| 刘美月,刘建平,胡万宁,等.联合体位固定技术在肺癌放射治疗中的应用研究[J].中华放射医学与防护杂志,2018,38(11):830-835.Liu Meiyue,Liu Jianping,Hu Wanning,et al.Application of combined body position fixation in radiation therapy of lung cancer[J].Chin J Radiol Med Prot,2018,38(11):830-835 |
| 联合体位固定技术在肺癌放射治疗中的应用研究 |
| Application of combined body position fixation in radiation therapy of lung cancer |
| 投稿时间：2018-06-15 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.11.006 |
| 中文关键词: 肺癌 发泡胶 热塑膜 摆位误差 靶区体积 |
| 英文关键词:Lung cancer Polystyrene foam Thermoplastic film Set-up error Target volume |
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| 中文摘要: |
| 目的 对比分析采用联合体位固定与热塑膜固定的肺癌患者放疗时的摆位误差，探讨不同固定方式下临床靶体积（CTV）至计划靶体积（PTV）外扩边界及其对正常肺组织受照剂量的影响。方法 回顾性选取2016年10月至2018年3月在唐山市人民医院接受过胸部放射治疗的90例患者资料，按不同固定方式将患者分成联合体位组（热塑膜+发泡胶固定）50例，热塑膜组（热塑膜固定）40例。两组患者根据统一标准勾画靶区，1次/周锥形CT（CBCT）与计划CT图像匹配后分别记录左右、上下、前后（x、y、z轴）方向摆位误差，通过t检验进行分析。根据MPTV=2.5∑+0.7δ计算联合体位组患者CTV至PTV外扩边界。通过治疗计划系统（TPS）系统分别计算两组患者的双肺V5、V20、V30，并进行对比分析。结果 联合体位组与热塑膜组摆位误差在x轴分别为（1.00±0.58）和（3.28±0.43）mm、y轴分别为（1.42±0.28）和（4.03±0.41）mm、z轴分别为（1.06±0.44）和（3.18±0.34）mm，两组患者x、y、z 轴上的摆位误差比较，差异均有统计学意义（t=-20.740、-35.596、-25.015，P<0.05）。联合体位固定技术在中央型与周围型肺癌患者及在左、右肺癌患者摆位误差比较，差异均无统计学意义（P>0.05）。通过MPTV=2.5∑+0.7δ得出联合体位组患者CTV至PTV外扩边界在x、y、z轴分别为2.906、3.746 和2.958 mm。A、B两组对比得出，B组中V5、V20、V30均值分别较A组减小1.5%、3.1%、4.8%。结论 联合体位固定技术可提高肺部肿瘤患者放射治疗体位固定的精确性，将CTV至PTV外扩边界进一步缩小，对减小放射性肺炎的发生具有一定价值。 |
| 英文摘要: |
| Objective To explore the CTV to PTV external expansion boundary and the effect of the dose of normal lung tissue under different fixed modes by a comparative analysis of combined body position and thermoplastic film fixed set-up error of radiation therapy for lung cancer. Methods From October 2016 to March 2018, the patients who received chest radiology at the Tangshan people's hospital were enrolled as subjects retrospectively divided into two groups, including 50 patients with lung cancer radiotherapy with combined body position fixation, and 40 patients with lung cancer with thermoplastic film fixation. The two groups of patients drew the target areas in accordance with the unified standard, and the set-up error of left and right, up and down, front and rear (x, y, z axis) were recorded respectively after 1 time/week cone CT(CBCT) matched with the planned CT image and analyzed by ttest. According to the MPTV=2.5Σ+0.7δ, CTV to PTV external expansion boundary in the combined body position group were calculated. And the V5、V20 and V30 of two groups of patients were calculated and analyzed by TPS system. Results The set-up error of the combined body position group and thermoplastic film group were respectively (1.00±0.58) mm and (3.28±0.43) mm on the x axis, (1.42±0.28) mm on the y axis and (4.03±0.41) mm, (1.06±0.44) mm and (3.18±0.34) mm on the z axis. The set-up errors of the two groups were statistically significant on x, y and z axis(t=-20.740, -35.596, -25.015,P<0.05). There was no significant difference in set-up errors between the central and peripheral lung cancer patients and between left and right lung cancer patients(P>0.05).Through the MPTV=2.5Σ+0.7δ, CTV to PTV external expansion boundary in the combined body position fixation group was 2.906, 3.746 and 2.958 mm on x, y and z axis respectively. The comparison between group A and B showed that the mean values of V5, V20 and V30 in group B were reduced by 1.5%, 3.1% and 4.8% respectively compared with group A. Conclusions The combined body position technique can improve the accuracy of lung cancer patients after radiation therapy,and further reduce the boundary of CTV to PTV, which is of certain value to reduce the occurrence of radiation pneumonitis. |
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