摘要
目的研究乳腺癌两种不同固定技术对调强放疗精确度的影响。方法收集本院80例施行VMAT技术放疗乳腺癌病例。40例使用个体化真空固定垫及形状记忆热塑网膜固定技术设为A组;其余40例则使用个体化真空垫及体表标线固定技术设为B组。A、B组首次放疗前均进行CBCT扫描,并记录A、B两组首次线性、旋转摆位误差,当线性误差大于5 mm,旋转误差大于20时进行校正后治疗,记录并分析其通过率。结果 1A组X、Y、Z、Rx、Ry、Rz轴方向上首次摆位误差为:(2.18±1.78)mm、(3.01±3.10)mm、(2.64±3.53)mm、(1.07±0.88)0、(1.17±0.88)0、(0.71±0.65)0;B组X、Y、Z、Rx、Ry、Rz轴方向上首次摆位误差为:(4.00±3.32)mm、(3.67±2.77)mm、(4.3±3.4)mm、(1.37±1.19)0、(0.82±0.83)0、(0.79±0.65)0,A组X、Z轴的线性摆位误差高于B组,具有统计学意义(P<0.05);2A、B两组X、Y、Z轴方向线性摆位误差≤3 mm的通过率分别为:30(75%)、26(65%)、29(72.5%);18(45%)、21(52.0%)、16(40%);A、B两组Rx、Ry、Rz方向上旋转摆位误差≤20的通过率分别为:35(85%)、33(82.5%)、38(95%);26(65.5%)、36(90%)、36(90%)。A组X、Z、Rx方向的摆位误差通过率高于B组,有显著性统计学意义(P<0.05)。3A、B两组X、Y、Z轴方向线性摆位误差≥5 mm的通过率分别为:37(92.5%)、30(75%)、37(92.5%);29(72.5%)、28(70%)、22(55%)。A、B两组Rx、Ry、Rz方向上旋转摆位误差≥30的通过率分别为:38(95%)、38(95%)、40(100%);36(90%)、39(97.5%)、40(100%)。A组X、Z方向的摆位误差通过率高于B组,有显著性统计学意义(P<0.05)。大于30的旋转误差各轴位上均无显著性差异(P>0.05)。在使用形状记忆热塑网膜时Z、Y、Z轴CTV-PTV外放间距分别为:6.70 mm、9.70 mm、9.07 mm;不使用形状记忆热塑网膜时Z、Y、Z轴CTV-PTV外放间距增加到:12.32 mm、11.11 mm、13.13 mm。结论乳腺癌调强放疗使用个体化真空固定垫及形状记忆热塑网膜固定技术能显著减少摆位误差,�
Objective Study the influence of two different immobilization techniques on set-up errors by CBCT in IMRT for breast cancer. Methods Eighty patients with breast cancer were included in this study and separated into A group and B group. Patients in A group were immobilized with vacuum bag and thermoplastic mask. B group were immobilized with vacuum bag only. CBCT scan and auto- match online were regularly performed before the treatment,acquired the set- up errors in x,y,z,u,v,w axis,then adjust the PTV center when the translation errors greater than 5mm and the rotation errors greater than 2o,at last,analyze the pass rate of the two groups.Results The translation errors and the rotation errors in x-,y-,z-axis of the A group were（ 2.18±1.78） mm,（ 3.01±3.10） mm,（ 2.64±3.53） mm,（ 1.07±0.88） 0,（ 1.17±0.88） 0,（ 0.71±0.65） 0respectively. The translation errors and the rotation errors in x-,y-,z-axis of the B group were（ 4. 00 ± 3. 32）mm,（ 3.67±2.77） mm,（ 4.3± 3.4） mm,（ 1.37± 1.19） 0,（ 0.82± 0.83） 0,（ 0. 79 ± 0. 65） 0 respectively. There were statistically significant in set up error between the two groups on the X and Z axis（ P〈0.05）. The pass rate of the translation errors on the x- / y- / z- axis,which is equal or lesser than 3mm of the two groups were 30（ 75%）,26（ 65%）,29（ 72.5%）,18（ 45%）,21（ 52.0%） and 16（ 40%）. The pass rate of the rotation errors on the Rx / Ry / Rz- axis,which is equal or lesser than 2 degree were 35（ 85%）,33（ 82. 5%）,38（ 95%）,26（ 65.5%）,36（ 90%） and 36（ 90%） respectively. There were statistically significance between the two groups on X / Z / Rx axis（ P〈0.05）. The pass rate of the translation errors on the x- / y- / z-axis,which is equal or greater than 5mm of the two groups were37（ 92.5%）,30（ 75%）,37（ 92.5%）,29（ 72.5%）,28（ 70%） and 22（ 55%）.The pass rate of the rotation errors on the Rx / Ry / Rz- axis which is equal or greater than 3 degree were 38（
出处
《齐齐哈尔医学院学报》
2016年第23期2883-2885,共3页
Journal of Qiqihar Medical University
基金
国家临床重点专科建设项目(2013-2014)
福建省临床重点专科建设项目(2012)
