摘要
目的在使用多功能体板结合热塑膜固定腹盆部放疗患者时,比较两种体表标记勾画方式对患者体位固定稳定性的影响。方法选取2022年8月至2023年1月上海交通大学医学院附属同仁医院采用多功能体板结合热塑膜进行体位固定的患者50例,按照体位标记勾画方式分为A、B两组,每组各25例。A组为热塑膜制作完成后,在热塑膜上边缘进行体表标记勾画;B组为热塑膜制作完成后,取下热塑膜,使用等中心激光线在患者体表的投影进行三组体表标记勾画。以腰3~5为主要配准对象进行手工配准,使用治疗前CBCT图像分析两组患者的首次摆位通过率、在x、y、z轴3个方向的摆位误差及摆位误差的正负方向分布。结果 A、B组患者的首次摆位通过率分别为76.9%、86.1%,两组均满足临床要求,且B组优于A组,两组比较差异有统计学意义(P<0.05)。B组在x和y轴方向的摆位误差均小于A组(均P<0.05);两组在z轴方向摆位误差的差异比较均无统计学意义(均P>0.05)。两组的摆位误差在x与z轴正负方向分布频率的差异比较均无统计学意义(均P>0.05);两组的摆位误差在y轴正负方向分布频率的差异比较有统计学意义(P<0.05)。结论两种体表标记勾画方式都符合临床上对腹盆部患者常规分割放疗的摆位要求,使用等中心激光线在患者体表投影进行三组体表标记勾画产生的摆位误差更小,优于使用热塑膜上边缘进行体表标记勾画的方式,能提高腹盆部患者的体位固定稳定性。
Objective To compare the effects of two methods of marking surface landmarks on the patient’s positional stability when using a multifunctional body board in combination with thermoplastics to fix the abdominal and pelvic areas for radiotherapy patients.Methods 50 subjects who underwent positional fixation using a multifunctional body board in combination with thermoplastics from August 2022 to January 2023.The subjects were divided into two groups,A and B,with 25 cases each,according to the different methods of body surface marking.In group A,landmarks were marked on the body surface on the top edge of the thermoplastics.In group B,three sets of surface landmarks were marked on the patient’s body according to the laser line on the projection of the patient’s body surface when the thermoplastics were completed.Manual registration is performed using L3 to L5 as the main registration targets.The pre-treatment CBCT image is used to analyze the first-time positioning pass rate,setup errors in the x-,y-,and z-axis directions,and the distribution of positive and negative setup errors in both groups of patients.Results The pass rates of the first-time positioning of patients in Groups A and B were 76.9%and 86.1%,respectively,which met the clinical requirements.Group B had a better first-time positioning pass rate than group A,and the difference between the two groups was statistically significant(P<0.05).The pendulum errors of group B were smaller than those of group A in both the x-axis and y-axis(all P<0.05),and the difference between the two groups in terms of the pendulum errors in the z-axis direction was not statistically significant(all P>0.05).The difference in the frequency distribution of the pendulum error in the positive and negative directions of the x-and z-axis between the two groups was not statistically significant(all P>0.05).The difference in the frequency of distribution of the pendulum error in the positive and negative directions of the y-axis between the two groups was statistically significant(P<0.05).Conclusions The proposed two methods of surface landmark marking are generally in line with the positioning requirements for conventional fractionation radiotherapy for abdominal and pelvic patients.Using a laser line on the projection of the patient’s body surface for three sets of surface landmark markings produces smaller setup errors and is better than using the top edge of the thermoplastics for surface landmark markings,improving the positional stability of abdominal and pelvic patients.
作者
林海涛
朱虹
刘富博
张新磊
孙航标
贺旭伟
李凤
胡群超
Lin Haitao;Zhu Hong;Liu Fubo;Zhang Xinlei;Sun Hangbiao;He Xuwei;Li Feng;Hu Qunchao(Department of Radiotherapy,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200050,China;Department of Oncology,Chengdu Seventh People’s Hospital,Chengdu 610044,China)
出处
《国际生物医学工程杂志》
CAS
2023年第4期342-347,共6页
International Journal of Biomedical Engineering
基金
国家自然科学基金青年项目(82102815)。
关键词
放射治疗
腹部肿瘤
体位固定
摆位误差
Radiotherapy
Abdominal tumors
Positional fixation
Setup error
