.05)for the number of times the absolute value of rotation angle was>3°in all three groups.The differences were statistically significant(P<0.05)when comparing the positional errors in the SI,LR and AP directions among the three groups.In the SI direction,group 2 was lower than group 1 and group 3.In the AP direction,group 1 was lower than group 2 and group 3.In the LR direction,group 3 was lower than group 1 and group 2.When comparing the three groups in the PITCH and ROLL directions,the differences were statistically significant(P<0.05),and in the PICTH direction,there were differences between group 1 and group 2(P<0.05).In the ROLL direction,there were differences between group 1 and group 2,group 2 and group 3(P<0.001).Conclusion:In pelvic tumour radiotherapy,each of the three techniques of postural fixation has its own advantages.Compared to

关 键 词：盆腔肿瘤 体位固定 锥形束CT 六维方向 

分 类 号：R737.3[医药卫生—肿瘤]