面罩固定技术应用于颈段及胸上段食管癌放疗的可行性探究

Feasibility of Mask Immobilization Techniques in Radiotherapy for Cervical and Upper-Thoracic Esophageal Cancer

目的探讨头颈肩面罩固定技术在颈段、胸上段食管癌放疗中的应用及其临床意义。方法选取在本院TrueBeam放射治疗系统治疗的66例颈段及胸上段食管癌患者,其中使用面罩固定技术34例,采用非面罩固定技术32例,利用锥形束CT(Cone-Beam Computed Tomography,CBCT)影像技术研究两组患者在治疗中的摆位误差,进行对比分析。结果面罩固定技术组在X、Y、Z轴方向上的摆位误差分别为(1.70±1.40)、(2.30±1.70)、(2.10±1.60)mm,而非面罩固定技术组为(2.80±2.40)、(2.70±2.40)、(2.00±1.70)mm,两组间比较应用检验,X轴方向无明显差异(>0.05),Y轴和Z轴方向差异均有显著意义(<0.01)。结论面罩固定技术用于颈段、胸上段食管癌放疗,重复性好,摆位误差小,对提高放疗精确性具有重要意义,值得在临床中推广。

Objective To investigate the feasibility and clinical significance of mask immobilization techniques in radiotherapy for cervical and upper-thoracic esophageal cancer.Methods To compare and analyze the setup errors for two types of immobilization methods in radiotherapy of cervical and upper-thoracic esophageal cancer with cone-beam CT(CBCT).There were 66 patients included in this study,34 cases were immobilized with head&shoulder mask,and 32 cases without mask.Results In the patients immobilized with mask,the average setup error in Z-axis,Y-axis,and X-axis directions were(1.70±1.40)mm,(2.30±1.70)mm,(2.10±1.60)mm.In comparison,the setup error in patients without mask was(2.80±2.40)mm in X-axis,(2.70±2.40)mm in Y-axis and(2.00±1.70)mm in Z-axis,respectively.There were no significant dif erences(>0.05)in displacement of X-axis between the two immobilization techniques.However,the setup error in Y-axis and Z-axis direction were significantly dif erent(<0.01).Conclusion In radiotherapy of cervical and upper-thoracic esophageal cancer,setup accuracy of patients immobilized with mask is more stable than other methods,which can be popularized in clinic.