辅助标记点在鼻腔鼻窦肿瘤放疗中的应用价值

Study on the value of auxiliary marking in radiotherapy for nasai cavity and paranasal sinus carcinoma

目的探讨鼻腔鼻窦肿瘤放疗过程中鼻根标记点辅助摆位的作用。方法回顾性分析2018年6月1日至2019年8月31日接受放疗的鼻腔鼻窦肿瘤患者63例,所有患者均接受头颈肩热塑模和发泡胶体位固定,其中38例接受鼻根辅助标记点固定(标记组),25例以常规体位固定技术固定(常规组)。采用千伏级锥形束CT(CBCT)进行空间位置偏差比较。结果标记组在X轴方向误差≤1 mm者占81.8%,Y轴方向误差≤1 mm者占78.9%;常规组在X轴和Y轴方向误差≤1 mm者分别占64.3%和50.3%。两组比较,标记组在X轴和Y轴方向明显优于常规组(P<0.05)。标记组与常规组在X、Y、Z轴方向的误差分别为(0.93±0.66)mm和(1.36±0.82)mm(P=0.037)、(1.03±0.74)mm和(1.57±1.14)mm(P=0.042)、(1.03±0.51)mm和(1.07±0.60)mm(P=0.812)。标记组和常规组的旋转误差分别为(0.31±0.47)°和(0.85±0.43)°(P=0.015)。结论辅助标记点可以提高鼻腔鼻窦肿瘤放疗的摆位精度,减少旋转误差,值得临床推广。

Objective To analyze the effect of adjuvant marker assisted positioning in radiotherapy for nasai cavity and paranasal sinus carcinoma.Methods The data of 63 patients with nasal cavity and paranasal sinuses tumor who received radiotherapy from June 12018 to August 312019 was retrospectively reviewed.All the patients received thermoplastic modeling and foaming colloid fixation at head,neck and shoulder,including 38 patients in auxiliary marker of nasal root group(marker group)and 25 patients with conventional body position fixation technique(conventional group).Kilovoltage cone-beam computed tomography(CBCT)was used to compare the deviation in spatial position.Results Marker group accounted for 81.8%and 78.9%of patients with X-axis and Y-axis error≤1 mm.Conventional group accounted for 64.3%and 50.3%of patients with X-axis and Y-axis error≤1 mm.Compared with conventional group,marker group was better in X and Y direction(P<0.05).The errors in X,Y and Z directions in marker group and conventional group were(0.93±0.66)mm vs.(1.36±0.82)mm(P=0.037),(1.03±0.74)mm vs.(1.57±1.14)mm(P=0.042),(1.03±0.51)mm vs.(1.07±0.60)mm(P=0.812).The rotation errors in marker group and conventional group was(0.31+0.47)°vs.(0.85±0.43)°(P=0.015).Conclusion The auxiliary markers can improve the positioning accuracy in radiotherapy for nasai cavity and paranasal sinus carcinoma,reduce the rotation error,which is worthy of clinical promotion.