射波刀椎体追踪方式治疗腰椎转移肿瘤的体位误差研究

Study on Posture Error of Lumbar Spine Vertebral Tracking in the Treatment of Lumbar Metastatic Tumor

目的射波刀椎体追踪方式治疗腰椎转移肿瘤的体位误差研究。方法方便选取该院2016年2月-2018年2月收治的腰椎转移肿瘤患者26例,采用交叉视野脊柱追踪方式对患者的靶区位置进行校正,分析射波刀椎体追踪方式的运行效果。结果经过对应的研究分析,其中经过放射性治疗的误差确认,通过有效的治疗控制研究得出治疗前后时间段中,Y[治疗前(0.19±0.12)mm、治疗期间(0.36±0.21)mm,t=1.021,P=0.000]、Z[治疗前(0.26±0.14)mm、治疗期间(0.32±0.20)mm,t=1.625,P=0.017]以及DOwN-UP°[治疗前(0.28±0.12)mm、治疗期间(0.32±0.21)mm,t=1.214,P=0.002]、CCW-CW°[治疗前(0.41±0.12)mm、治疗期间(0.39±0.12)mm,t=1.214,P=0.022]3个方向均差异有统计学意义(P<0.05),表示X方向和L-R°方向的体位变化中运动不明显,分析其原因是因为患者在在治疗中因为呼吸不顺畅发生了自主的体位变化,最终让患者产生了体位偏差。结论经过实时追踪的方式产生的偏差不大,整体符合治疗要求。腰椎肿瘤患者由于病变位置的特殊性和患者耐受性差的缘故,采用快速、有效的放射治疗方式,可以使患者在肿瘤治疗中得到更大的受益。

Objective To study the position error of the vertebral body with the radio knife in the treatment of lumbar metastatic tumors.Methods Twenty-six patients with lumbar metastatic tumors treated in the hospital from February 2016 to February 2018 were convenient selected,and the target position of the patients was corrected by cross-field spine tracking.Results Through corresponding research,among which the errors of radiotherapy were confirmed,and the effective treatment control study showed that in the time period before and after treatment,Y[(0.19±0.12)mm before treatment,(0.36±0.21)mm during treatment,t=1.021,P=0.000],Z[(0.26±0.14)mm before treatment,(0.32±0.20)mm during treatment,t=1.625,P=0.017]and DOwN-UP°[(0.28±0.12)mm before treatment,(0.32±0.21)mm during treatment,t=1.214,P=0.002],CCW-CW°[(0.41±0.12)mm before treatment,(0.39±0.12)mm during treatment,t=1.214,P=0.022],and all three directions have statistically significant differences(P<0.05),the movement in the body position changes in the X direction and L-R°direction is not obvious.The reason for this analysis is that the patient's body position changes due to unsmooth breathing during treatment caused the patient to have a position deviation.Conclusion The deviation produced by the real-time tracking method is not large,and it meets the treatment requirements as a whole.Due to the specificity of the location of the disease and poor tolerance of patients with lumbar tumors,the use of rapid and effective radiation therapy can make patients more benefit in tumor treatment.