两种不同体位固定技术对食管癌放疗的摆位误差临床比较分析

Clinical comparative analysis of positional error of radiotherapy for esophageal cancer between two different positional fixation techniques

目的探究在食管癌患者的放射治疗中采取不同的体位固定技术对摆位误差的影响,为临床提高患者放疗的准确性和治疗效果提供依据。方法选取2020年2月至2022年2月于上海市杨浦区市东医院肿瘤放疗科接受放疗治疗的56例食管癌患者进行回顾性分析,根据放疗中体位固定技术的不同分为对照组(28例,低温热塑膜固定)和研究组(28例,真空负压垫和翼型板联合固定),分析两组患者X轴(左右方向)、Y轴(上下方向)、Z轴(前后方向)的摆位误差的差异。结果研究组X轴、Y轴及Z轴的线性摆位误差分别为(1.87±0.45)mm、(2.31±0.89)mm、(1.56±0.58)mm,均明显小于对照组X轴、Y轴及Z轴的摆位误差(2.20±0.67)mm、(2.90±0.93)mm、(2.77±0.82)mm,差异有统计学意义(t=2.164、2.425、6.375,P=0.036、0.019、0.000);研究组X轴、Y轴及Z轴的旋转误差分别为(0.82±0.52)°、(0.63±0.34)°、(0.65±0.39)°,小于对照组X轴、Y轴及Z轴的摆位误差(0.83±0.49)°、(0.72±0.43)°、(0.73±0.46)°,差异无统计学意义(t=0.074、0.869、0.702,P=0.941、0.389、0.486)。结论在食管癌患者放疗过程中应用真空负压垫和翼型板联合固定的方式,可以进一步减少摆位误差,从而提高患者放疗的准确性和治疗效果,可考虑作为食管癌患者放疗治疗中的一种可靠体位固定技术。

Objective To explore the influence of two different position fixation techniques on the positioning error of radiotherapy for esophageal cancer,so as to provide a clinical basis for improving the accuracy and therapeutic effect of radiotherapy in patients.Methods A retrospective analysis was conducted on 56 patients with esophageal cancer who received radiotherapy treatment with our hospital from February 2020 to February 2022,and the positional fixation techniques in radiotherapy were divided into control groups(28 cases,low-temperature thermoplastic film fixation)and research group(28 cases,vacuum negative pressure pad and airfoil plate combined fixation),and the difference in pendulum error of X axis(left and right direction),Y axis(upper and lower direction)and Z axis(front and rear direction)were analyzed between the two groups of patients.Results The linear pendulum errors of the X,Y,and Z axis of the study group are(1.87±0.45)mm,(2.31±0.89)mm,and(1.56±0.58)mm,respectively,all were significantly less than the pendulum error(2.20±0.67)mm,(2.90±0.93)mm,(2.77±0.82)mm of the X axis,Y axis and Z axis of the control group(t=2.164,2.425,6.375,P=0.036,0.019,0.000);The rotation errors of the X,Y,and Z axis of the study group are(0.82±0.52)°,(0.63±0.34)°and(0.65±0.39)°,respectively,all were significantly less than the pendulum error(0.83±0.49)°,(0.72±0.43),(0.73±0.46)of the X axis,Y axis and Z axis of the control group(t=0.074,0.869,0.702,P=0.941,0.389,0.486).Conclusion The application of vacuum negative pressure pad and airfoil joint fixation in the course of radiotherapy in patients with esophageal cancer can further reduce the positioning error,thereby improving the accuracy and treatment effect of radiotherapy in patients,and can be considered as a reliable position fixation technology in radiotherapy treatment for patients with esophageal cancer.