胸部和腹部肿瘤患者不同放疗摆位技术精准度对比分析  

Comparative analysis of the accuracy of different radiotherapy positioning techniques in patients with chest and abdominal tumors

作　　者：王云刚 闫先瑞 杨保成 孔祥宾 楚志翔 杨光杰 朱健[2] WANG Yungang;YAN Xianrui;YANG Baocheng;KONG Xiangbin;CHU Zhixiang;YANG Guangjie;ZHU Jian(School of Basic Medicine,QingdaoUniversity,Qingdao,Shandong 266071,China;Department of Radiation Physics Technology,Shandong Cancer Hospital and Institute,Shandong First Medical Universityand Shandong Academy of Medical Sciences,Jinan,Shandong 250117,China;Department of Nuclear Medicine,Af filiated Hospital of Qingdao University,Qingdao,Shandong 266100,China)

机构地区：[1]青岛大学医学部基础医学院,山东青岛266071 [2]山东省肿瘤防治研究院(山东省肿瘤医院)放射物理技术科,山东第一医科大学(山东省医学科学院),山东济南250117 [3]青岛大学附属医院核医学科,山东青岛266100

出　　处：《中华肿瘤防治杂志》2024年第3期167-172,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金面上项目(82172072);山东省自然科学基金重点支持项目(ZR2020LZL001);山东省泰山学者青年专家项目(tsqn201909140)。

摘　　要：目的对比分析真空负压袋联合弓形尺和真空负压袋两侧直接标记对胸部肿瘤和腹部肿瘤患者摆位误差的影响。方法选取山东省肿瘤防治研究院2020-10-13-2021-09-02收治的20例胸部肿瘤和20例腹部肿瘤患者进行研究,采用分层分组方法,先按胸部肿瘤和腹部肿瘤分为两层,分别在每层内分组,将胸部肿瘤患者分为A、B组,腹部肿瘤患者C、D两组,其中A、C两组为弓形尺定位组,B、D两组为直接标记定位组。每次治疗前行CBCT扫描和图像配准,记录在前后(AP)、上下(SI)、左右(RL)三个方向摆位误差。分析治疗过程中出现的随机误差值及绝对值≤0.5 cm的误差值占比。结果A组和B组AP方向摆位误差分别为(0.37±0.45)和(0.43±0.35)cm,Z=-1.684,P=0.092;RL方向摆位误差分别为(-0.01±0.46)和(-0.02±0.41)cm,Z=-4.851,P<0.001。C组和D组SI方向摆位误差为别为(-0.08±0.42)和(-0.25±0.40)cm,Z=-4.768,P<0.001;RL方向摆位误差分别为(0.10±0.28)和(-0.01±0.30)cm,Z=-3.761,P<0.001。A组AP、SI和RL方向摆位误差绝对值≤0.5 cm占比分别为63.0%、74.0%和89.0%;B组分别为62.0%、84.5%和78.0%;C组分别为76.0%、79.0%和89.0%;D组分别为83.0%、70.5%和89.5%。结论弓形尺辅助真空负压袋摆位方式和真空负压袋直接标记摆位方式均能满足临床放疗精度要求。实际治疗过程中,可根据患者健康情况和设备运行状态来灵活选择两种方式。Objective To compare and analyze the effects of vacuum negative pressure bag combined with bow shaped ruler and direct labeling on both sides of the vacuum negative pressure bag on positioning errors in patients with chest and abdominal tumors.Methods Twenty patients with chest tumors and twenty patients with abdominal tumors admitted to Shandong Cancer Hospital and Institute from October 13,2020to September 2,2021 were selected,and a stratified grouping method was used.Patients with chest tumors and abdominal tumors were divided into two layers and then grouped separately within each layer.Patients with chest tumors were divided into groups A and B,and patients with abdominal tumor in groups C and D.Among them,groups A and C were the arc-shaped ruler localization group,while groups B and D were the direct labeling localization group.Before each treatment,Cone Beam Computed Tomography(CBCT)scanning and image registration were performed,and positioning errors were recorded in three directions:front and back(AP),up and down(SI),and left and right(RL).The proportion of random error values and absolute error values≤0.5cm that occur during the treatment process were analyzed.Results The positioning errors in the AP direction of Group A and Group B were(0.37±0.45)and(0.43±0.35)cm,respectively,with Z=-1.684and P=0.092;The positioning errors in the RL direction were(-0.01±0.46)and(-0.02±0.41)cm,respectively,with Z=-4.851and P<0.001.The SI direction positioning errors of Group C and Group D were(-0.08±0.42)and(-0.25±0.40)cm respectively,Z=-4.768,P<0.001;The positioning errors in the RL direction were(0.10±0.28)and(-0.01±0.30)cm,respectively,with Z=-3.761and P<0.001.The absolute values of≤0.5cm positioning errors in the AP,SI,and RL directions of Group A accounted for 63.0%,74.0%,and 89.0%,respectively;Those for Group B were62.0%,84.5%,and 78.0%,respectively;Those for Group C were 76.0%,79.0%,and 89.0%,respectively;Those for Group D were 83.0%,70.5%,and 89.5%,respectively.Conclusions Both the bow shaped ruler a

关 键 词：胸部肿瘤 腹部肿瘤 影像引导 摆位技术 锥形束CT 

分 类 号：R73[医药卫生—肿瘤]