| 夏校春,宁丽华,严森祥.乳腺癌放疗中两种不同摆位方式的剂量分布及摆位误差比较[J].中华放射医学与防护杂志,2018,38(9):675-679 |
| 乳腺癌放疗中两种不同摆位方式的剂量分布及摆位误差比较 |
| Companison of dose distribution and setup error of two different positions and immobilization techniques in breast cancer radiotherapy |
| 投稿时间：2018-04-27 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.09.007 |
| 中文关键词: 乳腺癌 放射治疗 固定方式 剂量 摆位误差 |
| 英文关键词:Breast cancer Radiotherapy Position and immobilization Dosimetric Setup error |
| 基金项目: |
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| 中文摘要: |
| 目的 比较研究乳腺癌放射治疗成角度胸前板（ABB）和平板胸前板（PBB）两种摆位方法治疗计划的剂量学参数及摆位误差。方法 选取2017年3月至2018年1月在浙江大学医学院附属第一医院就诊的20例左侧乳腺癌术后患者病例资料，按不同摆位方法分ABB组和PBB组，每组10例，在定位扫描的CT图像上勾画靶区、心脏和肺等结构。计划设计采用切线野中野（FIF）技术，比较两种摆位方法治疗计划的计划靶区体积（PTV）、肺、心脏的剂量学参数及摆位误差。结果 两种摆位方式治疗计划在肿瘤靶区覆盖方面差异无统计学意义（P>0.05）。患侧肺V20 ABB组和PBB组分别为（11.2±3.2）%和（15.9±5.3）%，两组比较差异有统计学意义（t=-2，47，P<0.05），V30 ABB组和PBB组分别为（9.8±1.5）%和（12.9±2.2）%，两组比较差异有统计学意义（t=-4.46，P<0.05）。心脏剂量V25 ABB组和PBB组分别为（1.9±0.2）%和（2.8±0.4）%，两组比较差异有统计学意义（t=-8.28，P<0.05），V30 ABB组和PBB组分别为（1.8±0.1）%和（2.7±0.3）%，两组比较差异有统计学意义（t=-8.34，P<0.05），心脏平均剂量Dmean ABB组和PBB组分别为（3.0±0.5）和（5.3±1.2）Gy，两组比较差异有统计学意义（t=5.58，P<0.05）。ABB摆位在左右（LR）、上下（SI）、前后（AP）的平移误差分别为（3.23±2.63）、（5.42±3.22）、（4.58±2.30）mm，在θ、Φ、ψ方向的旋转误差分别为（1.60±0.56）°、（3.40±1.65）°、（2.50±1.72）°。PBB摆位误差在LR、SI、AP的平移误差分别为（2.35±1.22）、（2.17±1.29）、（2.27±1.58）mm，在θ、Φ、ψ方向的旋转误差分别为（1.37±0.43）°、（1.79±0.71）°、（2.06±0.63）°，且进出SI、前后AP、侧翻Φ误差，两组比较差异均有统计学意义（t=3.06，2.80，3.33，P<0.05）。结论 两种摆位方式治疗计划在肿瘤靶区覆盖方面差异无统计学意义，ABB摆位方式对正常组织的保护效果优于PBB摆位方式。但摆位精度PBB比ABB摆位方式更具优势。 |
| 英文摘要: |
| Objective To compare the dose distribution and setup error of angled breast board position (ABB) with plain breast board position (PBB) in breast cancer radiotherapy. Methods Twenty consecutive postoperative left breast cancer patients in the First Affiliated Hospital, Zhejiang University were enrolled from March 2017 to January 2018. All cases were assigned into the ABB and PBB groups according to positions and there were 10 cases in each groups respectively. The target volume, heart and lung structures were defined on the CT images of the localized scan. The plan was designed using the field in field (FIF) technique to compare the dosimetric parameters of the PTV, lung, and heart treatments, and the setup errors for the two different positions. Results The ipsilateral lung V20[ABB:(11.2±3.2)%, PBB:(15.9±5.3)%, t=-2.47,P< 0.05], and V30[ABB:(9.8±1.5)%, PBB:(12.9±2.2)%, t=-4.46,P<0.05] were both statistically significant for the two different position and immobilization. Heart dose V25[ABB:(1.9±0.2)%, PBB:(2.8±0.4)%, t=-8.28, P<0.05], V30[ABB:(1.8±0.1)%, PBB:(2.7±0.3)%, t=-8.34,P< 0.05], and Dmean of heart[ABB:(3.0±0.5)Gy, PBB:(5.3±1.2)Gy, t=5.58,P<0.05] were all statistically significant for the two different positions. The translational errors of ABB and PBB on LR, SI, and AP were (3.23±2.63), (5.42±3.22), (4.58±2.30) mm, and (2.35±1.22), (2.17±1.29), (2.27±1.58) mm, respectively. The rotation errors of pitch(θ), yaw(Φ) and roll(ψ) for ABB and PBB were (1.60±0.56)°, (3.40±1.65)°, (2.50±1.72)°, and (1.37±0.43)°, (1.79±0.71)°, (2.06±0.63)°, respectively. Meanwhile, the in-and out-SI, anterior and posterior AP, yaw rotation error(Φ) were also statistically significant(t=3.06, 2.80, 3.33,P<0.05). Conclusions There is no statistically significant difference in the tumor target between the two position and immobilization techniques. However, the ABB is better than the PBB in normal tissue sparing while the setup accuracy of PBB is better than the ABB. |
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