老年乳腺癌患者放疗摆位前静息时长对放疗计划剂量的影响  

Effects of resting time before radiotherapy positioning on planned dose of radiotherapy in elderly patients with breast cancer

作　　者：李亚 戈伟强 薛一鸣 Li Ya;Ge Weiqiang;Xue Yiming(Department of Radiotherapy,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院放疗科,上海200040

出　　处：《老年医学与保健》2024年第5期1343-1347,共5页Geriatrics & Health Care

摘　　要：目的分析老年乳腺癌患者放射治疗摆位前静息时长对放射治疗摆位误差及计划剂量的影响。方法选取2022年1月—2024年5月在复旦大学附属华东医院放疗科治疗的98例≥60岁老年乳腺癌患者为研究对象,随机均分为7组。每组等待不同的静息时长后进行初始摆位,并在治疗前使用锥形束CT进行影像验证。对误差结果进行统计学分析,并将摆位误差代入模拟计划,评估靶区和重要危及器官的剂量学指标。结果静息时长增大时,左右、头脚方向无显著变化;腹背方向摆位误差随着静息时长增加而减小,当静息时长大于30 s后误差降至最小区间,分别为(2.36±0.20)mm、(2.37±0.24)mm、(2.40±0.16)mm和(2.38±0.19)mm。在静息时长大于30 s的各组靶区中,模拟计划的靶区适形度和均匀性均表现出明显的优势。结论静息时长大于30 s后摆位误差下降至最小区间并趋于稳定。在老年乳腺癌患者治疗中,需谨慎考虑静息时长的管理。患者平静休息一段时间后再进行摆位,有助于放松患者情绪,缓解肌肉紧张,降低腹背方向误差,对靶区和重要危及器官的剂量分布具有积极意义。Objective To analyze the effects of resting time before radiotherapy positioning on radiotherapy positioning error and planned dose in elderly patients with breast cancer.Methods 98 patients aged 60 years and older with breast cancer treated in Department of Radiotherapy of Huadong Hospital Affiliated to Fudan University from January 2022 to May 2024 were selected as study subjects and randomly divided into seven groups.Each group waited for different resting time before initial positioning,and cone-beam CT was used for imaging verification before treatment.The error results were statistically analyzed.The positioning error was substituted into the simulation plan to evaluate the dosimetric indicators of the target area and important organs at risk.Results With the increase of resting time,there was no significant change in the left-right and superior-inferior directions.However,the positioning errors in the abdominal and dorsal direction decreased with the increase of resting time.When the resting time was longer than 30 s,the errors decreased to the minimum range,which were(2.36±0.20)mm,(2.37±0.24)mm,(2.40±0.16)mm and(2.38±0.19)mm,respectively.In the groups with a resting time longer than 30 s,the simulated plan showed significant advantages in target area conformity and uniformity.Conclusion When the resting time is longer than 30 s,the positioning error decreases to the minimum range and tends to be stable.In the treatment of elderly patients with breast cancer,the management of resting time should be carefully considered.After resting for a period of time before positioning,patients can relax their emotions,relieve muscle tension,reduce errors in the direction of the abdomen and back.It has a positive effect on the dose distribution of the target area and important organs at risk.

关 键 词：老年 乳腺癌 放射治疗 静息时长 摆位误差 剂量评估 

分 类 号：R730.55[医药卫生—肿瘤] R737.9[医药卫生—临床医学]