肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2015年
3期
179-182
,共4页
彭逊%甘勇%林珠%林正忠%林浩%陈泽伟
彭遜%甘勇%林珠%林正忠%林浩%陳澤偉
팽손%감용%림주%림정충%림호%진택위
图像引导放疗%子宫颈肿瘤%体位固定%摆位误差
圖像引導放療%子宮頸腫瘤%體位固定%襬位誤差
도상인도방료%자궁경종류%체위고정%파위오차
Image-guided radiotherapy%Cervical cancer%Fixed position%Setup errors
目的 利用TrueBeam直线加速器图像引导放疗技术(CBCT)校验腘窝固定法减少子宫颈癌摆位误差的价值,寻找适合术后精确放疗的体位固定方式.方法 30例子宫颈癌术后患者随机分成两组,A组采用梯形固定器腘窝固定,B组采用传统真空垫体部固定,通过CBCT记录轴向摆位误差及旋转误差数值,采用Stroom扩边公式计算两种固定方式计划靶区(PTV)外扩值,比较不同固定法摆位误差及稳定性,比较危及正常器官照射体积差异.结果 A、B组X轴向误差分别为(0.19±0.14)cm、(0.24±0.19)cm(P=0.03),Y轴向分别为(0.17±0.12)cm、(0.25±0.21)cm(P=O.02),Z轴向分别为(0.13±0.11)cm、(0.22±0.18)cm(P=0.01),旋转误差分别为(0.05±0.02)°、(0.5±0.21)°(P=0.00),A、B两组在X轴向PFV外扩值分别为0.56、0.73 cm,Y轴向分别为0.51、0.78 cm,Z轴向分别为0.40、0.67 cm,PTV体积分别为(1 167±271)mm3、(1 379±297)mm3,A、B组骨盆、小肠、膀胱、直肠照射体积分别为(84± 12)mm3比(130±17)mm3、(81±51)mm3比(117 ±64)mm3、(62±40) mm3比(75±47) mm3、(21±16)mm3比(31 ±21)mm3.结论 腘窝固定法可减少子宫颈癌术后外照射放疗摆位误差,提高稳定性,减少危及正常器官的照射体积,更适合精确放疗的应用.
目的 利用TrueBeam直線加速器圖像引導放療技術(CBCT)校驗腘窩固定法減少子宮頸癌襬位誤差的價值,尋找適閤術後精確放療的體位固定方式.方法 30例子宮頸癌術後患者隨機分成兩組,A組採用梯形固定器腘窩固定,B組採用傳統真空墊體部固定,通過CBCT記錄軸嚮襬位誤差及鏇轉誤差數值,採用Stroom擴邊公式計算兩種固定方式計劃靶區(PTV)外擴值,比較不同固定法襬位誤差及穩定性,比較危及正常器官照射體積差異.結果 A、B組X軸嚮誤差分彆為(0.19±0.14)cm、(0.24±0.19)cm(P=0.03),Y軸嚮分彆為(0.17±0.12)cm、(0.25±0.21)cm(P=O.02),Z軸嚮分彆為(0.13±0.11)cm、(0.22±0.18)cm(P=0.01),鏇轉誤差分彆為(0.05±0.02)°、(0.5±0.21)°(P=0.00),A、B兩組在X軸嚮PFV外擴值分彆為0.56、0.73 cm,Y軸嚮分彆為0.51、0.78 cm,Z軸嚮分彆為0.40、0.67 cm,PTV體積分彆為(1 167±271)mm3、(1 379±297)mm3,A、B組骨盆、小腸、膀胱、直腸照射體積分彆為(84± 12)mm3比(130±17)mm3、(81±51)mm3比(117 ±64)mm3、(62±40) mm3比(75±47) mm3、(21±16)mm3比(31 ±21)mm3.結論 腘窩固定法可減少子宮頸癌術後外照射放療襬位誤差,提高穩定性,減少危及正常器官的照射體積,更適閤精確放療的應用.
목적 이용TrueBeam직선가속기도상인도방료기술(CBCT)교험객와고정법감소자궁경암파위오차적개치,심조괄합술후정학방료적체위고정방식.방법 30례자궁경암술후환자수궤분성량조,A조채용제형고정기객와고정,B조채용전통진공점체부고정,통과CBCT기록축향파위오차급선전오차수치,채용Stroom확변공식계산량충고정방식계화파구(PTV)외확치,비교불동고정법파위오차급은정성,비교위급정상기관조사체적차이.결과 A、B조X축향오차분별위(0.19±0.14)cm、(0.24±0.19)cm(P=0.03),Y축향분별위(0.17±0.12)cm、(0.25±0.21)cm(P=O.02),Z축향분별위(0.13±0.11)cm、(0.22±0.18)cm(P=0.01),선전오차분별위(0.05±0.02)°、(0.5±0.21)°(P=0.00),A、B량조재X축향PFV외확치분별위0.56、0.73 cm,Y축향분별위0.51、0.78 cm,Z축향분별위0.40、0.67 cm,PTV체적분별위(1 167±271)mm3、(1 379±297)mm3,A、B조골분、소장、방광、직장조사체적분별위(84± 12)mm3비(130±17)mm3、(81±51)mm3비(117 ±64)mm3、(62±40) mm3비(75±47) mm3、(21±16)mm3비(31 ±21)mm3.결론 객와고정법가감소자궁경암술후외조사방료파위오차,제고은정성,감소위급정상기관적조사체적,경괄합정학방료적응용.
Objective To evaluate the effect of popliteal fossa fixed method to reduce the setup errors in patients with postoperative cervical carcinoma by CBCT of TrueBeam Linear accelerator.Methods 30 cases of postoperative cervical cancer patients were randomly divided into two groups,group A with popliteal fossa fixed method by trapezoidal fixation,group B with traditional vacuum pad fixation.CBCT was used to record both setup errors and rotational errors,Stroom extension formula was used to calculate the PTV expansion value coming from the two different fixation methods.Results There was significant difference in setup errors between group A and group B.The setup errors in the left-right direction (X),cranial-caudal direction (Y) and anterior-posterior direction (Z) were (0.19±0.14) cm,(0.17±0.12) cm and (0.13±0.11) cm in group A,respectively.On the contrary,the setup errors in X,Y and Z were (0.24±0.19) cm,(0.25±0.21) cm and (0.22±0.18) cm in group B,respectively.The rotational errors were 0.05°±0.02° in group A,comparing with 0.5°±0.21° in group B (P =0.00).The PTV expanded margin in group A was 0.56 cm in X direction,0.51 cm in Y direction,0.40 cm in Z direction,in comparing with 0.73 cm,0.78 cm and 0.67 cm in group B,respectively.Group A remarkably reduced the PTV,pelvis,small intestine,bladder and rectum irradiated volumes [(1 167±271) mm3 vs (1 379±297) mm3,(84±12) mm3 vs (130±17) mm3,(81±51) mm3 vs (117±64)mm3,(62±40) mm3 vs (75±47) mm3,(21±16) mm3 vs (31±21) mm3].Conclusion Popliteal fossa fixed method can reduce setup errors and improve the stability of positioning,more suitable in precise radiotherapy for postoperative cervical cancer patients,which has the value of further validation.
