基于Halcyon加速器头颈部肿瘤放疗中塑形垫应用的研究

Study on the application of customized Klarity AccuCushion in radiotherapy for head and neck cancer using Varian Halcyon accelerator

目的探讨塑形垫联合头颈肩面罩与单纯使用头颈肩面罩在基于Halcyon加速器的头颈部肿瘤放疗中摆位误差的区别,探讨其在临床应用中的价值。方法选取在天津医科大学肿瘤医院接受放疗的49例头颈部肿瘤患者为研究对象,其中采用塑形垫联合头颈肩面罩定位方式的28例患者作为A组,单纯使用头颈肩面罩定位方式的21例患者作为B组。两组治疗过程中实行每天1次kV锥形束CT(CBCT),收集左右、头脚、前后3个方向上的摆位误差并进行比较分析。结果所有患者均顺利完成放疗,A组共进行kV CBCT扫描926次,B组678次。A组在左右方向[(0.12±0.09)cm vs.(0.17±0.10)cm]、头脚方向[(0.10±0.07)cm vs.(0.19±0.11)cm]、前后方向[(0.12±0.08)cm vs.(0.16±0.11)cm]的摆位误差小于B组,且A组左右、头脚、前后3个方向上0~0.10 cm和>0.10~0.20 cm区段的摆位误差比例高于B组,差异有统计学意义(P<0.05)。结论塑形垫联合头颈肩面罩的体位固定方式较单纯头颈肩面罩的体位固定方式可以减少摆位误差。

Objective To investigate the differences of set-up errors by the Klarity AccuCushion with head-neck-shoulder mask and the traditional head-neck-shoulder mask using Varian Halcyon accelerator,and explore the clinical application value in radiotherapy for patients with head and neck cancer.Methods A total of 49 patients with head and neck cancer who received radiotherapy in Tianjin Medical University Cancer Institute and Hospital were selected,28 patients in group A were immobilized by Klarity AccuCushion combined with head neck shoulder mask,another 21 patients in group B were immobilized by the traditional head neck shoulder mask.During the treatment,kV CBCT was performed once a day.The set-up errors of patients in left-right,superior-inferior,anterior-post directions were collected and analyzed.Results All the patients successfully completed radiotherapy.A total of 926 kV CBCT scans were performed in group A and 678 scans in group B.The set-up errors of group A in left and right direction[(0.12±0.09)cm vs.(0.17±0.10)cm],head and foot direction[(0.10±0.07)cm vs.(0.19±0.11)cm],front and rear direction[(0.12±0.08)cm vs.(0.16±0.11)cm]were smaller than those of group B,and the proportion in 0-0.10 cm and>0.10-0.20 cm of group A in the three directions was higher than those of group B,the difference was statistically significant(P<0.05).Conclusion Compared with the traditional simple use of head neck shoulder mask,the im-mobilization method of Klarity AccuCushion combined with head neck shoulder mask can reduce the set-up error.