CAJ | 학술논문

目的探讨双臂平放置身体两侧(A组)与双臂交叉抱肘上举置额前(B组)两种不同体位对食管癌分次放疗摆位误差的影响.方法采用病例对照研究,患者仰卧双臂A或B体位,热塑体膜固定.放疗前3次及其后至少1次/周CBCT扫描,骨配准并结合人工校对获得患者左右、上下、前后方向线性摆位误差并行成组t检验.结果每组各11例,A组CBCT共92人次,B组共87人次.摆位绝对误差只有左右方向(x轴)A组大于B组,分别为(2.46±1.79)、(1.91±1.71) mm(P =0.036).摆位相对误差只有上下方向(y轴)A组小于B组,分别为(0.09±3.90)、(1.91±4.12) mm (P=0.003).三维矢量摆位误差A、B组相近(P=0.751).放疗中每周绝对摆位误差和三维矢量摆位误差A、B组均相近(P＞0.05).结论两种体位对食管癌分次放疗的摆位误差各有优劣,但均在可控范围内.可根据临床实际选用合适的治疗体位.
목적 탐토쌍비평방치신체량측(A조)여쌍비교차포주상거치액전(B조)량충불동체위대식관암분차방료파위오차적영향.방법 채용병례대조연구,환자앙와쌍비A혹B체위,열소체막고정.방료전3차급기후지소1차/주CBCT소묘,골배준병결합인공교대획득환자좌우、상하、전후방향선성파위오차병행성조t검험.결과 매조각11례,A조CBCT공92인차,B조공87인차.파위절대오차지유좌우방향(x축)A조대우B조,분별위(2.46±1.79)、(1.91±1.71) mm(P =0.036).파위상대오차지유상하방향(y축)A조소우B조,분별위(0.09±3.90)、(1.91±4.12) mm (P=0.003).삼유시량파위오차A、B조상근(P=0.751).방료중매주절대파위오차화삼유시량파위오차A、B조균상근(P＞0.05).결론 량충체위대식관암분차방료적파위오차각유우렬,단균재가공범위내.가근거림상실제선용합괄적치료체위.
Objective To compare the effect of set-up errors to two different body positions that are putting arms on the side of the body (A group) or placing arms folded across the elbow on forehead (B group) in esophageal cancer' fraction radiotherapy.Methods By using case-control study,all supine patients were divided into the A group and the B group.After patients were fixed by thermoplastic membrane,they were located by spiral CT and treated by using IGRT.During treatmwnt,there were three cone-beam CT scans in the first week and then at least one scan weekly.We obtained the linear set-up errors data by using bone registration with manual proofreading in 3 directions that were left and right (x),head and feet (y),abdomen and back (z) by using CBCT.Means were compared by using independent sample t-test,and ratios were compared by chi-square test.Results Every group had 11 cases that the A group had 92 people times and the B group had 87 people times.Absolute set-up errors of two different positions:only x-axis,the mean of the A group was (2.46 ± 1.79) mm.But the mean of the B group was (1.91 ± 1.71)mm,which was significantly less than the A group (P =0.036).Relative set-up errors of two groups:only y-axis,the mean of the B group was (1.91 ± 4.12) mm.The A group was (0.09 ± 3.90) mm,which was significantly less than the B group (P =0.003).There was no significant difference of three-dimensional set-up errors (P=0.751).And there was no significant difference in absolute weekly set-up errors or weekly three-dimensional set-up errors in radiotherapy (P ＞ 0.05).Conclusions The each of two body positions in esophageal cancer' fraction radiotherapy has advantage and disadvantage for set-up errors,but they were in control and didn't affect the radiotherapy planning.We can choose appropriate treatment position according to clinical practice.