发泡胶在头颈部肿瘤患者调强治疗中的应用及对位移误差的影响

Application of styrofoam in intensity modulation treatment of head and neck tumors and its effect on shifting error

目的对比研究发泡胶在头颈部肿瘤患者调强治疗中的应用及对位移误差的影响。方法选取浙江省嘉兴市第一医院肿瘤科2019年1-12月100例需行调强治疗的头颈部肿瘤患者,根据固定方法的不同,将其分为固定枕组(n=50),发泡胶固定组(n=50),固定枕组采用常规头、颈肩枕膜固定,发泡胶固定组采用发泡胶和头颈肩膜固定,分别比较两组在不同时间段内的放疗在不同轴上的移位误差、临床治疗疗效及放疗期间体位摆放平均移位误差。结果发泡胶固定组临床疗效均明显优于固定枕组(P<0.05);两组在首次放疗期间X、Y、Z轴上体位摆放误差比较,差异无统计学意义(P>0.05);两组在半个月放疗期间X、Y、Z轴上体位摆放误差比较,差异有统计学意义(P<0.05),且发泡胶固定组体位摆放误差均小于固定枕组;两组在末次放疗期间X、Y、Z轴上体位摆放误差比较,差异有统计学意义(P<0.05),且发泡胶固定组体位摆放误差均小于固定枕组;两组在整体放疗期间X、Y、Z轴上体位摆放误差比较,差异有统计学意义(P<0.05),且发泡胶固定组体位摆放误差均小于固定枕组。结论发泡胶在头颈部肿瘤患者调强治疗中,可明显减少移位造成的误差,提高患者舒适度,帮助患者进行更好的体位固定,且适形性与重复率高,值得临床进一步推广。

Objective To compare the application of styrofoam in the intensity modulation treatment of head and neck tumors and its effect on the shifting error.Methods One hundred cases of head and neck tumors requiring the intensity-modulated treatment in the oncology department of Jiaxing Municipal First Hospital from January to December 2019 were selected and divided into the fixed pillow group(n=50)and styrofoam fixed group(n=50)according to the different fixation methods.The fixed pillow group adopted the conventional head,neck and shoulder pillow membrane fixation,while the styrofoam fixed group adopted the styrofoam and head,neck and shoulder membrane fixation.The shifting errors of the radiotherapy in different axes during different time periods,clinical treatment effects and mean shifting error of body position placement during radiotherapeutic period were compared between the two groups.Results The clinical effect of the styrofoam fixed group was significantly better than that of the fixed pillow group(P<0.05);the shifting errors of body position placement in the X,Y and Z axes during the first radiotherapeutic period had no statistical difference between the two groups(P>0.05);the shifting errors of body position placement in the X,Y and Z axes during the half month radiotherapeutic period had the statistical difference between the two groups(P<0.05),moreover the position error of the styrofoam fixed group was smaller than that of the fixed pillow group;the shifting errors of body position placement in the X,Y and Z axes during the last radiotherapeutic period had statistical difference between the two groups(P>0.05),moreover the position error of the styrofoam fixed group was smaller than that of the fixed pillow group;the errors of body position placement in the X,Y and Z axes during the overall radiotherapeutic period had the statistically significant difference between the two groups(P<0.05),moreover the body positioning errors of the styrofoam fixed group was less than those of the fixed pillow group.Conclusion Styrofoam can significantly reduce the error caused by displacement in the intensify-modulated treatment of head and neck tumor patients,improve the comfort level of the patients,help patients to better conduct the body position fixation,moreover the shape-adaptability and the repetition rate are high,which is worthy of further clinical promotion.