| 黎国全,胡斌,朱斌,梁志文,彭振军.射波刀金标追踪治疗中脊柱辅助摆位的临床应用价值[J].中华放射医学与防护杂志,2019,39(6):439-443 |
| 射波刀金标追踪治疗中脊柱辅助摆位的临床应用价值 |
| The auxiliary setup value of fiducial marker tracking with spine during Cyber-knife radiosurgery |
| 投稿时间：2018-07-24 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.06.007 |
| 中文关键词: 射波刀 放射治疗 脊柱摆位 旋转偏差 |
| 英文关键词:Cyber-knife Radiotherapy Auxiliary setup Rotation deviation |
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| 中文摘要: |
| 目的 统计分析射波刀金标追踪和金标呼吸跟踪治疗中<3颗金标结合脊柱辅助摆位与≥3颗金标计算旋转偏差的区别，并阐述脊柱辅助摆位在<3颗金标治疗中的临床应用价值。方法 选取145例采用金标追踪和金标呼吸跟踪的肿瘤患者执行放疗，其中观察组94例（<3颗金标），对照组51例（≥3颗金标）；治疗前对观察组所有病例添加1个脊柱摆位计划，分别统计金标追踪和金标呼吸跟踪在所选脊柱距离下脊柱辅助摆位修正的旋转偏差，分析观察组和对照组计算的旋转偏差结果。结果 金标追踪脊柱辅助摆位结果：金标与所选脊柱中心距离<20、20~40、40~60、60~80和>80 mm旋转统计偏差均值分别为（0.494±0.350）°、（1.291±0.590）°、（1.705±0.739）°、（2.512±0.761）°和（2.796±1.081）°，观察组和对照组旋转总偏差分别为（1.742±0.784）°、（1.805±0.562）°。金标呼吸跟踪结果：在上述情况下旋转统计偏差均值分别为（1.190±0.547）°、（1.956±0.735）°、（2.141±0.670）°、（2.957±0.648）°和（4.027±0.695）°，观察组和对照组旋转总偏差分别为（2.619±0.906）°，（2.233±0.763）°。金标追踪与金标呼吸跟踪的脊柱辅助摆位与金标计算的旋转偏差结果差异均无统计学意义（P>0.05）。结论 金标追踪治疗中，脊柱辅助摆位修正旋转偏差范围随金标与所选脊柱中心距离增加而增大，当金标与所选脊柱距离<60 mm时可以认为脊柱辅助摆位计算的旋转偏差与金标计算的旋转偏差具有同等的肿瘤旋转校正效果；当可使用的金标<3颗且金标与邻近脊柱中心最小距离较近时（<60 mm），可以采用添加脊柱辅助摆位计划计算肿瘤旋转方向的偏差。 |
| 英文摘要: |
| Objective To explore the clinical value of an auxiliary set-up method with fiducial markers and Synchrony tracking implanted in spine during Cyber-knife stereotactic radiotherapy by comparing the rotational setup errors between auxiliary setup with less than and more than three fiducial markers. Methods A total of 145 cases of tumor patients with fiducial tracking and Synchrony tracking were selected for radiotherapy, including 94 cases in the observation group (<3 fiducial markers) and 51 cases in the control group (≥ 3 fiducial markers).Before treatment, one spinal alignment plan was added to all the cases in the observation group, and the rotation deviation of the selected spinal distance and the assisted spinal alignment correction of the fiducial marker tracking and the fiducial marker respiratory tracking were counted respectively, and the result of the rotation deviation calculated in the observation group and the control group were analyzed. Results Fiducial tracking spine auxiliary setup result:fiducial marks and selected the spine center distance < 20, 20-40, 40-60, 60-80 and > 80 mm rotating statistical average deviation (0.494±0.350)°, (1.291±0.590)°, (1.705±0.739)°, (2.512±0.761)° and (2.796±1.081)°, respectively, rotate observation group and control group total deviation (1.742±0.784)°, (1.805±0.562)°, respectively.Synchrony tracking result in the above case rotation statistical average deviation was (1.190±0.547)°, (1.956±0.735)°, (2.141±0.670)°, (2.957±0.648)° and (4.027±0.695)°, respectively, while rotation total deviation in observation group and control group (2.619±0.906)°, (2.233±0.763)°,respectively.There was no significant difference in the rotation deviation between the assisted spinal set-fup and the calculation of rotation deviation between the fiducial tracking and the synchrony tracking (P>0.05). Conclusions In the fiducial tracking treatment, the range of rotation deviation for the spinal auxiliary set-up correction increases with the increase of the distance between the fiducial markers and the selected spinal center. When the distance between the fiducial marker and the selected spinal is less than 60 mm, the rotation deviation calculated by the spinal auxiliary setup has the same tumor rotation correction effect as that calculated by the fiducial markers.When less than 3 fiducial markers are available and the minimum distance between the fiducial marks and the center of the adjacent spine is relatively close (< 60 mm), the deviation of the rotation direction of the tumor can be calculated by adding the spinal auxiliary setup plan. |
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