基于CT模拟机的调强放疗计划三断层面复位方法及其减少摆位误差效果的分析  

The three transverse planes position verification method for IMRT plans based on CT simulator and the analysis of its effect on reducing positioning errors

作　　者：肖友立 朱婉琳 陈路桥 倪千喜 XIAO Youli;ZHU Wanlin;CHEN Luqiao;NI Qianxi(Radiation Oncology Center,Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University,Hunan Changsha 410013,China)

机构地区：[1]湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院放疗中心,湖南长沙410013

出　　处：《现代肿瘤医学》2023年第23期4400-4404,共5页Journal of Modern Oncology

基　　金：湖南省卫生健康委科研基金资助项目(编号:202109031159)。

摘　　要：目的:探讨基于CT模拟定位机进行调强放射治疗计划的三断层面位置验证方法的建立,并分析此位置验证方式相对CT模拟定位机常规单层面位置验证方式的优势。方法:抽取90例头颈和盆腹部肿瘤放疗患者随机分成两组,其中基于CT模拟定位机三层面位置验证方法的实验组44例,CT模拟定位机常规单层面位置验证方式的对照组46例。并按照两种不同的标记方式进行放疗摆位后进行CBCT位置验证,分别记录患者在放射治疗过程中中心点位置在X(左右)、Y(头脚)、Z(前后)轴三维方向上的摆位线性位移误差。结果:考虑到不同部位体位固定方式不同对摆位误差的影响,将选取的病例分成盆腹部和头颈部两组分别进行比较。其中盆腹部实验组X、Y、Z轴三个方向上的线性位移误差分别为(1.33±0.78)、(1.87±0.94)、(1.26±0.87)mm,对照组三个方向上的线性位移误差分别为(2.22±1.75)、(3.23±2.38)、(1.70±1.30)mm;头颈部实验组X、Y、Z轴三个方向上的线性位移误差分别为(0.92±0.71)、(1.11±0.86)、(0.86±0.73)mm,对照组三个方向上的线性位移误差分别为(0.86±0.77)、(1.34±1.21)、(1.08±0.87)mm。结果显示盆腹部三个方向上的组间差异均有统计学意义(均P<0.05);头颈部在X、Y方向上两组之间差异无统计学意义(P>0.05),在Z轴方向上差异有统计学意义(P<0.05)且改进后位置验证方法的摆位误差均值要低于常规位置验证方法。结论:相对CT模拟定位机常规单层面位置验证方式,基于CT模拟定位机进行调强放射治疗计划的三层面位置验证方法的建立,对于盆腔部位患者能有效减少三维位置上的摆位误差;对于头颈部患者,能有效减少在Z轴方向上的摆位误差,使得患者的放射治疗更加精准。Objective:To explore the establishment of a three transverse planes position verification method for IMRT plans based on CT simulator,and analyze the advantages of this method compared to the conventional single transverse plane position verification method based on CT simulator.Methods:90 patients with head-neck,and pelvis-abdominal tumors undergoing radiotherapy were randomly divided into two groups.Among them,44 were in the experimental group based on the three transverse planes position verification method of CT simulator,and 46 were in the control group based on the conventional single transverse plane position verification method of CT simulator.And perform CBCT position verification after radiotherapy positioning according to two different labeling methods.Record the linear displacement error of the patient's center point position in the three-dimensional direction of the X(left-right),Y(superior-inferior),and Z(anterior-posterior)axes during the radiotherapy process separately.Results:Considering the impact of different fixation methods on positioning errors in different parts of the body,divide the selected cases into two groups:pelvis-abdomen region and head-neck region for comparison.The displacement errors in the X,Y and Z axes of the pelvis-abdomen experimental group were(1.33±0.78),(1.87±0.94),and(1.26±0.87)mm.The displacement errors of the control group in three directions were(2.22±1.75),(3.23±2.38),and(1.70±1.30)mm.The positioning displacement errors in the X,Y and Z axes of the head-neck experimental group were(0.92±0.71),(1.11±0.86),and(0.86±0.73)mm.The displacement errors of the control group in three directions were(0.86±0.77),(1.34±1.21),and(1.08±0.87)mm.The results showed that there were statistically significant differences between the groups in the three directions of the pelvic and abdominal regions(all P<0.05).There was no statistically significant difference between the two groups in the X and Y directions of the head and neck(P>0.05),but there was a statistically significa

关 键 词：CT模拟定位机 位置验证 调强放疗 摆位误差 

分 类 号：R730.55[医药卫生—肿瘤]