伽玛刀治疗体部肿瘤的分次间摆位误差及其影响因素

Interfractional Positional Errors of Gamma Knife Treatment of Body Tumors and Their Influencing Factors

目的 分析伽玛刀治疗体部肿瘤的分次间摆位误差及其影响因素。方法 回顾性收集125例2019年1月至2020年3月于中国人民解放军联勤保障部队第九八八医院接受伽玛刀治疗的体部肿瘤患者临床资料,统计分次间摆位误差数据,即每例患者每个分次在3个方向上[前后A/P(Y)、左右L/R(X)、头尾C/C(Z)]校正前后的摆位误差,并探讨相关影响因素。结果 经图像引导校正后,患者在A/P(Y)、L/R(X)、C/C(Z)方向上的总体摆位误差(OSE)、剩余摆位误差均减小,均在2 mm以内,且校正前、校正后A/P(Y)、L/R(X)、C/C(Z)方向上的摆位误差及OSE对比,差异有统计学意义(P<0.05)。治疗体位、双上肢位置、腹带使用情况均可对其产生影响,且在总体摆位误差方面,仰卧位优于俯卧位(P<0.05)。结论 伽玛刀治疗体部肿瘤能提高体部摆位验证精度,有效满足体部立体定向放疗的要求。

Objective To analyze of interfractional positional errors and their influencing factors in Gamma knife treatment of tumors in the body.Methods The clinical data of 125 patients with body tumors who received Gamma knife treatment in the 988 th Hospital of the People’s Liberation Army Joint Logistic Support Force from January 2019 to March 2020 were retrospectively collected.The data of the placement error between the scores were recorded,that is,the placement error of each patient before and after correction in three directions [front-back,A/P(Y),left-right,L/R(X),head-to-tail,C/C(Z)] for each class,and related influencing factors were discussed.Results After image-guided correction,the patient’s overall setup error(OSE) and residual positioning errors in the A/P(Y),L/R(X),C/C(Z) directions were reduced,and within 2 mm,and the positioning errors before and after correction in the directions of A/P(Y),L/R(X),C/C(Z) and OSE were compared,and the difference was statistically significant(P<0.05).At the same time,the treatment position,the position of the upper limbs and the use of the abdominal girdle could all affect it,and the supine position was better than the prone position in terms of overall setup error(P<0.05).Conclusion Gamma knife treatment of body tumors can improve the accuracy of body pose verification and effectively meet the requirements of stereotactic body radiotherapy.