乳腺癌胸壁电子线射野摆位固定方法的研究

Study on the chest wall fields in breast cancer with different fixation method

目的通过分析乳腺癌胸壁电子线射野摆位和体位固定方法，探讨不同固定方法的摆位质量差异。方法根据不同的体位固定方法分为常规组和改进组。常规组无固定装置，使用普通的海绵枕头或棉枕；改进组用真空垫成型固定技术对患者进行固定摆位放射治疗，两组各15例、30个野次，对30个野次测量数据进行分析。结果全部患者放射治疗前后体位均有不同程度的移动。常规组胸壁野上界移动距离4～8mm[（5．867±1．246）mm]，胸壁野前界移动距离8-13mm[（9．867±1．257）mm]，改进组胸壁野上界移动距离3～6mm[（4．133±0．915）mm]，胸壁野前界移动距离2～6mm[（4．333±1．175）mm]，常规组体位移动值均大于改进纽，差异有显著性意义（P〈0．01）；常规组中体位移动≥5mm的28野次（93．33％），高于改进组的13野次（43．33％），两组差异有显著性意义（P〈0．001）；胸壁射野垂直度分析，常规组比改进组差，差异有显著性意义（P〈0．001）。结论真空垫成型固定摆位较常规摆位方法稳定性、重复性更好。误差更小，更符合放射治疗规范。

Objective To explore the different fixation methods in breast cancer patients received electronic irradiation to the chest walt. Methods All patients were divided into two groups. The revised group were received electronic irradiation to the chest wall with vacuum pad for fixation. The common group were completed the irradiation without fixation devices. The movement of chest wall irradiation fields were measured. The veracity and stability between the two groups were compared. Resuits Before and after radiation therapy , all the patients showed vary degree of body movement. The distance of upper movement of chest wall fields were 4 - 8 mm [ [ 5. 867± 1. 246 ）mm ] in the common group and 3 - 6 mm[ （ 4. 133 ± 0. 915 ） mm ] in the revised group respectively. The mobile distance of anterior borderline were 8 - 13 mini （9. 867 ± 1. 257 ） mm] in the common group and 2 - 6 mm[ （4. 333 ± 1. 175）mm] in the revised group resperctively（ P 〈 0. 01 ）. The body movement distance , which larger than 5mm, were 28 fields（93.33% ） in the common group and 13 fields （43.33% ） in the revised groupl P 〈 0. 001 ） . The verticality of chest wall fields was better in the revised group（ P 〈 0. 0011. Conclusion The veracity and stability of the body position is better in the revised group.