妇科肿瘤放射治疗中不同摆位方法的对比研究及位置偏差分析  

Comparative study of different positioning methods and position deviation analysis in gynecological tumor radiotherapy

作　　者：明学中 顾洁 孙丽[1] 张彬 武雅琴[1] MING Xue-zhong;GU Jie;SUN Li;ZHANG Bin;WU Ya-qin(Department of Radiation Oncology,Jiangsu Cancer Hospital,Jiangsu Institute of Cancer Research,Nanjing Medical University Affiliated Cancer Hospital,Nanjing 210009,Jiangsu,China)

机构地区：[1]江苏省肿瘤医院,江苏省肿瘤防治研究所,南京医科大学附属肿瘤医院放疗科,江苏南京210009

出　　处：《生物医学工程与临床》2025年第1期34-40,共7页Biomedical Engineering and Clinical Medicine

基　　金：江苏省妇幼健康科研项目(F202165)。

摘　　要：目的探讨不同摆位方法在妇科肿瘤放射治疗中的应用,比较其在治疗位置偏差和摆位时间上的差异,以期提高治疗的准确度和患者的舒适度。方法选择江苏省肿瘤医院2023年4月至10月进行放射治疗的妇科肿瘤患者106例,年龄24~76岁,平均年龄49.6岁;身高147~170 cm,平均身高160.4 cm;体质量45~80 kg,平均体质量61.9 kg;小学及以下37.7%,中学59.4%,大学2.9%;卡氏功能评分80~90分,平均卡氏功能评分87.9分。采用随机数字表法均分为A、B两组。A组使用自然体位摆位法,B组采用“三线合一”摆位法进行摆位治疗,以患者体表标记线与激光线吻合为标准。记录分析摆位时间及分次间和分次内六维方向上的体位移动误差。结果两组患者摆位时间差异无统计学意义(P>0.05)。在分次间的误差中,组间平移误差差异无统计学意义(P>0.05),但A组旋转误差显著优于B组[左右方向(0.93±0.48)°vs(1.18±0.41)°,头脚方向(0.97±0.49)°vs(1.24±0.53)°,腹背方向(1.21±0.65)°vs(1.73±0.69)°。P<0.05];在分次内的误差中,A组在腹背方向的平移误差明显更优[(0.12±0.18)cm vs(0.14±0.20)cm。P<0.05]。误差累积分布显示,A组在腹背方向上,分次间的旋转误差和分次内的平移误显著低于B组(26.3%vs 37.1%,2.6%vs 6.6%。P<0.05),表现出更高的摆位精度和稳定性。结论自然体位摆位法在减少摆位误差和提高靶区覆盖率方面表现出色,特别是在控制旋转误差和分次内体位稳定性上的改进明显,适用于临床放射治疗,值得临床推广。Objective To investigate application of different positioning methods in gynecological tumor radiotherapy,and compare the differences in treatment position deviation and positioning time for improving the treatment accuracy and patient comfort.Methods From April to October 2023,a total of 106 patients with gynecological tumor treated with radiotherapy were enrolled,which aged 24-76 years old with mean age of 49.6 years old;height was 147-170 cm with mean height of 160.4 cm;body mass was 45-80 kg with mean body mass of 61.9 kg;education level of primary school and below in 37.7%,middle school in 59.4%and university in 2.9%;Karnofsky performance score was 80-90 scores with mean score of 87.9 scores.All of them were divided into 2 groups by random number table method,group A was treated with natural positioning method and group B performed“three-line alignment”positioning method,and body surface marker line of patient was consistent with laser line as the standard.The positioning time and position movement error in six-dimensional direction between intra-and inter-group were recorded and analyzed.Results There was no significant difference in positioning time between 2 groups(P>0.05).In inter-group error,there was no significant difference for translation error between 2 groups(P>0.05),but rotation error in group A was significantly better than that in group B[left-right direction(0.93±0.48)°vs(1.18±0.41)°,superior-inferior direction(0.97±0.49)°vs(1.24±0.53)°,and anteroposterior direction(1.21±0.65)°vs(1.73±0.69)°.P<0.05].In intra-group error,the translation error at ventral-dorsal direction of group A was significantly better than that of groups B[(0.12±0.18)cm vs(0.14±0.20)cm.P<0.05].The cumulative error distribution showed that the inter-group rotation error and intra-group translation error at ventral-dorsal direction in group A were significantly lower than those in group B(26.3%vs 37.1%,2.6%vs 6.6%.P<0.05),which exhibited higher positioning accuracy and stability.Conclusion It is demonstrated

关 键 词：自然体位 摆位方法 妇科肿瘤 放射治疗 位置偏差 

分 类 号：R737.3[医药卫生—肿瘤] R730.55[医药卫生—临床医学]