改良颈肩体热塑膜固定下颈胸段食管癌放射治疗中的摆位误差分析

doi:10.3969/j.issn.1000-8535.2023.09.009

广州医药 ›› 2023, Vol. 54 ›› Issue (9): 52-57.DOI: 10.3969/j.issn.1000-8535.2023.09.009

改良颈肩体热塑膜固定下颈胸段食管癌放射治疗中的摆位误差分析

万丽娟, 许晓燕, 王亭亭, 王沛沛, 黄普胜, 李金凯

南京医科大学第一附属医院放射治疗科（江苏南京 210029）

收稿日期:2023-02-12 出版日期:2023-09-20 发布日期:2023-10-12
通讯作者: 李金凯,E-mail：lijinkai1028@163.com

Analysis of set-up errors in radiotherapy of cervical thoracic esophageal cancer under modified neck shoulder body thermoplastic film fixation

WAN Lijuan, XU Xiaoyan, WANG Tingting, WANG Peipei, HUANG Pusheng, LI Jinkai

Radiotherapy Department,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China

Received:2023-02-12 Online:2023-09-20 Published:2023-10-12

摘要/Abstract

摘要： 目的应用锥形束CT比较改良颈肩体热塑膜和传统颈肩体热塑膜体位固定装置在颈胸段食管癌患者放射治疗中的摆位差异,分析两种固定方式对锁骨上下区摆位误差的影响。方法分析2021年6月—2022年10月在南京医科大学第一附属医院行放射治疗的29例食管癌患者的临床资料。将患者分为改良颈肩体热塑膜组（改良组）和光板颈肩体热塑膜组（对照组）,对比分析2组病例不同配准区域的摆位误差。结果改良组在X（左右）方向的平移误差及Rz（冠状面）方向的旋转误差小于对照组,差异有统计学意义（P<0.05）。改良组锁骨上下区在X（左右）方向的平移误差以及Rx（矢状面）方向的旋转误差小于对照组,差异有统计学意义（P<0.05）。改良组的整体靶区外放范围在X、Y方向上均小于颈肩体组,改良组在锁骨上下区的X方向靶区外放范围也更小。结论对于颈胸段食管癌需行锁骨上下区放疗的患者,应用改良颈肩体热塑膜可减少平移误差,控制旋转角度,减少靶区外放范围。

关键词: 食管癌, 体位固定, 摆位误差分析, 放射治疗

Abstract: Objective To compare the set-up errors between the modified neck-shoulder body thermoplastic film and the traditional neck-shoulder body thermoplastic film fixation device in the radiotherapy of patients with cervical and thoracic esophageal cancer by cone beam CT,and to analyze the influence of the two fixation methods on the positioning error of the upper and lower clavicular region．Methods The clinical data of 29 patients with esophageal cancer who underwent radiotherapy in the First Affiliated Hospital of Nanjing Medical University from June 2021 to October 2022 were analyzed．The patients were divided into two groups：the modified neck-shoulder body thermoplastic film group（the modified group）and the smooth neck-shoulder body thermoplastic film group（the control group）,the positioning errors in different regions of the two groups were compared and analyzed．Results The translation error in the X（left and right）direction and the rotation error in the Rz（coronal plane）direction of the modified group were smaller than those of the control group,and the differences were statistically significant（P<0.05）．The translation error in the X（left and right）direction and the rotation error in the Rx（sagittal plane）direction of the superior and inferior clavicular region in the modified group were smaller than those in the control group,and the differencs were statistically significant（P<0.05）．The overall target area of the modified group was smaller in X and Y directions than that of the neck-shoulder body group,and the target area of the improved group in X direction was also smaller in the upper and lower clavicle area．Conclusions For patients with cervical and thoracic esophageal cancer who need radiotherapy in the upper and lower clavicular region,the application of modified neck shoulder body thermoplastic film can reduce the translation error,control the rotation angle and reduce the external radiation range of the target region．

Key words: esophageal cancer, body position fixation, set-up error analysis, radiotherapy

万丽娟, 许晓燕, 王亭亭, 王沛沛, 黄普胜, 李金凯. 改良颈肩体热塑膜固定下颈胸段食管癌放射治疗中的摆位误差分析[J]. 广州医药, 2023, 54(9): 52-57.

WAN Lijuan, XU Xiaoyan, WANG Tingting, WANG Peipei, HUANG Pusheng, LI Jinkai. Analysis of set-up errors in radiotherapy of cervical thoracic esophageal cancer under modified neck shoulder body thermoplastic film fixation[J]. Guangzhou Medical Journal, 2023, 54(9): 52-57.

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改良颈肩体热塑膜固定下颈胸段食管癌放射治疗中的摆位误差分析

Analysis of set-up errors in radiotherapy of cervical thoracic esophageal cancer under modified neck shoulder body thermoplastic film fixation

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