摘要
目的:应用锥形束CT(CBCT)观察食管癌和肺癌六维方向的摆位误差,分析六维床对食管癌平移和旋转方向校正的必要性及其临床意义。方法:选取2019年10月~2021年12月在中山大学肿瘤防治中心放疗的胸部肿瘤患者,食管癌组、肺癌组各85例,收集所有患者前3次CBCT扫描,通过六维方向与计划中的定位CT图像进行配准,获得头脚方向(SI)、左右方向(LR)、前后方向(AP)、绕Z轴旋转(RTN)、绕X轴旋转(PITCH)、绕Y轴旋转(ROLL)6个方向的摆位误差。原始数据取绝对值,采用Kolmogorov-Smirnov Z非参数秩和检验进行统计分析。结果:食管癌组和肺癌组在SI、LR、AP平移方向摆位误差取绝对值分别为:0.30(0.10, 0.50)、0.10(0.10, 0.30)、0.10(0.10, 0.20)和0.20(0.10, 0.40)、0.20(0.10,0.30)、0.10(0.10, 0.30)cm;在RTN、PITCH、ROLL旋转方向的摆位误差取绝对值分别为0.50°(0.30°, 0.90°)、0.90°(0.40°,1.60°)、0.90°(0.40°, 1.40°)和0.40°(0.10°, 0.70°)、0.70°(0.20°, 1.30°)、0.50°(0.10°, 1.00°),食管癌组和肺癌组中SI、RTN、PITCH、ROLL方向比较,差异均有统计学意义(P<0.05),而LR、AP方向比较,差异无统计学意义(P>0.05)。结论:基于CBCT引导下,六维配准技术配合六维床能降低胸部肿瘤患者放疗时摆位误差,特别是长靶区如食管癌方面,校正旋转摆位误差有明显优势。
Objective To analyze the 6-dimensional setup errors of esophageal cancer and lung cancer with the use of conebeam CT(CBCT), and to discuss the necessity and clinical significance of 6-dimensional couch for translational and rotational errors correction in esophageal cancer. Methods Patients with thoracic tumors treated with radiotherapy at Sun Yatsen University Cancer Center from October 2019 to December 2021 were enrolled, with 85 cases each in esophageal cancer group and lung cancer group. The first 3 CBCT scans of all patients were collected for obtaining the 6-dimensional setup errors, including superior-inferior(SI), left-right(LR), anterior-posterior(AP) directional setup errors, and rotational setup errors around Z-axis(RTN), X-axis(PITCH), Y-axis(ROLL). The absolute values of the raw data were analyzed by Kolmogorov-Smirnov Z nonparametric rank sum test. Results The absolute values of SI, LR, and AP setup errors were 0.30(0.10, 0.50), 0.10(0.10, 0.30), 0.10(0.10, 0.20) cm in esophageal cancer group, and 0.20(0.10, 0.40), 0.20(0.10, 0.30), 0.10(0.10, 0.30) cm in lung cancer group. The RTN, PITCH, and ROLL setup errors were 0.50°(0.30°, 0.90°), 0.90°(0.40°,1.60°), 0.90°(0.40°, 1.40°) in esophageal cancer group, and 0.40°(0.10°, 0.70°), 0.70°(0.20°, 1.30°), 0.50°(0.10°, 1.00°) in lung cancer group. There were statistically significant differences between esophageal cancer group and lung cancer group in SI, RTN, PITCH and ROLL setup errors(P<0.05), but not in LR and AP setup errors(P>0.05). Conclusion Guided by CBCT,6-dimensional registration technique with 6-dimensional couch can reduce the setup errors during radiotherapy for thoracic tumors, especially for long target areas such as esophageal cancer, and has obvious advantages in correcting the rotational setup errors.
作者
肖亮杰
方涌文
王宇留
林晓生
许森奎
姚文燕
赵磊
方键蓝
XIAO Liangjie;FANG Yongwen;WANG Yuliu;LIN Xiaosheng;XU Senkui;YAO Wenyan;ZHAO Lei;FANG Jianlan(Department of Radiotherapy,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Guangdong Institute of Esophageal Cancer,Guangzhou 510060,China)
出处
《中国医学物理学杂志》
CSCD
2022年第10期1189-1193,共5页
Chinese Journal of Medical Physics
基金
国家自然科学基金(81874220)
广东省医学科学技术研究基金(A2020621)
广东省食管癌研究所科技计划(Q202107)。
关键词
锥形束CT
食管癌
肺癌
六维床
摆位误差
cone-beam CT
esophageal cancer
lung cancer
six-dimensional couch
setup error
