Bodyfix固定装置在老年肺癌患者立体定向放疗中的应用

Application of Bodyfix fixation device in stereotactic body radiotherapy for elderly patients with lung cancer

目的探讨Bodyfix固定装置在老年肺癌患者立体定向放疗(SBRT)中的临床应用价值。方法回顾性分析2021年1月至10月在华中科技大学同济医学院附属同济医院接受SBRT的63例老年肺癌患者临床资料,根据不同固定方式分为Bodyfix联合真空袋固定装置组(Bodyfix组,20例)和4D呼吸门控技术联合真空袋固定装置组(真空袋组,43例)。每次治疗前使用锥形束CT(CBCT)进行位置验证,记录水平(X)、头脚(Y)、前后(Z)方向的线性和旋转误差。结果 Bodyfix组在X、Y、Z方向上的线性误差分别为1.7 mm(1.3 mm,3.0 mm)、4.6 mm(4.3 mm,5.3 mm)、1.3 mm(0.8 mm,2.8 mm),旋转误差分别为(0.46±0.04)°、(-0.48±0.05)°、0.64°(0.38°,1.07°);真空袋组在X、Y、Z方向上的线性误差分别为2.1 mm(1.6 mm,3.3 mm)、2.8 mm(1.8 mm,3.7 mm)、3.0 mm(2.3 mm,3.8 mm),旋转误差分别为(0.69±0.04)°、(-0.70±0.04)°、0.64°(0.42°,0.86°)。两组Y、Z方向上的线性误差和X、Y方向上的旋转误差分别比较,差异均有统计学意义(P值分别为<0.001、<0.001、0.003、0.007)。结论与4D呼吸门控技术相比,Bodyfix固定装置的X、Y方向旋转误差和Z方向线性误差更小,可作为老年肺癌患者SBRT体位固定的有效手段。

Objective To explore the clinical application value of Bodyfix fixation device in stereotactic body radiotherapy(SBRT)for elderly patients with lung cancer.Methods The clinical data of 63 elderly patients with lung cancer who received SBRT in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January to October 2021 were retrospectively analyzed.According to different fixation methods,the patients were divided into Bodyfix combined with vacuum bag fixation device group(Bodyfix group,20 cases)and 4D respiratory gating technology combined with vacuum bag fixation device group(vacuum bag group,43 cases).Cone beam CT(CBCT)was used for position verification before each treatment,linear and rotational errors in the horizontal(X),head-to-foot(Y),front-to-back(Z)directions were recorded.Results The linear errors of Bodyfix group in the X,Y and Z directions were 1.7 mm(1.3 mm,3.0 mm),4.6 mm(4.3 mm,5.3 mm)and 1.3 mm(0.8 mm,2.8 mm),and the rotational errors were(0.46±0.04)°,(-0.48±0.05)°and 0.64°(0.38°,1.07°);the linear errors of vacuum bag group in the X,Y and Z directions were 2.1 mm(1.6 mm,3.3 mm),2.8 mm(1.8 mm,3.7 mm)and 3.0 mm(2.3 mm,3.8 mm),and the rotational errors were(0.69±0.04)°,(-0.70±0.04)°and 0.64°(0.42°,0.86°).The differences in linear errors in the Y and Z directions and rotational errors in the X and Y directions between the two groups were statistically significant(P values were<0.001,<0.001,0.003 and 0.007).Conclusions Compared with the 4D respiratory gating technology,the Bodyfix fixation device has smaller rotational errors in the X and Y directions and linear errors in the Z direction.It can be used as an effective method of postural fixation for SBRT in elderly patients with lung cancer.