发泡胶热塑膜组合固定方式下头部及头颈部肿瘤质子重离子治疗中的摆位误差分析  

Setup error analysis during proton and heavy ion therapy for head and head neck tumor patients with fixation by thermoplastic film combined with styrofoam

作　　者：刘珠磊 步蕊蕊 周丹 里尧 吴玲敏 张东鹏 张江兵 尤丹 LIU Zhu-lei;BU Rui-rui;ZHOU Dan;LI Yao;WU Ling-min;ZHANG Dong-peng;ZHANG Jiang-bing;YOU Dan(Department of Medical Physics,Shanghai Proton and Heavy Ion Center,Shanghai 201321,China;Shanghai Key Laboratory of Radiation Oncology,Shanghai 201321,China;Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy,Shanghai 201321,China;Department of Medical Physics,Fudan University Cancer Center,Shanghai 201321,China)

机构地区：[1]上海市质子重离子医院放射物理科,上海201321 [2]上海市放射肿瘤学重点实验室,上海201321 [3]上海质子重离子放射治疗工程技术研究中心,上海201321 [4]复旦大学附属肿瘤医院放射物理科,上海201321

出　　处：《医疗卫生装备》2024年第7期56-61,共6页Chinese Medical Equipment Journal

摘　　要：目的:分析发泡胶热塑膜组合固定方式下头部及头颈部肿瘤患者在质子重离子治疗中的摆位误差。方法:回顾性选取2018年1—12月于某院接受质子重离子治疗的20例患者,其中10例为头部肿瘤(临床靶区位于头部)患者、10例为头颈部肿瘤(临床靶区分布于头部及颈部)患者,全部患者均采用发泡胶热塑膜组合方式固定。将影像引导后获取的患者头颈部影像与CT定位数字重建影像进行配准,记录每位患者于首5次和末5次放疗中在六维方向(左右平移、头脚平移、前后平移、等中心旋转、俯仰旋转、横滚旋转)上的摆位误差。采用SPSS 23.0统计学软件和EXCEL对数据进行处理。结果:头部肿瘤患者于首5次与末5次放疗中在六维方向上的摆位误差比较,差异无统计学意义(P>0.05)。头颈部肿瘤患者于首5次与末5次放疗中在头脚平移方向和俯仰旋转方向上的摆位误差比较,差异有统计学意义(P<0.05);在其余4个方向上的摆位误差比较,差异无统计学意义(P>0.05)。头部肿瘤患者与头颈部肿瘤患者在六维方向上的摆位误差经六维治疗床的校准后均可满足临床要求。结论:发泡胶热塑膜组合固定方式对于头部肿瘤患者在六维方向上的摆位重复性良好,而对于头颈部肿瘤患者在头脚平移方向和俯仰旋转方向上的摆位重复性欠佳,临床上可采取相应措施来减少头部及头颈部肿瘤患者在质子重离子治疗中的摆位误差。Objective To analyze the setup errors during proton and heavy ion therapy for head and head neck tumor patients fixed by thermoplastic film combined with styrofoam.Methods Totally 20 patients undergoing proton and heavy ion therapy at some hospital from January to December 2018 were selected retrospectively,of whom 10 ones had head tumors with clinical targets located in the head and the other 10 cases had head and neck tumors with clinical targets distributed in the head and neck.All the 20 patients were fixed with thermoplastic film combined with styrofoam.The head and neck images of the patients acquired after image guidance were aligned with the CT localization-based digitally reconstructed radiograph images,and the setup errors at six-dimensional directions(left-right translation,head-foot translation,forward-backward translation,isocentric rotation,pitch rotation and transverse-roll rotation)were recorded in the first five and the last five times of radiotherapy treatment.The data were processed by using the SPSS 23.0 statistical software and EXCEL.Results There were no significant differences between the head tumor patients in the setup errors at the six directions during the first and last five times of radiotherapy(P>0.05).The head and neck tumor patients did not have obvious differences in the setup errors at the the directions of left-right translation,forward-backward translation,isocentric rotation and transverse-roll rotation(P>0.05),while did at the directions of head-foot translation and pitch rotation(P<0.05).The head and head neck tumor patients with the fixation by thermoplastic film combined with styrofoam had their setup errors at the six directions meet clinical requirements after calibration by the six-dimensional treatment table.Conclusion The fixation mode by thermoplastic film and styrofoam behaves well to enhance the setup repeatability for head tumor patients at the six-dimensional directions,while not so well for head neck tumor patients at the directions of head-foot translation and

关 键 词：发泡胶热塑膜组合固定 质子重离子治疗 头部肿瘤 头颈部肿瘤 摆位误差 

分 类 号：R318[医药卫生—生物医学工程] R815[医药卫生—基础医学]