POSIREST-2手臂支撑装置联合真空垫在乳腺癌调强放疗中的应用  

Application of POSIREST-2 arm support device combined with vacuum pad in intensive modulated radiation therapy for breast cancer

作　　者：陈登源 张林燕 沈思婷 黄宪平 黎彩霞 陈佐耀 陈奇通 崔绍军 CHEN Dengyuan;ZHANG Linyan;SHEN Siting;HUANG Xianping;LI Caixia;CHEN Zuoyao;CHEN Qitong;CUI Shaojun(Department of Oncology,Luoding People’s Hospital,Guangdong,Luoding 527200,China)

机构地区：[1]广东省罗定市人民医院肿瘤科,广东罗定527200

出　　处：《中国医药科学》2024年第12期158-162,共5页China Medicine And Pharmacy

基　　金：广东省云浮市医药卫生科研立项课题(2021B092)。

摘　　要：目的探讨乳腺癌保乳术后使用POSIREST-2手臂支撑装置联合真空垫固定进行调强放疗的应用效果。方法选取罗定市人民医院肿瘤科2021年6月至2022年12月收治的50例乳腺癌保乳术后患者,采用随机数表法将其分为真空垫组(使用真空垫,n=25)和联合支撑组(使用POSIREST-2手臂支撑装置联合真空垫,n=25)。在患者分次治疗前,通过直线加速器验证系统拍摄患者正侧位片,测量骨性标志物与数字重建放射影像在左右(X)、头脚(Y)、腹背(Z)三个维度的误差值,分析两种固定方式的摆位精度、稳定性及操作重复性,并利用数据计算两组患者临床靶区(CTV)至计划靶区(PTV)的外扩值。结果两组在X方向的摆位误差比较,差异无统计学意义(P>0.05),在Y和Z方向的摆位误差比较,差异有统计学意义(P<0.05)。两组CTV至PTV的外扩值在三个维度X、Y、Z方向分别为0.56、0.57、0.39 cm与0.37、0.25、0.20 cm。结论尽管真空垫固定方式在一定程度上可以满足临床的需求,但联合支撑固定方法在术后保乳患者的摆位精度和重复性方面表现更为优越。因此,POSIREST-2手臂支撑装置联合真空垫的固定方式在乳腺癌保乳术后放射治疗的临床应用上具有推广和实用价值。Objective To investigate the application of POSIREST-2 arm support device combined with vacuum pad fixation in intensive modulated radiation therapy for breast cancer after breast conservation surgery.Methods A total of 50 patients with breast cancer after breast-conserving surgery admitted to the Department of Oncology of Luoding People’s Hospital from June 2021 to December 2022 were selected,and they were divided into the vacuum pad group(using vacuum pads,n=25)and the combined support group(using POSIREST-2 arm support device combined with vacuum pads,n=25),according to the random number table method.Before the patients were treated in different stages,the frontal radiographs of the patients were taken by the linear accelerator verification system,and the error values of bone markers and digital reconstructed radiological images were measured in three dimensions,which were left and right(X),head and foot(Y)and abdomen and back(Z).The positioning accuracy,stability and operational repeatability of the two fixation methods were analyzed,and the data were used to calculate extrapolation value from the clinical target volume(CTV)to the planned target volume(PTV)of the two groups of patients.Results There was no statistically significant difference in the positioning error in the X direction between the two groups(P>0.05),while there was statistically significant difference in the positioning error in the Y and Z directions(P<0.05).The extrapolation values of CTV to PTV in the two groups were 0.56 cm,0.57 cm,0.39 cm,and 0.37 cm,0.25 cm and 0.20 cm in the three dimensions of X,Y and Z,respectively.Conclusion Although the vacuum pad fixation method can meet the clinical requirement to some extent,the combined support fixation method is superior in the positioning accuracy and repeatability of postoperative breast conservation patients.Therefore,the fixation method of POSIREST-2 arm support device combined with vacuum pad has popularization and practical value in the clinical application of radiotherapy after breast

关 键 词：乳腺癌 调强放疗 摆位误差 体位定位 真空垫 保乳术 

分 类 号：R737.9[医药卫生—肿瘤]