新型体位固定系统在全骨髓照射中的应用

Study of clinical application of a novel immobilization system in total marrow irradiation

目的应用MVCT分析新型体位固定系统在全骨髓照射(TMI)中的应用效果。方法回顾分析2016-2017年武汉大学中南医院接受TMI治疗的22例患者的资料。新型体位固定组12例,组合式固定组10例。分析2个组患者头颈部、胸部、腹盆部、下肢的摆位误差数据,采用两独立样本t检验分析差异。结果在头颈部新型体位固定组患者在左右、头脚、前后和沿长轴旋转方向摆位误差分别为(1.06±0.79)、(1.34±0.66)、(2.45±1.48)mm和(0.63°±0.65°),在胸部分别为(1.58±1.13)、(2.38±1.99)、(2.05±1.68)mm和(0.31°±0.32°),在腹盆部分别为(1.67±1.24)、(3.88±2.20)、(1.96±1.32)mm和(0.48°±0.53°),在下肢分别为(0.95±0.73)、(1.99±1.35)、(3.66±2.13)mm和(0.24°±0.31°);组合式固定组患者分别为(2.59±2.58)、(3.28±1.85)、(3.71±2.43)mm和(1.15°±1.18°),在胸部分别为(4.38±3.69)、(5.64±3.78)、(2.72±1.91)mm和(1.55°±0.86°),在腹盆部分别为(4.14±2.97)、(6.97±3.68)、(2.21±2.26)mm和(1.23°±0.74°),在下肢分别为(2.28±1.15)、(5.97±3.00)、(3.44±1.93)mm和(1.09°±0.94°)。2个组患者各部位摆位误差在左右、头脚及旋转方向上不同(P<0.05),而在胸腹部位分次间摆位稳定性在左右、头脚及旋转方向上也不同(P<0.05)。结论新型体位固定系统可显著提高摆位精度和摆位稳定性,提高患者的治疗精度。

Objective To evaluate the clinical application value of a novel immobilization system in total marrow irradiation (TMI) with MVCT image. Methods From 2016 to 2017, a retrospective analysis of the setup errors of 22 patients receiving TMI in two groups (twelve patients were immobilized with the novel immobilization system in group 1, ten patients were immobilized with the combinatorial immobilization devices in group 2) was performed in this study on Zhongnan Hospital of Wuhan University. Two-sample t-test was used to analyze the differences of setup errors and the consistency of setup between two groups. Results In group 1, the setup errors on left-right, superior-inferior, anterior-posterior and rotation directions were (1.06±0.79),(1.34±0.66),(2.45±1.48) mm and (0.63°±0.65°) for the head and neck position,(1.58±1.13),(2.38±1.99),(2.05±1.68) mm and (0.31°±0.32°) for the chest position,(1.67±1.24),(3.88±2.20),(1.96±1.32) mm and (0.48°±0.53°) for the pelvis position, and (0.95±0.73),(1.99±1.35),(3.66±2.13) mm and (0.24°±0.31°) for the lower limb, respectively. In group 2, the setup errors were (2.59±2.58),(3.28±1.85),(3.71±2.43) mm and (1.15°±1.18°) for the head and neck position,(4.38±3.69),(5.64±3.78),(2.72±1.91) mm and (1.55°±0.86°) for the chest position,(4.14±2.97),(6.97±3.68),(2.21±2.26) mm and (1.23°±0.74°) for the pelvis position,(2.28±1.15),(5.97±3.00),(3.44±1.93) mm and (1.09°±0.94°) for the lower limb, respectively. The setup errors significantly differed between two groups on the left-right, superior-inferior and rotation directions for all positions (all P<0.05). The setup consistency significantly differed between two groups on the left-right, superior-inferior and rotation directions for the chest and pelvis positions (all P<0.05). Conclusion The novel immobilization system can significantly improve the setup accuracy and setup consistency, and enhance the precision of treatment for patients.