3D打印乳腺托架减少放射性臂丛神经损伤初步探究  

A preliminary study of a 3D-printed breast bracket to reduce radiation brachial plexus injury

作　　者：徐博 唐晓燕 黄发生 叶荣 谭林 Bo Xu;Xiaoyan Tang;Fasheng Huang;Rong Ye;Lin Tan(Sichuan Academy of Medical Sciences,Cancer Center,Sichuan Provincial People's Hospital,Chengdu 610000,China)

机构地区：[1]四川省医学科学院,四川省人民医院肿瘤中心,成都市610000

出　　处：《中国肿瘤临床》2024年第11期557-560,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:比较3D打印乳腺托架与普通头枕乳腺癌患者在放疗过程中锁骨区,颈椎区和肱骨区的摆位误差,回访患者臂丛神经受损情况,从而分析3D打印乳腺托架是否能减少放射性臂丛神经损伤(radiation-induced brachial plexopathy,RIBP)。方法:分析2022年1月至2022年11月四川省人民医院收治58例乳腺癌患者,随机分为保乳3D乳腺托架与普通头枕,术后3D乳腺托架和普通头枕共4组。分别按照锁骨区、颈椎区和肱骨区3个部位进行配准获取摆位误差数据,分析在升降方向(vrt)、头脚方向(lng)和左右方向(lat)3个方向的误差。同时选取2022年1月至2022年11月本院100例患者,随机分为上述4组患者,回访其臂丛神经受损情况,并分类记录。结果:3D乳腺托架保乳患者在锁骨区,颈椎区和肱骨区的升降,头脚和左右方向的摆位误差分别为(0.95±0.70)mm、(0.90±0.61)mm、(1.50±0.07)mm,(1.50±1.16)mm、(1.16±0.87)mm、(1.45±1.21)mm、(1.31±0.82)mm、(1.10±0.87)mm、(1.64±1.04)mm。普通保乳患者分别为(1.68±0.67)mm、(2.92±1.20)mm、(2.37±1.07)mm,(2.60±1.22)mm、(2.81±1.19)mm、(2.34±1.09)mm、(2.66±1.17)mm、(3.11±1.20)mm、(2.52±1.21)mm。两组摆位误差比较,差异均具有统计学意义(均P<0.05)。回访臂丛神经受损情况显示3D乳腺托架组0级占有率比普通头枕组高24%,1级占有率比普通头枕低22%,其他分级差异不大。结论:3D乳腺托架患者在3个区域的摆位误差均小于普通头枕。回访结果显示3D乳腺托架患者臂丛神经受损情况也较普通头枕患者好。Objective To compare the positioning errors of the clavicular,cervical,and humeral regions during radiotherapy between a 3D-printed breast bracket and common head-occipital pillow in patients with breast cancer and to assess patients with brachial plexus damage to determine whether 3D-printed breast brackets can reduce radiation-induced brachial plexopathy(RIBP).Methods A total of 58 patients admitted to Sichuan Provincial People's Hospital from January 2022 to October 2022 were randomly assigned into four groups:breast-conserving patients with 3D-printed breast bracket,breast-conserving patients with common head pillow,postoperative patients with 3D-printed breast bracket,and postoperative patients with common head pillow.The positioning error data were obtained for the clavicular,cervical,and humeral regions,and the errors in the elevating direction(vrt),head and foot direction(lng),and left and right direction(lat)were analyzed.At the same time,100 patients treated at Sichuan Provincial People's Hospital from January 2022 to November 2022 were randomly assigned into the above four groups,and their brachial plexus damage was assessed and classified.Results In postoperative patients with 3D-printed breast bracket,the vrt,lng,and lat positioning errors in the clavicle,cervical,and humeral regions were(0.95±0.70)mm,(0.90±0.61)mm,(1.50±0.077)mm,(1.50±1.16)mm,(1.16±0.87)mm,(1.45±1.21)mm,(1.31±0.82)mm,(1.10±0.87)mm,and(1.64±1.04)mm,respectively.In breast-conserving patients,the positioning errors were(1.68±0.67)mm,(2.92±1.20)mm,(2.37±1.07)mm,(2.60±1.22)mm,(2.81±1.19)mm,(2.34±1.09)mm,(2.66±1.17)mm,(3.11±1.20)mm,and(2.52±1.21)mm,respectively.There was significant difference in the positioning error between the two groups(P<0.05).The return visit for brachial plexus damage showed that grade 0 was 24%higher in the 3D-printed breast bracket groups than in the ordinary headrest groups,grade 1 was 22%lower,and there were no significant differences in the other grades.Conclusions The positioning error of th

关 键 词：3D打印乳腺托架 摆位误差 臂丛神经 放射性损伤 

分 类 号：R737.9[医药卫生—肿瘤]