负压真空袋固定全上肢在乳腺癌保乳术后调强放疗中体位精度及重复性研究  

Study on the position accuracy and repeatability of the whole upper limb fixed by negative pressure vacuum bag in IMRT after breast-conserving surgery for breast cancer

作　　者：李清山 宋伟[1] 符天晓[1] LI Qingshan;SONG Wei;FU Tianxiao(Department of Tumor Radiotherapy,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院肿瘤放疗科,江苏苏州215006

出　　处：《临床肿瘤学杂志》2024年第2期172-177,共6页Chinese Clinical Oncology

基　　金：2020年度省部共建放射医学与辐射防护国家重点实验室开放课题(GZK1202002);江苏省医学重点学科(ZDXK202235)。

摘　　要：目的 探讨负压真空袋固定全上肢在乳腺癌保乳术后调强放射治疗(IMRT)中的体位精度及重复性价值。方法 回顾性分析2020年10月至2022年5月乳腺癌保乳术后调强放疗患者34例,随机均分为试验组和对照组。试验组采用80 cm×120 cm真空袋全上肢塑型固定;对照组采用70 cm×100 cm真空袋上肢部分塑型固定,双手交叉置于额前。治疗前后分别获取左右(X)、头脚(Y)、腹背(Z)三维方向分次间、分次内的摆位误差(ΔP1、ΔP2);由ΔP1计算临床靶体积(CTV)至计划靶体积(PTV)三维方向的外放范围。计算当次治疗前后三维方向体表线偏移值ΔP3。两组ΔP1、ΔP2、ΔP3在同一方向上的摆位误差采用配对样本t检验;ΔP1与ΔP3在组内的相关性采用Pearson相关性分析。结果 试验组和对照组在X、Y、Z三维方向上的ΔP1进行比较,差异无统计学意义(P>0.05);试验组和对照组在X、Y、Z三维方向上的PTV外扩值分别为4.97 mm、6.31 mm、5.38 mm和8.24 mm、9.96 mm、7.52 mm,差异有统计学意义(P=0.02)。试验组和对照组在Z方向的ΔP2分别为(0.29±1.02)mm、(-0.09±1.49)mm,ΔP3分别为(-0.63±0.95)mm、(-1.05±1.35)mm,两组差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,两组ΔP1与ΔP3在Z方向均存在相关性(r=0.450,P<0.05;r=0.630,P<0.05)。结论 真空袋固定全上肢可提高乳腺癌保乳术后全乳IMRT中的体位精度及重复性,可能有一定的临床参考及推广价值。Objective To investigate the values of the position accuracy and repeatability of the whole upper limb fixed by negative pressure vacuum bag in intensity modulated radiotherapy(IMRT)after breast-conserving surgery.Methods A total of 34 patients with breast cancer treated with radiotherapy after breast-conserving surgery from October 2020 to May 2022 were randomly divided into experimental group and control group.The whole upper limb was fixed with the vacuum bags of 80 cm×120 cm in experimental group.The part upper limb was fixed with the vacuum bags of 70 cm×100 cm in control group,and the hands crossed in front of the forehead.Before and after treatment,the inter-fraction and intra-fraction setup errors(ΔP1 andΔP2)in the left and right(X),head and feet(Y),ventral and dorsal(Z)three-dimensional directions were obtained.Three-dimensional directions external ranges from the clinical target volume(CTV)to the planning target volume(PTV)were calculated by theΔP1.The body surface lines shifts of the three-dimensional directions before and after treatment(ΔP3)were calculated.The paired sample t-tests were performed for the same dirction set-up errors ofΔP1,ΔP2 andΔP3 in the experimental and control group,respectively.The Pearson correlation analysis was performed for theΔP1 andΔP3 of the same dirction errors.Results There were no significance differences in the three-dimensional directions ofΔP1 between experimental group and control group(P>0.05).The PTV expansion values in the X,Y,and Z directions of the experimental and control groups were 4.97 mm,6.31 mm,5.38 mm,and 8.24 mm,9.96 mm,7.52 mm,respectively,with statistically significant differences(P=0.02).TheΔP2 of Z direction in the experimental and control groups was(0.29±1.02)mm and(-0.09±1.49)mm,respectively,and theΔP3 values were(-0.63±0.95)mm and(-1.05±1.35)mm,respectively,with statistically significant differences between the two groups(P<0.05).There was an correlation betweenΔP1 andΔP3 in the Z direction of experimental and control groups(r

关 键 词：乳腺癌 调强放射治疗 真空袋 体位固定 摆位误差 

分 类 号：R737.9[医药卫生—肿瘤]