辅助体表标记摆位方法在胸腹部超重患者中的应用

Application of adjuvant skin-marker positioning in overweight patients with thoracic and abdominal tumors

目的探讨辅助体表标记摆位方法是否可以减少胸腹部肿瘤超重患者放疗摆位误差。方法入组2018年1-12月在福建医科大学附属第一医院行放疗的胸腹部肿瘤超重患者60例,随机均分成两组:A组用常规体表标记摆位,B组用常规体表标记+辅助体表标记摆位,均采用头体一体式体位固定板+热塑体膜固定;治疗前行锥形束CT扫描并在线自动匹配,记录各方向平移摆位误差数据,两组摆位误差比较采用t检验。结果A组和B组在左右、头脚、腹背方向的摆位误差分别为(4.47±2.91)mm和(2.97±1.68)mm(P<0.001)、(5.43±2.61)mm和(3.21±1.62)mm(P<0.001)、(3.87±2.40)mm和(2.59±1.57)mm(P<0.001)。结论采用辅助体表标记摆位方法可以减少胸腹部肿瘤超重患者的摆位误差,能提高治疗摆位重复性。

Objective To investigate whether adjuvant skin-marker positioning can decrease the set-up errors in overweight patients with thoracic and abdominal tumors.Methods A total of 60 overweight patients with thoracic and abdominal tumors treated with radiotherapy in the First Affiliated of Fujian Medical University between January 2018 and December 2018 were randomly divided into two groups.In group A,conventional skin-marker positioning was adopted.In group B,conventional skin-marker positioning combined with adjuvant skin-marker position was employed.All patients were immobilized with thermoplastic positioning body membrane with head-body plate fixation.The set-up errors in the right-left,head-foot and dorsoventral directions were obtained from cone-beam CT(CBCT)scan system before radiation delivery.The set-up errors were statistically compared between two groups by using t-test.Results In group A,the set-up errors in the right-left,head-foot and dorsoventral directions were(4.47±2.91)mm,(5.43±2.61)mm and(3.87±2.40)mm,significantly higher compared with(2.97±1.68)mm,(3.21±1.62)mm and(2.59±1.57)mm,respectively(all P<0.001).Conclusion Adjuvant skin-marker positioning method can reduce the set-up errors and enhance the positioning repeatability in overweight patients with thoracic and abdominal tumors receiving radiotherapy.