摘要
目的分析4种不同固定方法在前列腺癌调强放疗摆位精度上的差异,为临床决策和靶区外扩边界提供依据。方法选取2017-01-05-2020-12-19在中山大学肿瘤防治中心进行调强放疗的70例前列腺癌患者为研究对象,其中1.8m真空袋固定(A组)19例,个体化俯卧架固定(B组)19例,Orfit架固定(C组)14例,1.2m真空袋固定(D组)18例。所有患者每次放疗前进行机载锥形束CT(CBCT)扫描,获得头脚(SI)、左右(LR)、前后(AP)平移方向误差并进行非参数检验,应用公式计划靶区外扩边界(M_(PTV))=2.5Σ+0.7σ分别计算出对应的计划靶区(PTV)外扩边界,并分析摆位误差与身体质量指数的相关性。结果1723次摆位误差数据结果:A组LR、SI、AP分别为(0.60±2.49)、(0.44±3.16)和(-1.07±4.48)mm,B组分别为(0.28±2.71)、(0.19±3.45)和(-3.08±3.86)mm,C组分别为(-0.55±2.96)、(-1.42±4.76)和(-0.25±2.35)mm,D组分别为(0.62±2.95)、(-0.69±3.90)和(0.39±2.55)mm。Kruskal-Wallis秩和检验和Dunnett T3多重比较发现:LR方向,B组<C组<A组、D组,P<0.001;SI方向,A组、B组<D组<C组,P<0.001;AP方向,C组<D组<A组<B组,P=0.001。A组LR、SI、AP的M_(PTV)分别为4.82、6.38和10.68mm,B组分别为5.57、6.86和8.36mm,C组分别为6.82、10.7和5.59mm,D组分别为6.43、9.09和8.54mm。结论4种固定器的体位固定精度均能符合临床使用标准。个体化俯卧板在LR和SI方向的摆位误差最小,Orfit架在AP方向的控制更好,1.8m真空袋在SI方向上具有优势。
Objective To analyze the differences in the positioning accuracy of four different fixation methods in intensitymodulated radiotherapy for prostate cancer,to provide a basis for clinical decision-making and margin of the planning target volume(PTV).Methods A total of 70prostate cancer patients who underwent IMRT in Sun Yat-sen University Cancer Center from 2017-01-05to 2020-12-19were selected as the research objects,of which 19were fixed with 1.8-meter vacuum bag(group A),19were fixed with an individualized prone frame Fixation(group B),14cases were fixed with Orfit frame(group C)and 18cases were fixed with 1.2mvacuum bag(group D).All patients underwent cone beam CT scans before radiotherapy to obtain head-to-foot(SI),left-right(LR),and anterior-posterior(AP)set-up errors for nonparametric tests.The margin of PTV(M_(PTV))was calculated by Formulas(M_(PTV))=2.5Σ+0.7σ,and the correlation between the set-up errors and body mass index was analyzed.Results Totally 1723set-up errors were obtained:LR(0.60±2.49)mm,SI(0.44±3.16)mm,AP(-1.07±4.48)mm for Group A;LR(0.28±2.71)mm,SI(0.19±3.45)mm,AP(-3.08±3.86)mm for Group B;LR(-0.55±2.96)mm,SI(-1.42±4.76)mm,AP(-0.25±2.35)mm for Group C;LR(0.62±2.95)mm,SI(-0.69±3.90)mm,AP(0.39±2.55)mm for Group D.Kruskal Wallis rank sum test and Dunnett T3multiple comparison showed that set-up errors for four groups were increasing in proper order in the LR direction,group B<group C<group A and group D,P<0.001;set-up error for four groups in the SI direction was group A and group B<group D<group C,P<0.001;set-up error for four groups in the AP direction was group C<group D<Group A<Group B,P=0.001.The MPTVof Group A(LR:4.82mm,SI:6.38mm,AP:10.68mm);Group B(LR:5.57mm,SI:6.86mm,AP:8.36mm);Group C(LR:6.82mm,SI:10.7mm,AP:5.59mm);Group D(LR:6.43 mm,SI:9.09mm,AP:8.54mm).Conclusions The immobilization accuracy of the four types of fixation methods can meet the clinical standards.The personalized prone plate has the smallest set-up error in the LR and SI directions,and the Orfit frame has better control in the AP direction.The 1.8-meter vacuum bag has an advantage in the SI direction.
作者
黄虹
陈炫光
林志悦
何梦雪
林楚燕
王宇留
林承光
许森奎
姚文燕
HUANG Hong;CHEN Xuan-guang;LIN Zhi-yue;HE Meng-xue;LIN Chu-yan;WANG Yu-liu;LIN Cheng-guang;XU Sen-kui;YAO Wen-yan(State Key Laboratory of Oncology in South China,Sun Yat-sen University Cancer Center,Guangzhou510060,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2022年第19期1422-1426,共5页
Chinese Journal of Cancer Prevention and Treatment
基金
广东省医学科学技术研究基金(A2017613)
广东省医学科学技术研究基金(A2020621)。
关键词
体位固定
前列腺癌
放射治疗
摆位误差
外扩边界
immobilization
prostate cancer
radiotherapy
set-up error
margin of planning target volume
