碳纤维治疗床板联合固定底板对宫颈癌放射治疗计划PD剂量验证的影响  

Influence of bed board of carbon fiber for treatment combined with fixed bottom board on PD dose verification of radiotherapy plans for cervical cancer

作　　者：王敏[1] 吕懂霞 刘叶红 时飞跃[1,3] 秦伟[1] 赵环宇[1] 魏晓为[1] Wang Min;Lv Dongxia;Liu Yehong;Shi Feiyue;Qin Wei;Zhao Huanyu;Wei Xiaowei(Center of Radiotherapy for Tumor,Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,China;Department of Clinical Medical Equipment,Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,China;Research Center of Medical Physics,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)肿瘤放疗中心,南京210006 [2]南京医科大学附属南京医院(南京市第一医院)临床医学工程处,南京210006 [3]南京医科大学医学物理研究中心,南京210029

出　　处：《中国医学装备》2025年第3期5-9,共5页China Medical Equipment

基　　金：国家自然科学基金面上项目(81773240);江苏省自然科学基金面上项目(BK20181118)。

摘　　要：目的:探讨碳纤维治疗床板和固定底板对宫颈癌固定野调强放射治疗(IMRT)计划射野剂量学(PD)剂量验证结果的影响。方法:回顾性选取2019年1月至2020年1月南京市第一医院收治的15例宫颈癌患者,设计所有患者固定野IMRT计划。对每个病例选取机架角度为180°的照射野制作对应的PD剂量验证计划,每例验证计划中均包含有2个分射野AA180_0和AA180_1。使用Clinac iX加速器执行每例验证计划时加速器机头与电子射野影像装置之间分别放置无碳纤维材料、碳纤维治疗床板以及碳纤维治疗床板+碳纤维固定底板3种形式的材料。对分射野(AA180_0和AA180_1)及总射野(AA180)在无碳纤维材料、碳纤维治疗床板、碳纤维治疗床板+碳纤维固定底板3种不同材料条件下的γ通过率数据进行对比分析。结果:对于分射野AA180_0的3种不同材料条件下的γ通过率分别为(96.09±1.38)%、(90.48±2.24)%和(81.85±2.46)%,分射野AA180_1的3种不同材料条件下的γ通过率分别为(96.05±1.06)%、(91.86±2.22)%和(86.26±2.74)%;对于总射野AA180的3种不同材料条件下的γ通过率分别为(90.78±1.40)%、(84.82±2.56)%和(78.49±3.18)%;分射野AA180_0、AA180_1和总射野AA180的3种不同材料条件下的γ通过率比较,差异均有统计学意义(F=177.80、80.00、91.42,P<0.01);碳纤维治疗床板+碳纤维固定底板与无碳纤维材料相比,总射野AA180的γ通过率显著下降12.29%。结论:在宫颈癌调强治疗的PD剂量验证中,碳纤维材质的治疗床板联合固定底板均能对验证结果产生不利影响;治疗床板的单独使用带来的影响相对较小;当碳纤维治疗床板联合固定底板使用时,将导致PD剂量验证结果明显变差。Objective:To investigate the effect of bed board of carbon fiber for treatment combined with fixed bottom board on verification results of Portal Dosimetry(PD)dose of intensity-modulated radiation therapy(IMRT)plan of fixed field for cervical cancer.Methods:A total of 15 patients with cervical cancer who admitted to Nanjing First Hospital from January 2019 to January 2020 were retrospectively selected,and the IMRT plans of fixed field for all patients were designed.The radiation field with 180°gantry angle was selected for each case to make the corresponding PD dose verification plan,and each verification plan included two subfields:AA180_0 and AA180_1.Three types of materials were placed between the accelerator head and the electronic portal imaging device(EPID),which included material without carbon fiber,bed board with carbon fiber for treatment,and the combination of the bed board with carbon fiber for treatment and the fixed bottom board with carbon fiber,when the Clinac iX accelerator was used to conduct verification plan for each case.Theγpassing rates of the subfields(AA180_0 and AA180_1)and the total field(AA180)among three kinds of conditions,which included material without carbon fiber,bed board with carbon fiber for treatment,and the combination of the bed board with carbon fiber for treatment and the fixed bottom board with carbon fiber,were compared and analyzed.Results:For the subfield AA180_0,theγpassing rates under three different material conditions were respectively(96.09±1.38)%,(90.48±2.24)%and(81.85±2.46)%.For the subfield AA180_1,theγpassing rates under the above conditions were respectively(96.05±1.06)%,(91.86±2.22)%and(86.26±2.74)%.For the total field AA180,theγpassing rates were respectively(90.78±1.40)%,(84.82±2.56)%and(78.49±3.18)%.Theγpassing rates of the subfield AA180_0,subfield AA180_1,and the total field AA180 showed statistically significant differences among the three different material conditions(F=177.80,80.00,91.42,P<0.01).Compared with materials without carbon

关 键 词：宫颈癌 调强放射治疗(IMRT) 碳纤维 剂量验证 γ通过率 

分 类 号：R144.1[医药卫生—公共卫生与预防医学]