热塑体膜在胸腹部肿瘤放疗中的临床应用意义  

Clinical Signifucance of Thermoplastic Film in Radiotherapy of Thoracic and Abdominal Tumors

作　　者：朱家恺 陆维 李乾永 周依一 ZHU Jia-kai;LU Wei;LI Qian-yong;ZHOU Yi-yi(Department of Radiation Oncology,Fudan University Shanghai Cancer Center,Shanghai 200032)

机构地区：[1]复旦大学附属肿瘤医院放疗中心,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国医疗器械信息》2025年第2期7-9,共3页China Medical Device Information

摘　　要：目的:探讨胸腹部患者放疗时,热塑体膜的应用与否对其摆位误差所产生的影响。方法:回顾性选取复旦大学附属肿瘤医院2022年10月~2023年10月接受放疗的胸腹部肿瘤患者40例,据其治疗部位与是否应用热塑体膜的固定方法将其分为胸部A、B与腹部A、B共四组,每周获取一次锥形束CT(CBCT)影像,比较分析疗程内前三次CBCT影像与参考图像配准所得的六维方向摆位误差。结果:经比较,胸部两组与腹部两组平移方向误差均值范围分别为0.51~1.38mm和0.56~1.29mm,旋转方向误差均值范围分别为0.32°~0.78°和0.23°~0.55°,各方向误差=2mm或2°的概率分布中,胸部两组为83%~100%;腹部两组90%~100%。胸部两组的摆位误差在VRT(腹背)、LNG(头脚)和PITCH(俯仰)三个方向存在显著差异(P=0.046,0.03,0.03),腹部两组比较时仅在PITCH方向存在差异(P=0.047),其余方向误差无显著差异(P>0.05)。结论:胸腹部肿瘤患者放疗时,胸部可优先选择真空负压垫结合热塑体膜进行固定,腹部患者需根据其疗程周期与身体状态等多方面因素评估应用热塑体膜是否为其带来益处,再选择适用的体位固定技术。Objective:To investigate the effect of the application of thermoplastic film on the positioning error of patients with thoracic and abdominal radiotherapy.Methods:A total of 40 patients with thoracic and abdominal tumors who received radiotherapy from the Affiliated Cancer Hospital of Fudan University from October 2022 to October 2023 were retrospectively selected,and they were divided into four groups,chest A and B,abdominal A and B,according to the treatment site and the fixation method with or without thermoplastic membrane,and the cone beam CT(CBCT)images were obtained once a week,and the sixdimensional orientation error obtained from the registration of the first three CBCT images and the reference images in the course of treatment was compared and analyzed.Results:After comparison,the mean translation direction error ranges of 0.51-1.38mm and 0.56-1.29mm in the chest and abdominal groups,and the mean rotation error range was 0.32˚-0.78˚and 0.23˚-0.55˚,respectively,and the probability distribution of error in each direction=2mm or 2˚was 83%-100%in the chest group and 90%-100%in the abdominal group.There were statistically significant differences in VRT(ventral dorsal),LNG(cephalopod)and pitch(pitch)between the two groups(P=0.046,0.03,0.03),only difference in pitch direction(P=0.047),and no significant difference in other directions(P>0.05).Conclusion:During radiotherapy for patients with thoracic and abdominal tumors,vacuum negative pressure pads combined with thermoplastic membranes can be preferentially selected for chest fixation,and abdominal patients should evaluate whether the application of thermoplastic membranes brings benefits to them according to their treatment cycle and physical state,and then choose the appropriate body position fixation technology.

关 键 词：放射治疗 胸腹部肿瘤 体位固定技术 热塑体膜 CBCT摆位误差 

分 类 号：R730.5[医药卫生—肿瘤]