摘要
目的探讨自粘性组织等效膜在乳腺癌放射治疗中的临床应用价值。方法选择2019年4月1日~9月31日华中科技大学同济医学院附属同济医院经病理证实为乳腺癌的11例根治术后放疗患者,行个体化发泡胶体位固定垫固定,胸壁粘贴自粘性组织等效膜,再辅以颈肩胸一体化热塑网膜固定,采集CT定位影像,进行放射治疗计划设计,在图像中测量靶区范围内自粘性组织等效物与皮肤之间的间隙和相应点的皮肤剂量,测量肺组织剂量体积V_(20)和V_(5);利用直线加速器机载CBCT(锥形束CT)行靶区位置验证,前3验证结果与后续每周1次的验证结果进行比较,并在XVI(X线容积影像)系统中测量靶区范围内自粘性组织等效物与皮肤之间的间隙,与定位计划影像中的相应点的皮肤与补偿物之间的间隙比较,实施调强放射治疗。结果在靶区范围内,76.77%自粘性组织等效膜与皮肤间的间隙为0,其余部分间隙在0.2 cm以内,皮肤剂量在中内点(4970.00±213.92)cGy最小,下中点(4988.18±74.41)cGy最大;肺组织V_(20)为(27.34±1.80)%,V_(5)为(56.46±3.16)%。CBCT验证后靶区范围内自粘性组织等效膜与皮肤之间的间隙与定位计划影像中的相应点的皮肤与补偿物之间的间隙比较,差异无统计学意义(P>0.05);治疗前3次CBCT位置验证线性误差最小在X轴(0.02±0.27)cm,最大在Y轴(0.08±0.24)cm,旋转误差最小在Y轴(0.09±0.84)°,最大在X轴(0.36±0.93)°,前3次CBCT验证与后续的CBCT验证相应维度比较,差异无统计学意义(P>0.05)。结论乳腺癌根治术后调强放疗使用自粘性组织等效膜,组织等效膜与皮肤之间的间隙小且重复性良好,靶区剂量分布均匀、肺组织剂量体积较低,治疗前CBCT位置验证误差较小且稳定。
Objective To explore the clinical application value of self-adhesive tissue equivalent membrane in breast cancer radiotherapy.Methods From April 1st to September 31st,2019,11 patients with breast cancer confirmed by pathology from Tongji Hospital of Tongji Medical College of HUST were selected for postoperative radiotherapy with individualized styrofoam positioning pads and chest wall sticking.Self-adhesive tissue equivalent membrane,supplemented by the integration of neck,shoulder and thoracic thermoplastic omentum for fixation,acquire CT positioning images,carry out radiotherapy plan design,measure the gap between the self-adhesive tissue equivalent and the skin in the target area and the skin dose at the corresponding point in the image,and measure the lung tissue dose volume V_(20) and V_(5);Use linear accelerator airborne CBCT(cone beam CT)to verify the target location.The first 3 verification results were compared with the subsequent verification results once a week.In the XVI(X-ray volume imaging)system,the gap between the self-adhesive tissue equivalent and the skin in the target area was measured,and the gap between the skin and the compensation at the corresponding point in the positioning plan image was compared,and the adjustment was implemented.Intensive radiation therapy.Results Within the target area,the gap between the 76.77%self-adhesive tissue equivalent membrane and the skin was 0,and the remaining gap was within 0.2 cm.The skin dose was the smallest at the midpoint(4970.00±213.92)cGy,and the lower midpoint(4988.18±74.41)cGy was the largest;lung tissue V_(20) was(27.34±1.80)%,V_(5) was(56.46±3.16)%.After CBCT verification,the gap between the self-adhesive tissue equivalent membrane and the skin in the target area was compared with the gap between the skin and the compensation at the corresponding point in the positioning plan image,the difference was not statistically significant(P>0.05);The linear error of 3 CBCT position verification before treatment is the smallest on the X axis(0.02±0.
作者
郑仁超
郑祖安
刘琪
曹婷婷
肖志平
宋绪苗
ZHENG Ren-chao;ZHENG Zu-an;LIU Qi;CAO Ting-ting;XIAO Zhi-ping;SONG Xu-miao(Department of Oncology,Tongji Hospital,Tongji Medical College of HUST,Wuhan 430030,Hubei,China)
出处
《医学信息》
2021年第4期110-114,共5页
Journal of Medical Information
关键词
乳腺癌
调强放疗
自粘性组织等效膜
间隙
Breast cancer
Intensity-modulated radiotherapy
Self-adhesive tissue equivalent membrane
Gap
