基于六自由度床盆腔放疗妇瘤患者不同固定方式的比较分析

Comparative analysis of different fixation methods for gynecological cancer patients with pelvic radiotherapy based on 6-DOF bed

目的:研究接受基于六自由度床的盆腔放疗妇瘤患者体位固定方式的最优选择。方法:入组2015年06月23日至2016年01月14日于我院放射治疗科妇瘤患者共计32例,年龄36~72岁(中位年龄54岁),其中子宫内膜癌术后患者5例,宫颈癌术后患者10例,原发宫颈癌患者17例。A组:18例入组热塑膜体网组,B组:14例入组负压真空垫组。结果:经过机载六自由度床A、B两组整体校正前、后在X、Y、Z及RX方向上的摆位误差数据分别为(0.10±0.33、0.06±0.46、-0.29±0.39、0.18±1.95;0.01±0.08、-0.01±0.10、-0.03±0.08、-0.11±0.58)差异均有统计学意义(P<0.05),而RY及RZ方向没有统计学意义。在治疗前A组与B组六个方向上的摆位误差仅在Y及RX(0.12±0.41、-0.36±2.01;-0.01±0.52、0.89±1.67)方向上,差异有统计学意义(P均<0.05),其余四个方向的摆位误差均没有统计学意义。在治疗后A组与B组六个方向上的摆位误差在X1、Y1、RX1、RY1及RZ1(0.01±0.09、0.00±0.06、-0.01±0.42、0.22±0.27、0.01±0.22;0.02±0.90、-0.03±0.10、-0.03±0.50、0.33±0.33、0.08±0.31)方向上有统计学意义(P<0.05),在Z1方向上的摆位误差没有统计学意义。结论:在接受基于六自由度床的盆腔放疗的妇瘤患者,热塑膜体网固定方式优于负压真空垫的固定方式。

Objective:To explore the best choice of fixation options for gynecological cancer patients receiving pelvic radiotherapy under the condition of using a 6-DOF(six-degree-of-freedom)bed.Methods:From June 23,2015 to January 14,2016,a total of 32 patients aged 36~72 years old(median age 54)with gynecological cancer were treated in the Department of Radiation Oncology,Peking University Third Hospital,5 patients of whom had received endometrial cancer surgery,10 patients of whom had received cervical cancer surgery and 17 of whom patients had primary cervical cancer.Group A:18 cases in the thermoplastic film group.Group B:14 cases in the negative pressure vacuum pad group.Results:There were significant differences in X,Y,Z and RX directions(0.10±0.33,0.06±0.46,-0.29±0.39,0.18±1.95;0.01±0.08,-0.01±0.10,-0.03±0.08,-0.11±0.58,P<0.05)before and after the 6-DOF bed correction,but there were no significant differences in RY and RZ directions.Before treatment,the setup errors of the two groups were statistically different only in the directions of Y and RX(0.12±0.41,-0.36±2.01;-0.01±0.52,0.89±1.67,P<0.05),and there was no significant difference in other four directions.After treatment,the setup errors of the two groups were statistically different in the directions of X1,Y1,RX1,RY1 and RZ1(0.01±0.09,0.00±0.06,-0.01±0.42,0.22±0.27,0.01±0.22;0.02±0.90,-0.03±0.10,-0.03±0.50,0.33±0.33,0.08±0.31,P<0.05),and there was no significant difference in Z1 direction.Conclusion:The result shows that for gynecological cancer patients receiving pelvic radiotherapy based on 6-DOF bed,treatment with thermoplastic film fixation method is better than that of negative pressure vacuum pad fixation method.