不同固定技术对食管癌放射治疗精度的影响  

Effect of different fixation techniques on accuracy of radiotherapy for esophageal carcinoma

作　　者：李明[1] 郝其杰 刘福友 许俊 LI Ming;HAO Qijie;LIU Fu-you;XU Jun(Department of Radiotherapy,Nantong Cancer Hospital,Nantong University,Nantong 226361,Jiangsu,China;Department of Radiotherapy,Jiangsu Cancer Hospital,Nanjing Medical University,Nanjing 210000,Jiangsu,China)

机构地区：[1]南通市肿瘤医院·南通大学附属肿瘤医院放疗科,江苏南通226361 [2]江苏省肿瘤医院·南京医科大学附属肿瘤医院放疗科,江苏南京210000

出　　处：《生物医学工程与临床》2023年第5期575-579,共5页Biomedical Engineering and Clinical Medicine

基　　金：江苏省科学技术厅科技项目(BE2017679);南通市科技计划指导性项目(MSZ20209)。

摘　　要：目的探讨在线红外引导改良一体板联合颈胸膜固定技术减少食管癌患者的放射治疗摆位误差与提高摆位重复性。方法选择食管癌患者144例,其中男性68例,女性76例;年龄42~77岁,平均年龄60.5岁(标准差13.4岁);临床分期Ⅰ期42例,Ⅱ期65例,Ⅲ期37例。随机分为在线红外引导改良一体板联合颈胸膜固定组(试验组)72例,三维激光灯引导真空垫+翼型板固定组(对照组)72例。运用Elekta Synergy直线加速器机的锥形束CT(CBCT)对两组患者体位进行扫描,借助X射线容积成像系统对CBCT图像与定位CT图像进行配准得出摆位误差后对其进行统计学分析。结果试验组在X、Y、Z轴向平移误差为(1.76±0.99)mm、(1.45±0.78)mm、(1.38±0.81)mm,最大值为3.5 mm、3.7 mm、5.2 mm,验证通过率为98.61%、100.00%、98.61%;旋转误差为(1.37±0.90)°、(1.25±0.78)°、(1.39±0.90)°,最大值为2.5°、3.6°、3.7°,验证通过率为98.61%、100.00%、97.22%。对照组在X、Y、Z轴向平移误差为(1.95±1.07)mm、(2.08±1.40)mm、(2.23±1.08)mm,最大值为5.5 mm、6.4 mm、5.3 mm,验证通过率为97.22%、93.06%、97.22%;在X、Y、Z轴向旋转误差为(1.76±0.86)°、(1.60±0.78)°、(1.64±1.01)°,最大值为3.8°、3.4°、4.0°,验证通过率为95.83%、98.61%、97.22%。试验组与对照组摆位误差比较,在平移误差X轴向与旋转误差Z轴向差异无统计学意义(P>0.05),但在平移误差Y、Z轴向与旋转误差X、Y轴向差异有统计学意义(P<0.05)。结论在线红外引导下应用改良一体板联合颈胸膜对食管癌放射治疗患者进行体位固定相较于三维激光灯引导真空垫+翼型板能够提高摆位精度和重复性。Objective To explore the on-line infrared positioning system(OPS)modified integrated plate combined with cervical pleural fixation technique in reducing set-up error and improving set-up repeatability of radiotherapy in patients with esophageal carcinoma.Methods A total of 144 patients with esophageal carcinoma were enrolled,which included 68 males and 76 females,aged 4-77 years old with mean age of 60.5 years old(standard deviation 13.4 years old);clinical stage:42 cases in stageⅠ,65 in stageⅡand 37 in stageⅢ.All of the patients were randomly divided into OPS modified integrated plate combined with cervical pleural fixation group(n=72,experimental group)and three-dimensional laser-guided vacuum pad+airfoil plate fixation group(n=72,control group).The cone beam CT(CBCT)of Elekta Synergy linear accelerator machine was used to scan,the CBCT image and positioning CT image were registered by X-ray volume imaging system to obtain the set-up error,and then statistical analysis was performed.Results In experimental group,the axial translation errors of X,Y and Z were(1.76±0.99)mm,(1.45±0.78)mm and(1.38±0.81)mm;the maximum values were 3.5 mm,3.7 mm and 5.2 mm,verification pass rates were 98.61%,100.00%and 98.61%.Rotation errors were(1.37±0.90)°,(1.25±0.78)°and(1.39±0.90)°;maximum values were 2.5°,3.6°and 3.7°;verification pass rates were 98.61%,100.00%and 97.22%,respectively.In control group,the translation errors in X,Y and Z were(1.95±1.07)mm,(2.08±1.40)mm and(2.23±1.08)mm,maximum values were 5.5 mm,6.4 mm and 5.3 mm;verification pass rates were 97.22%,93.06%and 97.22%;rotation errors in X,Y and Z were(1.76±0.86)°,(1.60±0.78)°and(1.64±1.01)°,maximum values were 3.8°,3.4°and 4.0°,verification pass rates were 95.83%,98.61%and 97.22%.There was no significant difference between experimental group and control group in translation error X and rotation error Z(P>0.05),but there was significant difference between translation error Y,Z and rotation error X,Y(P<0.05).Conclusion It is demonstrated th

关 键 词：食管癌 放射治疗 摆位误差 锥形束CT 在线红外定位系统 

分 类 号：R735.1[医药卫生—肿瘤]