下颈部及上纵隔肿瘤放疗体位固定技术对比  

Comparison of postural fixation technique of radiotherapy for tumors in the lower neck and upper mediastinum

作　　者：张超强 林布雷 ZHANG Chao-qiang;LIN Bu-lei(The First Affiliated Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属第一医院,361000

出　　处：《中国现代药物应用》2023年第23期91-95,共5页Chinese Journal of Modern Drug Application

摘　　要：目的通过观察真空垫与热塑膜联合碳纤维一体板固定技术在下颈部及上纵隔肿瘤放射治疗(放疗)体位固定中对摆位误差、照射体积、剂量等的影响,为临床相关疾病患者放疗时的固定技术提供参考依据。方法100例下颈部及上纵隔肿瘤放疗患者,采用随机数字表法分为真空组与热塑膜组,每组50例。真空组疗效体位采取真空垫联合碳纤维一体板固定技术,热塑膜组疗效体位采取热塑膜联合碳纤维一体板固定技术。对比两组患者不同方向的摆位误差,靶病灶区域及周围器官的照射体积与剂量,毒性反应发生率。结果真空组X轴、Y轴、Z轴第10次放疗的摆位误差均大于第1次放疗,X轴第20次放疗的摆位误差大于第1次放疗、小于第10次放疗,Y轴、Z轴第20次放疗的摆位误差大于第1、10次放疗,差异有统计学意义(P<0.05);热塑膜组X轴第20次放疗的摆位误差小于第1、10次放疗,Y轴第10、20次放疗的摆位误差大于第1次放疗,Z轴第10次放疗的摆位误差大于第1次放疗,第20次放疗的摆位误差小于第10次,差异有统计学意义(P<0.05);热塑膜组X轴、Y轴、Z轴第1、10、20次放疗的摆位误差均小于真空组,差异有统计学意义(P<0.05)。两组靶病灶区域、肝脏及胃照射体积对比,差异无统计学意义(P>0.05);热塑膜组靶病灶区域照射剂量(50.23±3.85)Gy多于真空组的(45.07±1.75)Gy,肝脏照射剂量(12.20±2.80)Gy、胃照射剂量(27.30±2.72)Gy少于真空组的(20.68±3.18)、(37.75±3.69)Gy,差异有统计学意义(P<0.05)。两组毒性反应发生率对比,差异无统计学意义(P>0.05)。结论下颈部及上纵隔肿瘤患者放疗时采取热塑膜联合碳纤维一体板固定技术,可明显减少患者放疗过程中不同方向的摆位误差,同时提高靶病灶区域的照射剂量,降低周围器官的照射剂量,利于确保放疗精确度,且安全可靠,值得在临床相关疾病患者放疗固定技术中开展实施�Objective To observe the effects of vacuum pad or thermoplastic film combined with carbon fiber integrated plate on positioning error,irradiated volume and dose during radiotherapy for tumors in the lower neck and upper mediastinum,in order to provide reference for the fixation technology during radiotherapy for patients with clinically related diseases.Methods A total of 100 patients with tumors in the lower neck and upper mediastinum undergoing radiotherapy were divided into vacuum group and thermoplastic film group according to the random numerical table,with 50 cases in each group.The vacuum group was fixed by vacuum pad combined with carbon fiber integrated plate in radiotherapy position,and the thermoplastic film group was fixed by thermoplastic film combined with carbon fiber integrated plate in radiotherapy position.The positioning errors in different directions,the irradiated volume and dose of the target lesion area and surrounding organs,and the toxic reactions of the two groups were compared.Results In the vacuum group,the positioning errors of the 10th radiotherapy on X axis,Y axis and Z axis were greater than those of the 1st radiotherapy;the positioning errors of the 20th radiotherapy on X axis were greater than those of the 1st radiotherapy and smaller than those of the 10th radiotherapy;the positioning errors of the 20th radiotherapy on Y axis and Z axis were greater than those of the 1st and 10th radiotherapy;the differences were statistically significant(P<0.05).In the thermoplastic film group,the positioning error of the 20th radiotherapy on X axis was smaller than that of the 1st and 10th radiotherapy;the positioning error of the 10th and 20th radiotherapy on Y axis was greater than that of the 1st radiotherapy;the positioning error of the 10th radiotherapy on Z axis was greater than that of the 1st radiotherapy;the positioning error of the 20th radiotherapy was less than that of the 10th radiotherapy;the differences were statistically significant(P<0.05).The positioning errors of the 1st,10t

关 键 词：肿瘤 真空垫 热塑膜 体位固定技术 碳纤维一体板固定技术 放射治疗 

分 类 号：R734.5[医药卫生—肿瘤]