乳腺癌改良根治术后放射治疗自制固定装置的临床应用

Clinical application of a self-made fixed device of radiotherapy post modified radical mastectomy of breast cancer

目的:探讨乳腺癌改良根治术后放射治疗自制固定装置在临床应用中的可行性。方法:选取152例近期行乳腺癌改良根治术后接受放射治疗的患者,按照数表法将其随机分成对照组(75例)和观察组(77例),对照组采用传统乳腺托架固定;观察组采用自主研制的体位固定装置联合头部热塑膜及体部发泡胶膜固定。运用锥形束CT(CBCT)采集患者分次间与分次内摆位误差。结果:观察组患者分次间与分次内摆位误差相较对照组患者均有所下降。左右(X轴)、头脚(Y轴)和前后(Z轴)3个方向,分次间摆位误差对照组患者分别为(4.23±2.58)mm、(3.17±1.33)mm和(3.58±2.87)mm,观察组患者分别为(2.31±1.09)mm、(1.89±0.98)mm和(2.01±1.27)mm;分次内摆位误差对照组患者分别为(3.78±2.43)mm、(2.46±1.07)mm和(2.38±1.45)mm,观察组患者分别为(1.14±0.79)mm、(0.89±0.45)mm和(1.08±0.81)mm。结论:自主研制的乳腺固定改进装置联合发泡胶垫与热塑头模,在乳腺癌改良根治术后放射治疗应用中体位固定性好、精确度高且重复性更好。

Objective： To investigate the feasibility of self-made fixed device of radiotherapy post modified radical mastectomy of breast cancer in clinical application. Methods： 152 patients received radiotherapy post modified radical mastectomy of breast cancer were divided into the control group（75 cases） and observation group （77cases） as random number table. The patients of control group adopted treatment with routine breast bracket. In the control group, 77 patients were treated by using a self-made fixed device combined with body styrofoam and head thermoplastic mask. The intra-fractional and inter-fractional setup errors were measured by using cone-beam computed tomography（CBCT）. Results： The intra fractional setup errors and inter fractional setup errors of observation group were slightly lower than those of control group. In three directions that included left-right （X-axis）, head-foot （Y-axis） and front-back （Z-axis）, the inter fractional setup errors of control group were（4.23±2.58）, （3.17±1.33） and （3.58±2.87）mm while they were （2.31±1.09）, （1.89±0.98） and （2.01±1.27）mm in observation group, respectively. On the other hand, the intra fractional setup errors of control group were （3.78±2.43）, （2.46±1.07） and （2.38±1.45） mm, respectively, and they were （1.14±0.79）, （0.89±0.45） and （1.08±0.81）mm in observation group, respectively. Conclusion： The self-made modified fixed device that combined with body styrofoam and head thermoplastic mask has good body position stationarity, high accuracy and better repeatability in the application of radiotherapy post modified radical mastectomy of breast cancer.