射波刀金标追踪优化的临床应用价值

The clinical value of CyberKnife fiducial tracking optimization methods

目的:评价射波刀金标追踪优化方法的临床应用价值。方法:112例胸腹部肿瘤患者采用金标追踪放疗,对不符合金标追踪要求金标分别采取减小金标间距、加大金标刚体误差和采用单纯旋转误差监测模式及脊柱追踪辅助定位模式进行优化处理,比较优化前后可用金标数目≥3、等于2和1变化情况,统计采用单纯旋转误差监测模式及脊柱追踪辅助定位模式病例数目。结果:优化前后可用金标数目≥3、等于2和1病例分别由49例(43.8%)、47例(42.0%)、16例(14.3%)变化为68例(60.7%)、33例(29.5%)、11例(9.8%),差异具有统计学意义(P=0.035)。其中8例(7.1%)采用单纯旋转误差监测次优模式,44例(39.2%)采用脊柱追踪辅助定位方式,患者的体位旋转误差处于可控和可接受范围,无治疗意外发生。结论:综合采用金标追踪优化措施,有利于提高金标利用率和降低射波刀治疗风险。

Objective：To evaluate the cl inical value of CyberKnife f iducial tracking optimization methods. Methods：112 cases of tumor patients were used fiducial tracking radiotherapy. The optimization methods of reducing the fi-ducial space and enlarging the rigid error and taking the pure rotation error monitoring mode and taking spinal tracking aided positioning were adopted to the improper fiducial tracking, compared the change of available fiducial mark num-ber that was not less than 3 and equal to 2 and equal to 1 after using the optimization methods,counted the case num-ber of the patients who were taken the pure rotation error monitoring mode or spinal tracking aided positioning in Cy-berKnife fiducial tracking. Results：The available fiducial tracking number that was not less than 3 and equal to 2 and equal to 1 was 49（43. 8% ） ,47（42. 0% ） , 16（ 14. 3%） before using the optimization methods, and was 6 8（60. 7% ）, 33 （29.5%） ,11（9.8%） after using the optimization methods. The difference was statistically significant（P =0. 035 ）. In the cases,8 cases were used by the pure rotation error monitoring mode,44 cases were used with spinal tracking ai-ded positioning mode. The two modes made the patient s position rotation error in a controlled and acceptable range and no unexpected things occurred. Conclusion ： Using comprehensive fiducial tracking optimization methods is bene-ficial for improving the utilization rate of the fiducial mark and reducing the CyberKnife treatment risk.