不同摆位法对宫颈癌调强适形放射治疗中摆位固定精度的影响  

Effect of Different Positioning Methods on Fixation Accuracy of Positioning in Intensity-Modulated Conformal Radiation of Cervical Cancer

作　　者：胡胜荣[1] 缪继东[1] 周吉祥[1] 官文强 HU Shengrong;MIAO Jidong;ZHOU Jixiang;GUAN Wenqiang(Department of Tumor Radiotherapy,The Fourth People's Hospital of Zigong City,Zigong,Sichuan 643000,China)

机构地区：[1]四川省自贡市第四人民医院肿瘤放疗科,四川自贡643000

出　　处：《转化医学杂志》2024年第9期1315-1320,共6页Translational Medicine Journal

基　　金：吴阶平医学基金会临床科研专项资助基金项目(320.6750.2020-12-61);北京科创医学会发展基金会项目(KC2021-JK-0186-71);自贡市第四人民医院科研项目(21zd006)。

摘　　要：目的分析不同摆位法对宫颈癌调强适形放射治疗中摆位固定精度的影响。方法选取2022年6月至2024年4月自贡市第四人民医院收治的98例宫颈癌患者,均采取调强适形放射治疗,调强放疗中行治疗机下锥形束CT(CBCT)扫描,根据摆位固定方式不同分组,采用一体架+热塑膜固定的48例纳入A组,采用一体架+热塑膜+真空垫固定的50例纳入B组。比较2组摆位合格率及误差、计划靶区剂量分布情况、危及靶器官照射剂量、放疗相关毒副反应发生率及患者主观舒适满意度。结果A组摆位合格率为67.92%(163/240),低于B组的89.20%(223/250)(P<0.05)。A组X轴、Y轴摆位误差高于B组(P<0.05)。A组95%计划剂量占计划靶区百分比(V95%)、V100%、V105%较B组低(P<0.05);A组小肠、直肠、膀胱最大照射剂量(D_(max))、最小照射剂量(D_(min))、接受10 Gy及以上剂量体积占该器官总体积的百分比(V10)、V20、V50均高于B组(P<0.05)。A组放疗相关毒副反应总发生率58.33%(28/48),高于B组的38.00%(19/50)(P<0.05)。A组主观舒适满意度为56.25%(27/48),低于B组的84.00%(42/50)(P<0.05)。结论将一体架+真空垫+热塑膜应用于宫颈癌调强适形放射中,能有效减少摆位误差,更精确控制计划靶区、危及器官照射剂量,减少毒副反应的发生,还能提高患者舒适度。Objective To analyze the influence of different positioning methods on the fixation accuracy of positioning during intensity-modulated conformal radiation therapy of cervical cancer.Methods A total of 98 patients with cervical cancer treated from June 2022 to April 2024 were selected,all of whom were treated with intensity-modulated radiotherapy.The patients underwent cone beam computed tomography(CBCT)under the treatment machine during therapy.Forty-eight patients were grouped according to different positioning methods.Fifty cases fixed by integrated frame and thermoplastic film with vacuum pad were included in group B.The qualified rate and error of positioning,dose distribution in the planned target area,radiation dose to small intestine,rectum,and bladder,incidence of radiation-related toxicity,and subjective comfort satisfaction of patients were compared between the two groups.Results The qualified rate of group A was 67.92%(163/240),lower than that of group B,89.20%(223/250)(P<0.05).The error on the X-axis and Y-axis in group A was higher than that in group B(P<0.05).The percentage of 95%planned dose in the planned target area(V95%),the dose of V100%,and V105%in group A were lower than those in group B(P<0.05).The maximum radiation dose(D_(max)),minimum radiation dose(D_(min)),percentage of the total volume of the organ receiving 10 Gy or above dose(V10),V20,and V50 to small intestine,rectum,and bladder in group A were higher than those in group B(P<0.05).The incidence of radiotherapy-related toxicity in group A was 58.33%(28/48),higher than that in group B,38.00%(19/50)(P<0.05).The subjective comfort satisfaction of group A was 56.25%(27/48),lower than that of group B,84.00%(42/50)(P<0.05).Conclusion The application of an integrated frame,vacuum pad,and thermoplastic film in intensity-modulated conformal radiotherapy for cervical cancer can effectively reduce the positioning error,more accurately control the planned target area and the radiation dose to endangered organs,reduce the occurrence of toxic effe

关 键 词：宫颈肿瘤 放射疗法 调强适形 摆位固定 真空垫 

分 类 号：R737.33[医药卫生—肿瘤]