| 牛 娜,孙 丽,明学中.临床常规体位固定方式联合应用在乳腺癌精确放疗中位置偏差的研究[J].肿瘤学杂志,2021,27(12):1006-1010. |
| 临床常规体位固定方式联合应用在乳腺癌精确放疗中位置偏差的研究 |
| Positional Deviation in Precise Radiotherapy for Breast Cancer by Combined Application of Clinical Conventional Immobilization Devices |
| 中文关键词 |
| DOI：10.11735/j.issn.1671-170X.2021.12.B007 |
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| 中文关键词: 乳腺肿瘤 精确放疗 发泡胶 体位偏差 |
| 英文关键词:breast cancer precise radiotherapy styrofoam positional deviation |
| 基金项目:江苏省干部保健课题（BJ19031） |
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| 摘要点击次数: 747 |
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| 中文摘要: |
| 摘 要：［目的］ 研究乳腺癌放疗中联合体位固定方式的摆位准确性以及在控制患者体位习惯性方面的性能。［方法］ 选取96例乳腺癌术后放疗患者，随机分为3组，采用不同的联合体位固定技术：真空体膜联合一体平板组（A组）、真空垫联合乳腺托架组（B组）和发泡胶联合乳腺托架组（C组）。每组患者在治疗前和治疗后分别行CBCT扫描获取体位影像并与参考CT影像作刚性配准，得到各组分次间（治疗前）和分次内（治疗后）的三维平移位置偏差。［结果］ 患者坐标系下，在左右（L-R）和腹背（A-P）方向上，C组分次间的位置偏差分别为（0.13±0.07） cm和（0.23±0.13） cm，均小于A组的（0.22±0.12） cm和（0.34±0.16） cm（t=2.71，P=0.009；t=2.41，P=0.018）。A组分次内的位置偏差分别为（0.06±0.04） cm和（0.11±0.05） cm，明显小于B组的(0.09±0.05) cm和(0.16±0.08) cm（t=2.24，P=0.028；t=2.35，P=0.022）。分次间位置偏差小于0.5 cm的占比数为B组＞C组＞A组；分次内位置偏差小于0.1 cm的占比数为A组＞C组，B组不确定性较大，且A组随着疗程的推进分次内的位置偏差逐渐减小，明显优于B组和C组。 ［结论］ 乳腺托架通过与真空体膜或发泡胶联合后，患者分次间的位置偏差得到了明显改善，特别是与发泡胶联合，其在左右和腹背方向上显著优于真空体膜；真空体膜与一体平板联合应用后可更好地控制患者分次内的体位习惯性。 |
| 英文摘要: |
| Abstract： ［Objective］ To study the setup accuracy of fixed position in breast cancer radiotherapy and the performance in controlling habituation of patients. ［Methods］ Ninety-six patients who underwent postoperative radiotherapy of breast cancer were randomly divided into three groups， each of them using different combination of body position fixation technology：vacuum membrane combined with integrated plate group(group A)， vacuum pad combined with breast bracket group(group B) and styrofoam combined with breast bracket group(group C). For each group， CBCT scanning was performed before and after treatment to obtain body position images， and rigid registration was performed with reference to CT images to obtain both the intrafractional(before treatment) and interfractional(after treatment) three-dimensional translation setup deviation. ［Results］ In the patient coordinate system， the setup deviation of group C was (0.13±0.07) cm and (0.23±0.13) cm in the left-right(L-R) and anterior-posterior(A-P) directions， which were lower than (0.22±0.12) cm and (0.34±0.16) cm in group A(t=2.71， P=0.009； t=2.41， P=0.018)； the setup deviation of group A was (0.06±0.04) cm and (0.11±0.05) cm， which was significantly lower than (0.09±0.05) cm and (0.16±0.08) cm in group B(t=2.24， P=0.028； t=2.35， P=0.022). The relationship of proportion of setup deviation lower than 0.5 cm was group B> group C> group A， while that of proportion of position deviation lower than 0.1 cm was group A> group C. The uncertainty of group B was large. The setup deviation of group A gradually decreased with the progress of the course of treatment， which was significantly better than that of group B and group C. ［Conclusion］ The setup deviation of the breast bracket combined with the vacuum body membrane or styrofoam is improved significantly. Especially， when combined with styrofoam， it is better than vacuum body membrane in L-R and A-P directions. The combination of vacuum body membrane and integrated plate can better control the posture habit of patients in different treatment phases. |
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