聚氨酯发泡胶联合个体化头枕固定在乳腺癌术后放疗摆位精度研究  

Comparison of the fixation accuracy of polyurethane foam gel combined with individualized headrest in postoperative radiotherapy for breast cancer patients

作　　者：杨瑾[1] 房建南 陈国泉 王玺先 邱夏鸿 郭再仁 宋朝睿 石俊田[1] 马玉家 黄晓波 YANG Jin;FANG Jian-nan;CHEN Guo-quan;WANG Xi-xian;QIU Xia-hong;GUO Zai-ren;SONG Chao-rui;SHI Jun-tian;MA Yu-jia;HUANG Xiao-bo(Department of Radiation Oncology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 520120,Guangdong,China)

机构地区：[1]中山大学孙逸仙纪念医院肿瘤放疗科,广东广州520120

出　　处：《广东医学》2024年第4期479-484,共6页Guangdong Medical Journal

基　　金：广州市科技计划项目(2023A03J0723)。

摘　　要：目的探究聚氨酯发泡胶联合个体化头枕固定在乳腺癌术后放疗的固定精度研究,提高乳腺癌放疗摆位精度与重复性。方法选取乳腺癌术后放疗患者52例,使用聚氨酯发泡胶(对照组)与发泡胶联合个体化头枕(研究组)固定,采用调强放疗技术照射乳腺/胸壁靶区与锁骨上野,使用锥形束CT(CBCT)影像引导配准获得乳腺/胸壁靶区与锁骨上野的摆位误差,对327套CBCT影像摆位误差数据进行分析两组乳腺/胸壁和锁骨上野靶区位置的一致性。结果两组乳腺/胸壁靶区平移误差在腹背和头脚方向差异无统计学意义(P>0.05),左右方向研究组优于对照组[(1.87±1.45)mm vs.(2.32±1.66)mm,P=0.012],旋转误差在左右和头脚方向差异无统计学意义(P>0.05),在腹背方向研究组优于对照组[(0.78±0.66)°vs.(0.97±0.79)°,P=0.029];两组锁骨上下区域平移误差在头脚与腹背方向差异无统计学意义(P>0.05),在左右方向研究组优于对照组[(2.07±1.65)mm vs.(2.53±1.96)mm,P=0.047],旋转误差在左右和头脚方向研究组均小于对照组[(0.79±0.67)°vs.(1.07±0.88)°,P=0.009和(0.52±0.41)°vs.(0.79±0.67)°,P=0.001],腹背方向差异无统计学意义(P>0.05)。研究组和对照组乳腺/胸壁靶区左右、头脚和腹背方向PTV外扩值分别为2.62、3.46、3.30 mm与3.74、3.64、3.26 mm;锁骨上野PTV外扩值分别为3.36、3.49、4.14 mm与4.38、2.98、4.35 mm。结论聚氨酯发泡胶联合个体化头枕固定可提高乳腺癌术后放疗乳腺/胸壁靶区与锁骨上野的固定精度,乳腺/胸壁靶区与锁骨上野体位一致性更高。Objective To investigate the fixation accuracy of polyurethane foam gel combined with individualized headrest in postoperative radiotherapy for breast cancer and to improve the accuracy and reproducibility of breast cancer radiotherapy positioning.Methods Fifty-two patients undergoing postoperative radiotherapy for breast cancer were divided into two groups:the control group(using polyurethane foam gel)and the study group(using polyurethane foam gel combined with individualized headrest).Tangential radiotherapy was delivered to the breast/chest wall and supraclavicular region using intensity-modulated radiation therapy(IMRT).Cone-beam computed tomography(CBCT)images were used for image guidance registration to obtain setup errors in the breast/chest wall and supraclavicular target areas.The consistency of the positions of the breast/chest wall and supraclavicular target areas in 327 sets of CBCT images was analyzed between the two groups.Results There was no statistically significant difference in the translation errors of the breast/chest wall target area in the anterior-posterior and cranio-caudal directions between the two groups(P>0.05).In the left-right direction,the study group was superior to the control group[(1.87±1.45)mm vs.(2.32±1.66)mm,P=0.012].The rotation error in the anterior-posterior direction was lower in the study group than in the control group[(0.78±0.66)°vs.(0.97±0.79)°,P=0.029].For the supraclavicular region,there was no statistically significant difference in the translation errors in the cranio-caudal and cranio-caudal directions between the two groups(P>0.05).In the left-right direction,the study group was superior to the control group[(2.07±1.65)mm vs.(2.53±1.96)mm,P=0.047].The rotation errors in the left-right and cranio-caudal directions were lower in the study group than in the control group[(0.79±0.67)°vs.(1.07±0.88)°,P=0.009;and(0.52±0.41)°vs.(0.79±0.67)°,P=0.001],with no statistically significant difference in the cranio-caudal direction.The PTV margins for the bre

关 键 词：头部固定 摆位误差 乳腺肿瘤 放射疗法 

分 类 号：R737.9[医药卫生—肿瘤] R815[医药卫生—临床医学]