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李莉萍, 邓烨, 罗庭军, 陆锋, 雷应满, 赵志斌, 梁文杰. 精准体位固定模式在肺癌图像引导放疗中的作用[J]. 肿瘤防治研究, 2018, 45(10): 758-761. DOI: 10.3971/j.issn.1000-8578.2018.17.1547
引用本文: 李莉萍, 邓烨, 罗庭军, 陆锋, 雷应满, 赵志斌, 梁文杰. 精准体位固定模式在肺癌图像引导放疗中的作用[J]. 肿瘤防治研究, 2018, 45(10): 758-761. DOI: 10.3971/j.issn.1000-8578.2018.17.1547
LI Liping, DENG Ye, LUO Tingjun, LU Feng, LEI Yingman, ZHAO Zhibin, LIANG Wenjie. Precise Position Fixed Mode of Lung Cancer in Image-guided Radiotherapy[J]. Cancer Research on Prevention and Treatment, 2018, 45(10): 758-761. DOI: 10.3971/j.issn.1000-8578.2018.17.1547
Citation: LI Liping, DENG Ye, LUO Tingjun, LU Feng, LEI Yingman, ZHAO Zhibin, LIANG Wenjie. Precise Position Fixed Mode of Lung Cancer in Image-guided Radiotherapy[J]. Cancer Research on Prevention and Treatment, 2018, 45(10): 758-761. DOI: 10.3971/j.issn.1000-8578.2018.17.1547

精准体位固定模式在肺癌图像引导放疗中的作用

Precise Position Fixed Mode of Lung Cancer in Image-guided Radiotherapy

  • 摘要:
    目的 探讨肺癌图像引导放疗(image-guided radiotherapy, IGRT)中体位的最佳固定方式。
    方法 选取2016年1月—2017年6月期间在我院治疗的90例肺癌IGRT患者,在锥形束CT(cone-beam computer tomography, CBCT)下观测放疗时摆位误差值。将患者分为三组(A组负压真空垫(体膜)、B组头肩网罩、C组连体网罩)体位固定模式,每位患者放疗前5次进行CBCT扫描采集图像与计划CT图像配准,测量摆位误差。
    结果 本研究共采集图像450张,配准结果平移误差在患者左右(X)、头脚(Y)、前后(Z)三方向上,A组分别为(3.21±2.05)mm、(2.03±1.55)mm、(3.34±2.13)mm;B组分别为(1.81±1.53)mm、(3.13±2.15)mm、(3.26±2.04)mm;C组分别为(1.88±1.73)mm、(1.85±1.46)mm、(1.78±1.48)mm,A组与B组对比在X、Y方向、,B组与C组对比在Y、Z方向,A组与C组对比在X、Z方向上差异均有统计学意义(P < 0.05)。旋转误差在X、Y、Z方向A组分别为(2.52±1.03) °、(4.85±1.32)°、(4.53±1.25)°;B组(4.54±1.12)°、(2.61±1.52)°、(4.82±1.23)°;C组(2.08±1.12)°、(1.53 ±1.05)°、(1.51±1.38)°。旋转误差>3°的概率,C组明显小于A组与B组。
    结论 C组连体网罩固定模式放疗体位重复性好,建议肺癌乃至胸腹部肿瘤的放疗使用连体网罩固定模式。

     

    Abstract:
    Objective To investigate the best position fixed method of lung cancer in image-guided radiotherapy (IGRT).
    Methods From January 2016 to June 2017, 90 patients with lung cancer treated in our hospital were randomly selected to observe the setup errors. All patients underwent kilo-voltage cone beam CT(kvCBCT) before radiotherapy. Patients were divided into three groups: group A received negative pressure vacuum pad, group B received head and neck shoulder net cover, and group C received conjoined mesh cover. Each patient received CBCT scans five times before radiotherapy, and the images were matched with the planned CT images to measure the setup errors.
    Results A total of 450 images were collected to match the translation errors of the left-right (X), head-foot (Y), and anterior-posterior (Z) directions: (3.21±2.05)mm, (2.03±1.55)mm, (3.34±2.13)mm in A group; (1.81±1.53)mm, (3.13±2.15)mm, (3.26±2.04)mm in B group; and (1.88±1.73)mm, (1.85±1.46)mm, (1.78±1.48)mm in C group, respectively. There were significant differences in A group vs. B group in X, Y directions, B group vs. C group in Y, Z directions, and A group vs. C group in X, Z directions(all P < 0.05). Rotation errors in X, Y, Z directions were(2.52±1.03) °, (4.85±1.32) °, (4.53±1.25) ° in A group, (4.54±1.12) °, (2.61±1.52) °, (4.82±1.23) ° in B group, and (2.08±1.12) °, (1.53 ±1.05) °, (1.51±1.38) °in C group, respectively. The probability of the rotation error > 3°in group C was significantly less than those in group A and B.
    Conclusion The position repeatability of radiotherapy in group C with conjoined mesh cover fixed mode is good, and it is recommended that conjoined mesh cover fixed mode should be applied in the radiotherapy of lung cancer, and even chest and abdominal tumor.

     

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