两种头颈部肿瘤放射治疗体位固定差异的比较研究  

Comparative research of the differences of two kinds of position immobilizations of radiotherapy for the tumor on head and neck

作　　者：班卫华[1] 朱均强[2] 廖雪干 陈坚贤[1] BAN Wei-hua;ZHU Jun-qiang;LIAO Xue-gan(Radiotherapy Department,Baise People's Hospital,Baise 533000,China;不详)

机构地区：[1]百色市人民医院放疗科,广西百色533000 [2]玉林市红十字会医院放疗科,广西玉林537000

出　　处：《中国医学装备》2023年第11期21-25,共5页China Medical Equipment

基　　金：广西壮族自治区卫健委科研课题(Z20170260)“CTVision在头颈部肿瘤调强放疗中的应用研究”。

摘　　要：目的:比较研究塑形垫联合头颈肩膜固定方法与常规头枕结合头颈肩膜固定方法在调强放射治疗(IMRT)中摆位误差的区别,分析其在临床中的应用价值。方法:选取在医院接受CTVision系统图像引导IMRT的80例头颈部肿瘤患者,根据放射治疗中头颈肩膜固定方法的不同,将其分为塑形垫联合头颈肩膜固定组(简称塑形垫固定组)和常规头枕结合头颈肩膜固定组(简称常规固定组),每组40例。两组放射治疗中每周进行1次CTVision系统摆位验证,收集左右方向(x轴)、头脚方向(y轴)和前后方向(z轴)3个方向的摆位误差,并分析比较两组3个方向的摆位误差。结果:两组患者均能顺利完成放射治疗;塑形垫固定组在y轴、z轴方向的摆位误差小于常规固定组,差异有统计学意义(t=-3.238,t=-8.077;P<0.05);且塑形垫固定组在x轴、y轴和z轴3个方向上0~0.1 cm区段的摆位误差比例高于常规固定组,差异有统计学意义(x^(2)=34.740,x^(2)=81.729,x^(2)=58.160;P<0.05);在>0.2~0.3 cm区段塑形垫固定组在x轴、y轴和z轴3个方向的摆位误差比例明显低于常规固定组,差异有统计学意义(x^(2)=90.592,x^(2)=72.657,x^(2)=148.371;P<0.05)。结论:在头颈部肿瘤患者的IMRT体位固定中,采用塑形垫联合头颈肩膜的体位固定方式较常规头枕结合头颈肩膜的体位固定方式更舒适、重复性更好,且可减少摆位误差,具有临床应用价值。Objective:To compare and research the differences of positioning errors between the immobilization method with shaped cushion combined with head,neck and shoulder film and the immobilization method with routine head pillow combined with head,neck and shoulder film in intensity modulated radiation therapy(IMRT),and analyze the clinical application values of them.Methods:A total of 80 patients with tumors on head and neck who underwent IMRT that was guided by computed tomography(CT)Vision system image in the Baise People's Hospital were selected.According to the different immobilization methods of head,neck and shoulder film during radiotherapy,they were divided into the immobilization group by shaped cushion combined with head,neck and shoulder film(referred to as the shaped cushion immobilization group)and routine immobilization group by head pillow combined with head,neck and shoulder film(referred to as the routine immobilization group),with 40 patients in each group.Both two groups underwent 1 times of positioning verification of CTVision system per week in radiotherapy,and the positioning errors on left-right direction(x axis),head-foot direction(y axis)and front-rear direction(z axis)were respectively collected,and the positioning errors on the three directions of two groups were further analyzed and compared.Results:Both groups of patients were able to successfully complete radiotherapy.The positioning errors of the shaped cushion immobilization group were significantly less than those of the routine immobilization group on the y and z directions(t=-3.238,t=-8.077,P<0.05),respectively.Moreover,the proportions of positioning errors in the 0-0.1 cm range on the x,y,and z directions of the shaped cushion immobilization group were significantly higher than those of the routine immobilization group(x^(2)=34.740,x^(2)=81.729,x^(2)=58.160,P<0.05),respectively.In the>0.2-0.3 range on x,y and z axis directions,the proportions of positioning errors of the shaped cushion immobilization group were significantly lower t

关 键 词：塑形垫 头颈部肿瘤 CTVision系统 头颈肩膜固定 摆位误差 

分 类 号：R816.1[医药卫生—放射医学]