一种新型肿瘤放疗呼吸控制装置——腹部气压带的研制及临床试验

Development and clinical trial of abdominal pressure belt, a new breathing control device in tumor radiotherapy

目的:探讨新型胸腹部肿瘤放疗呼吸位移控制装置——腹部气压带在肿瘤放射治疗中的应用价值。方法:应用类似袖带式血压计的原理,手动充气对腹部气压带充气加压和机械气压表读数,实现对胸腹部肿瘤放疗中呼吸位移的控制。临床试验通过对采用传统的热塑模和新型胸腹部肿瘤放疗呼吸位移控制装置——腹部气压带的实际定位比较,运用放射治疗计划系统进行配准比较。结果:配准结果显示二者压迫成形的外轮廓差别不大。将所有位置CT图像从头至脚方向对胸腹部配准,发现胸廓上部分重合较好,但是下部胸骨(呼吸束缚带)的位置较低,二者稍有差别,对治疗没有差异性影响。结论:新型胸腹部肿瘤放疗呼吸位移控制装置——腹部气压带可以达到传统的热塑模放疗固定装置的作用,减少摆位误差,且操作简单,可在治疗过程中适时修正。新型胸腹部肿瘤呼吸控制装置在实际临床应用中具有较好的应用价值。

Objective To investigate the application value of the abdominal pressure belt in radiotherapy, which is a new breathing movement control device in thoracoabdominal tumor radiotherapy. Methods Based on the principles of cuff sphygmomanometer, the pressure of abdominal pressure belt was manually adjusted and the mechanical manometer were read, to control the breathing movement in the thoracoabdominal tumor radiotherapy. The actual position of the abdominal pressure belt was compared with that of classical thermoplastic film in clinical trials. And the radiotherapy treatment planning system was applied in the registration comparison. Results The registration results showed that little differences were found in outer contour between the thermoplastic film positioning and abdominal pressure belt positioning. According to the direction from head to foot, the thoracoabdominal registrations were performed in the CT images of all positions, and results showed that the upper part of thoracic was well overlapped. But the position of lower part of thoracic was lower, so do the breathing strap, with a slight difference between these two devices. No significant differences were found in the treatment effects. Conclusion The abdominal pressure belt, the new breathing movement control device in thoracoabdominal tumor radiotherapy, has a satisfactory application value in the clinical treatments, because it can achieve the movement control effect of classical thermoplastic film, reduce the position error, simplify the operation and realize the real-time correction during the radiotherapy treatment.