胸部肿瘤放射治疗两种体位固定技术摆位误差对比研究

Comparative Study of Two Position Fixation Techniques Positioning Errors for Thoracic Tumor Radiotherapy

目的:研究胸部肿瘤患者实施放射治疗时,两种体位固定技术摆位误差的测量情况。方法:研究时间为2017年5月~2018年5月,所研究对象均为此阶段某院收治的60例胸部肿瘤患者。根据随机分配原则将这60例患者分为对照组与观察组各30例,对照组患者采用真空垫固定体位,观察组患者采用头颈肩面膜固定体位。两组患者均在首次放射治疗前给予CBCT验证,并将CBCT图像与原计划CT图像进行配准校正,获得左右(X轴)、头脚(Y轴)、前后(Z轴)的线性误差及前后轴线(Y轴)的旋转误差共四个维度的误差数据,并分析比较两组的误差数值。结果:观察组与对照组X轴、Y轴及前后轴线(Y轴)的旋转三个维度的摆位偏差比较无统计学意义(P>0.05);观察组Z轴偏差低于对照组(P<0.05)。结论:在胸部肿瘤放射治疗中采用头颈肩面膜固定体位技术可减小其摆位误差,并显著提升其精准度,故更值得临床进一步推广并使用。

Objective: To study the measurement of the positioning errors of two posture fixation techniques during radiotherapy for the patients with thoracic tumor. Methods: The study time was from May 2017 to May 2018. The study subjects were 60 patients with thoracic tumors admitted to a hospital at this stage. According to the principle of random distribution, the 60 patients were divided into two groups: the control group(n=30) and the observation group(n=30). The control group was treated with a vacuum pad. The patients in the observation group were treated with the head and neck shoulder mask. Both groups of patients were given CBCT verification before the first radiation therapy, and the CBCT images were aligned with the original planned CT images to obtain a total of four dimensions of error data of linear errors of left and right(X-axis), head and foot(Y-axis), front-to-back(Z-axis) and rotation error of the front and rear axis(Y-axis), and the error values of the two groups are analyzed and compared. Results: There was no significant difference in the three dimensional deviations in the X-axis, Y-axis and anterior-posterior axis(Y-axis) between the observation group and the control group(P>0.05). The Z-axis deviation of the observation group was lower than that of the control group(P<0.05). Conclusion: The use of the head and neck shoulder mask fixation position technique in thoracic tumor radiotherapy can reduce the placement error and significantly improve its accuracy, so it is worth of further clinical promotion and use.