摘要
目的 探讨负压真空袋固定全上肢在乳腺癌保乳术后调强放射治疗(IMRT)中的体位精度及重复性价值。方法 回顾性分析2020年10月至2022年5月乳腺癌保乳术后调强放疗患者34例,随机均分为试验组和对照组。试验组采用80 cm×120 cm真空袋全上肢塑型固定;对照组采用70 cm×100 cm真空袋上肢部分塑型固定,双手交叉置于额前。治疗前后分别获取左右(X)、头脚(Y)、腹背(Z)三维方向分次间、分次内的摆位误差(ΔP1、ΔP2);由ΔP1计算临床靶体积(CTV)至计划靶体积(PTV)三维方向的外放范围。计算当次治疗前后三维方向体表线偏移值ΔP3。两组ΔP1、ΔP2、ΔP3在同一方向上的摆位误差采用配对样本t检验;ΔP1与ΔP3在组内的相关性采用Pearson相关性分析。结果 试验组和对照组在X、Y、Z三维方向上的ΔP1进行比较,差异无统计学意义(P>0.05);试验组和对照组在X、Y、Z三维方向上的PTV外扩值分别为4.97 mm、6.31 mm、5.38 mm和8.24 mm、9.96 mm、7.52 mm,差异有统计学意义(P=0.02)。试验组和对照组在Z方向的ΔP2分别为(0.29±1.02)mm、(-0.09±1.49)mm,ΔP3分别为(-0.63±0.95)mm、(-1.05±1.35)mm,两组差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,两组ΔP1与ΔP3在Z方向均存在相关性(r=0.450,P<0.05;r=0.630,P<0.05)。结论 真空袋固定全上肢可提高乳腺癌保乳术后全乳IMRT中的体位精度及重复性,可能有一定的临床参考及推广价值。
Objective To investigate the values of the position accuracy and repeatability of the whole upper limb fixed by negative pressure vacuum bag in intensity modulated radiotherapy(IMRT)after breast-conserving surgery.Methods A total of 34 patients with breast cancer treated with radiotherapy after breast-conserving surgery from October 2020 to May 2022 were randomly divided into experimental group and control group.The whole upper limb was fixed with the vacuum bags of 80 cm×120 cm in experimental group.The part upper limb was fixed with the vacuum bags of 70 cm×100 cm in control group,and the hands crossed in front of the forehead.Before and after treatment,the inter-fraction and intra-fraction setup errors(ΔP1 andΔP2)in the left and right(X),head and feet(Y),ventral and dorsal(Z)three-dimensional directions were obtained.Three-dimensional directions external ranges from the clinical target volume(CTV)to the planning target volume(PTV)were calculated by theΔP1.The body surface lines shifts of the three-dimensional directions before and after treatment(ΔP3)were calculated.The paired sample t-tests were performed for the same dirction set-up errors ofΔP1,ΔP2 andΔP3 in the experimental and control group,respectively.The Pearson correlation analysis was performed for theΔP1 andΔP3 of the same dirction errors.Results There were no significance differences in the three-dimensional directions ofΔP1 between experimental group and control group(P>0.05).The PTV expansion values in the X,Y,and Z directions of the experimental and control groups were 4.97 mm,6.31 mm,5.38 mm,and 8.24 mm,9.96 mm,7.52 mm,respectively,with statistically significant differences(P=0.02).TheΔP2 of Z direction in the experimental and control groups was(0.29±1.02)mm and(-0.09±1.49)mm,respectively,and theΔP3 values were(-0.63±0.95)mm and(-1.05±1.35)mm,respectively,with statistically significant differences between the two groups(P<0.05).There was an correlation betweenΔP1 andΔP3 in the Z direction of experimental and control groups(r
作者
李清山
宋伟
符天晓
LI Qingshan;SONG Wei;FU Tianxiao(Department of Tumor Radiotherapy,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)
出处
《临床肿瘤学杂志》
CAS
2024年第2期172-177,共6页
Chinese Clinical Oncology
基金
2020年度省部共建放射医学与辐射防护国家重点实验室开放课题(GZK1202002)
江苏省医学重点学科(ZDXK202235)。
关键词
乳腺癌
调强放射治疗
真空袋
体位固定
摆位误差
Breast cancer
Intensity modulated radiotherapy(IMRT)
Vacuum bag
Body position fixed
Set-up er-rors
