| 王美娇,周舜,刘嘉城,等.基于3D打印手握杆和光学体表引导技术的摆位方法在减少鼻咽癌放疗摆位误差的应用[J].中华放射医学与防护杂志,2026,46(3):280-287.Wang Meijiao,Zhou Shun,Liu Jiacheng,et al.Application of setup methods based on 3D-printed handheld rods and surface-guided radiotherapy in reducing setup errors of nasopharyngeal carcinoma patients[J].Chin J Radiol Med Prot,2026,46(3):280-287 |
| 基于3D打印手握杆和光学体表引导技术的摆位方法在减少鼻咽癌放疗摆位误差的应用 |
| Application of setup methods based on 3D-printed handheld rods and surface-guided radiotherapy in reducing setup errors of nasopharyngeal carcinoma patients |
| 投稿时间：2025-01-14 |
| DOI：10.3760/cma.j.cn112271-20250114-00021 |
| 中文关键词: 3D打印手握杆 光学体表系统 鼻咽癌 放射治疗 感兴趣区 |
| 英文关键词:3D-printed handheld rod Surface-guided radiotherapy (SGRT) Nasopharyngeal carcinoma Radiotherapy Regions of interest (ROIs) |
| 基金项目:北京市自然科学基金(25JL001);国家自然科学基金(12375335);内蒙古自治区自然科学基金(2025MS01001) |
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| 中文摘要: |
| 目的 本研究旨在评估3D打印手握杆和光学体表引导技术(SGRT)在减少鼻咽癌患者摆位误差中的应用价值,特别是对低颈部、胸椎及锁骨等区域的可重复性改善效果。方法 回顾性分析北京大学肿瘤医院60例鼻咽癌患者,分为传统摆位组、3D打印手握杆改进组和联合改进组(手握杆+SGRT)3组,每组20例。比较3种方法在计划靶区体积(PTV)以及多个感兴趣区域(包括7节颈椎C1~C7、第1胸椎T1、枕骨、口腔及双侧锁骨)的摆位误差差异。结果 在3D打印手握杆改进组中,PTV的线性方向摆位误差(升降、头脚、左右)分别为(-0.02±0.05)、(0±0.05)和(0±0.04)cm,旋转方向误差(俯仰角、翻滚角、偏转角)分别为(0.10±0.85)°、(-0.07±1.04)°和(-0.03±0.78)°。联合改进组的线性方向误差分别为(-0.01±0.05)、(-0.01±0.05)和(-0.01±0.05)cm,旋转方向误差分别为(0.02±0.77)°、(-0.12±0.77)°和(0.04±0.49)°。与传统摆位组相比,改进组的线性摆位精度显著提高(F=9.32、19.66、18.84, P<0.05),且在翻滚角和偏转角方向差异具有统计学意义(F=9.52、6.88, P<0.05)。在T1、口腔、左侧和右侧锁骨区域的线性方向上,3D打印手握杆改进组和联合改进组均优于传统摆位组,差异具有统计学意义(F=58.16、11.13、57.08、35.92, P＜0.05);旋转方向在C3、C4、C7、左侧和右侧锁骨区域,联合改进组的摆位误差均优于其他两组,差异具有统计学意义(F=11.13、13.49、6.58、5.47、27.14, P＜0.05)。对于T1区域,3D打印手握杆改进组的摆位误差显著低于其他两组,差异具有统计学意义(F=9.03, P＜0.05)。结论 基于3D打印手握杆改进组和联合改进组,显著降低了鼻咽癌肿瘤摆位误差,为患者提供可靠的临床支持。 |
| 英文摘要: |
| Objective To evaluate the value of 3D-printed handheld rod (3DP-HR) and surface-guided radiotherapy (SGRT) in reducing setup errors of nasopharyngeal carcinoma patients, especially in improving positional reproducibility in the lower neck, thoracic vertebrae, and clavicle. Methods A retrospective analysis was conducted for 60 nasopharyngeal carcinoma patients treated in Beijing Cancer Hospital. These patients were equally divided into three groups, namely the conventional, 3DP-HR-improved, and 3DP-HR+SGRT-improved groups, where patients were treated with conventional setup, improved setup using 3DP-HRs, and improved setup using 3DP-HRs combined with SGRT, respectively. The study compared the setup errors in the planning target volume (PTV) and multiple regions of interest (ROIs) (including seven cervical vertebrae (C1-C7), the first thoracic vertebra (T1), the occipital bone, the oral cavity, and bilateral clavicles) among the three groups. Results Regarding the PTV, the 3DP-HR-improved group exhibited setup errors of (-0.02 ± 0.05), (0 ± 0.05), and (0 ± 0.04) cm in three linear directions, i.e., vertical, longitudinal, and lateral, respectively, and (0.10 ± 0.85)°, (-0.07 ± 1.04)°, and (-0.03 ± 0.78)° in three rotational directions, i.e., pitch, roll, and rotation, respectively. In contrast, the 3DP-HR+SGRT-improved group demonstrated setup errors of (-0.01 ± 0.05), (-0.01 ± 0.05), and (-0.01 ± 0.05) cm in the vertical, longitudinal, and lateral directions, respectively, and (0.02 ± 0.77)°, (-0.12 ± 0.77)°, and (0.04 ± 0.49)° in the pitch, roll, and rotation directions, respectively. Compared to the conventional group, the two improved groups presented significantly enhanced linear setup accuracy (F = 9.32, 19.66, 18.48, P< 0.05), with statistical significance identified in roll and rotation angles (F = 9.52, 6.88, P < 0.05). In terms of ROIs, both the improved groups outperformed the conventional group in linear setup errors in the T1, oral cavity, and bilateral clavicles, with statistically significant intergroup differences (F = 58.16, 11.13, 57.08, 35.92, P < 0.05). The 3DP-HR+SGRT-improved group outperformed the other two groups in the rotational setup errors in C3, C4, C7, and bilateral clavicles, with statistically significant inter-group differences (F = 11.13, 13.49, 6.58, 5.47, 27.14, P < 0.05). Furthermore, the 3DP-HR-improved group exhibited significantly lower setup errors than the other two groups in the setup errors in the T1, with statistically significant inter-group differences (F = 9.03, P< 0.05). Conclusions The 3DP-HR-improved and 3DP-HR+SGRT-improved groups can significantly reduce the setup errors for nasopharyngeal carcinoma patients during radiotherapy, providing reliable clinical support. |
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