3D打印组织补偿物对头部和四肢肿瘤放疗中摆位误差的影响  

Effect of 3D printed bolus on setup errors in radiotherapy for head and limb tumors

作　　者：谈俊蕾 蒋马伟[1] Tan Junlei;Jiang Mawei(Oncology Department,Xinhua Hospital Affi liated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院肿瘤科,上海200092

出　　处：《实用肿瘤杂志》2025年第1期73-77,共5页Journal of Practical Oncology

摘　　要：目的研究使用个体化3D打印组织补偿物对头部和四肢肿瘤放疗中的摆位误差的影响。方法回顾性分析2021年8月至2023年6月于上海交通大学医学院附属新华医院使用(A组,n=15)和不使用(B组,n=15)3D打印组织补偿物的头部肿瘤患者,以及使用(C组,n=15)和不使用(D组,n=15)3D打印组织补偿物的四肢肿瘤患者。四组患者通过锥形束CT(cone beam CT,CBCT)扫描图像与计划CT图像进行配准,获取患者在X(左右)、Y(前后)和Z(上下)方向的平移和旋转摆位误差,每例患者均随机选取5次扫描的摆位误差数据来进行临床摆位误差评估。结果四组各取75例次摆位误差数据。A组患者在X、Y和Z方向平均平移摆位误差分别为1.18、1.46和0.95 mm,平均旋转摆位误差分别为0.94°、1.31°和0.92°;B组则为1.33、1.63和1.23 mm,以及1.33°、1.53°和1.00°;C组则为1.33、1.54和1.33 mm,以及0.80°、0.95°和0.85°;D组则为1.96、1.54和1.78 mm,以及1.08°、1.05°和1.01°。A组和B组在Z方向平移摆位误差和X方向旋转摆位误差上比较,差异均具有统计学意义(均P<0.05)。C组和D组在X和Z方向平移摆位误差和X方向旋转摆位误差上比较,差异均具有统计学意义(均P<0.05)。结论放疗中使用个体化3D打印组织补偿物可以减少头部肿瘤和四肢肿瘤患者Z方向平移摆位误差和X方向旋转摆位误差,并可以减少四肢肿瘤患者X方向平移摆位误差,提高放疗精准度。Objective To investigate the effect of the use of individualized 3D printed bolus on setup errors in radiotherapy for head and limb tumors.Methods A retrospective analysis was performed for head tumor patients who used(group A,n=15)and who did not use(group B,n=15)3D printed bolus,and limb tumor patients who used(group C,n=15)and who did not use(group D,n=15)3D printed bolus,at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from August 2021 to June 2023.The four groups were registered with planned CT images by cone beam CT(CBCT)scan images to obtain the translational and rotational setup errors in the X(lateral),Y(longitudinal),and Z(vertical)directions.For each patient,the setup errors of 5 scans was randomly selected for assessment of clinical setup errors.Results For each group,the setup error data of 75 scans were collected.In the X,Y,and Z directions,the average translational setup errors were 1.18,1.46,and 0.95 mm in the group A,1.33,1.63,and 1.23 mm in the group B,1.33,1.54,and 1.33 mm in the group C,and 1.96,1.54,and 1.78 mm in the group D;the average rotational setup errors were 0.94°,1.31°,and 0.92°in the group A,1.33°,1.53°,and 1.00°in the group B,0.80°,0.95°,and 0.85°in the group C,and 1.08°,1.05°,and 1.01°in the group D,respectively.The translational setup errors in the Z direction and rotational setup errors in the X direction were both significantly different between the group A and the group B(both P<0.05).The translational setup errors in the X and Z directions and the rotational setup errors in the X direction significantly differed between the group C and the group D(all P<0.05).Conclusions The use of individualized 3D printed bolus in radiotherapy can reduce Z-direction translational and X-direction rotational setup errors in both head tumor patients and limb tumor patients,and can also decrease X-direction translational setup errors in limb tumor patients,improving radiotherapy accuracy.

关 键 词：头部肿瘤 四肢肿瘤 3D打印组织补偿物 摆位误差 

分 类 号：R73[医药卫生—肿瘤]