中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2011年
4期
322-325
,共4页
林承光%林刘文%刘秉梯%刘小毛%李国文
林承光%林劉文%劉秉梯%劉小毛%李國文
림승광%림류문%류병제%류소모%리국문
鼻咽肿瘤/放射疗法%放射疗法,三维适形%放射疗法,调强%摆位误差
鼻嚥腫瘤/放射療法%放射療法,三維適形%放射療法,調彊%襬位誤差
비인종류/방사요법%방사요법,삼유괄형%방사요법,조강%파위오차
Nasopharyngeal neoplasms/radiotherapy%Radiotherapy,three-dimensional conformal%Radiotherapy,intensity modulation%Set-up error
目的 探讨鼻咽癌三维适形、调强放疗过程中头部和颈部摆位误差是否存在差异.方法 选择中晚期鼻咽癌(T2～4N1～3M0期)患者19例,头颈肩热塑面罩固定,将等中心点置于鼻咽腔附近.由三维激光灯在面罩上定出左、中、右原始十字标志点,并贴上直径约为0.3 mm的铅珠作为显像标记,然后CT扫描.将CT图像通过网络传至Peacock逆向计划系统进行计划设计,然后实施治疗.治疗1～6周每周在CT模拟机进行重复扫描,扫描及固定和摆位方法都与进行计划CT时相同.将每周验证体位重复性CT图像与计划CT图像通过读图软件进行比较,并利用双独立样本t检验头、颈部摆位误差.结果 左右、上下、头脚方向上颈部摆位误差分别为(2.44±2.24)、(2.05±1.42)、(1.83±1.53) mm,头部摆位误差分别为(1.05±0.87)、(1.23±1.05)、(1.17±1.55) mm;颈部和头部的摆位误差差异有统计学意义(t=-6.58、-5.28、-3.42,P=0.000、0.000、0.001).左右、上下、头脚方向上颈部系统误差分别是头部的2.33、1.67、1.56倍,颈部随机误差分别是头部的2.57、1.34、0.99倍.结论 鼻咽癌三维适形、调强放疗过程中采用头颈肩热塑面罩固定情况下,颈部的摆位误差大于头部.
目的 探討鼻嚥癌三維適形、調彊放療過程中頭部和頸部襬位誤差是否存在差異.方法 選擇中晚期鼻嚥癌(T2～4N1～3M0期)患者19例,頭頸肩熱塑麵罩固定,將等中心點置于鼻嚥腔附近.由三維激光燈在麵罩上定齣左、中、右原始十字標誌點,併貼上直徑約為0.3 mm的鉛珠作為顯像標記,然後CT掃描.將CT圖像通過網絡傳至Peacock逆嚮計劃繫統進行計劃設計,然後實施治療.治療1～6週每週在CT模擬機進行重複掃描,掃描及固定和襬位方法都與進行計劃CT時相同.將每週驗證體位重複性CT圖像與計劃CT圖像通過讀圖軟件進行比較,併利用雙獨立樣本t檢驗頭、頸部襬位誤差.結果 左右、上下、頭腳方嚮上頸部襬位誤差分彆為(2.44±2.24)、(2.05±1.42)、(1.83±1.53) mm,頭部襬位誤差分彆為(1.05±0.87)、(1.23±1.05)、(1.17±1.55) mm;頸部和頭部的襬位誤差差異有統計學意義(t=-6.58、-5.28、-3.42,P=0.000、0.000、0.001).左右、上下、頭腳方嚮上頸部繫統誤差分彆是頭部的2.33、1.67、1.56倍,頸部隨機誤差分彆是頭部的2.57、1.34、0.99倍.結論 鼻嚥癌三維適形、調彊放療過程中採用頭頸肩熱塑麵罩固定情況下,頸部的襬位誤差大于頭部.
목적 탐토비인암삼유괄형、조강방료과정중두부화경부파위오차시부존재차이.방법 선택중만기비인암(T2～4N1～3M0기)환자19례,두경견열소면조고정,장등중심점치우비인강부근.유삼유격광등재면조상정출좌、중、우원시십자표지점,병첩상직경약위0.3 mm적연주작위현상표기,연후CT소묘.장CT도상통과망락전지Peacock역향계화계통진행계화설계,연후실시치료.치료1～6주매주재CT모의궤진행중복소묘,소묘급고정화파위방법도여진행계화CT시상동.장매주험증체위중복성CT도상여계화CT도상통과독도연건진행비교,병이용쌍독립양본t검험두、경부파위오차.결과 좌우、상하、두각방향상경부파위오차분별위(2.44±2.24)、(2.05±1.42)、(1.83±1.53) mm,두부파위오차분별위(1.05±0.87)、(1.23±1.05)、(1.17±1.55) mm;경부화두부적파위오차차이유통계학의의(t=-6.58、-5.28、-3.42,P=0.000、0.000、0.001).좌우、상하、두각방향상경부계통오차분별시두부적2.33、1.67、1.56배,경부수궤오차분별시두부적2.57、1.34、0.99배.결론 비인암삼유괄형、조강방료과정중채용두경견열소면조고정정황하,경부적파위오차대우두부.
Objective To investigate the positioning errors of head and neck during intensity-modulated radiation therapy of nasopharyngeal carcinoma.Methods Nineteen patients with middle-advanced nasopharyngeal carcinoma (T2-4N1-3M0), treated by intensity-modulated radiation therapy, underwent repeated CT during their 6-week treatment course.All the patients were immobilized by head-neck-shoulder thermoplastic mask.We evaluated their anatomic landmark coordinated in a total of 66 repeated CT data sets and respective x, y, z shifts relative to their position in the planning CT.ResultsThe positioning error of the neck was 2.44 mm±2.24 mm,2.05 mm±1.42 mm,1.83 mm±1.53 mm in x, y, z respectively.And that of the head was 1.05 mm±0.87 mm,1.23 mm±1.05 mm,1.17 mm±1.55 mm respectively.The positioning error between neck and head have respectively statistical difference (t=-6.58,-5.28,-3.42,P=0.000,0.000,0.001).The system error of the neck was 2.33,1.67 and 1.56 higher than that of the head, respectively in left-right, vertical and head-foot directions;and the random error of neck was 2.57,1.34 and 0.99 higher than that of head respectively.Conclusions In the process of the intensity-modulated radiation therapy of nasopharyngeal carcinoma, with the immobilization by head-neck-shoulder thermoplastic mask, the positioning error of neck is higher than that of head.
