摘要
目的比较真空垫、乳腺托架合并发泡胶两种固定装置在老年乳腺癌调强放射治疗中的摆位误差,以寻求最佳的个体化固定装置。方法选择接受图像引导放射治疗的女性患者93例,年龄60~90岁,中位年龄74岁,其中60~69岁14例,70~79岁37例,≥80岁42例;身体质量指数(BMI)18.5~23.9 kg/m252例,BMI>23.9 kg/m241例;病灶位置左侧54例,右侧39例。其中47例使用真空垫进行固定,46例使用乳腺托架合并发泡胶进行固定。通过锥形束计算机体层摄影术(CBCT)记录患者术前、术后的两组数值,得出摆位位移数据,比较两组患者摆位误差的大小。结果乳腺托架合并发泡胶在乳腺癌保乳术前后、左右、上下三个方向的摆位误差分别是(0.10±0.16)cm、(0.05±0.26)cm、(0.08±0.11)cm,差异有统计学意义(P<0.05);真空垫在乳腺癌保乳术前后、左右、上下三个方向的摆位误差分别是(0.28±0.31)cm、(0.11±0.79)cm、(0.25±0.36)cm,差异有统计学意义(P<0.05)。使用真空垫固定方式中,60~69岁组左右、上下、前后的摆位误差分别是(0.09±0.49)cm、(0.25±0.46)cm、(0.22±0.59)cm,≥80岁组摆位误差最大,左右、上下、前后的摆位误差分别为(0.18±0.52)cm、(0.33±0.55)cm、(0.33±0.42)cm。同样在乳腺托架合并发泡胶中,60~69岁组左右、上下、前后摆位误差最小,分别为(0.01±0.32)cm、(0.06±0.23)cm、(0.06±0.45)cm,≥80岁组摆位误差最大,左右、上下、前后的摆位误差分别为(0.08±0.41)cm、(0.11±0.26)cm、(0.14±0.26)cm。结论在老年乳腺癌保乳术后调强治疗中,与真空垫相比,使用乳腺托架合并发泡胶进行体位固定的摆位误差更小,体位固定精确性更高,推荐用于临床治疗。
Objective To compare set-up error of vacuum pad and breast bracket combined styrofoam in intensity-modulated radiation therapy for elderly patients with breast cancer,and find the best individualized fixation device.Methods A total of93 female patients who received image-guided radiation therapy were enrolled,aged 60-90 years old with median age of 74years old,of which 14 cases were 60-69 years old,37 were 70-79 years old and 42 were≥80 years old.The body mass index(BMI)was 18.5-23.9 kg/m~2 in 52 cases and BMI>23.9 kg/m~2 in 41 cases.The lesions of 54 cases were located on the left side and 39 cases located on the right side.Among those patients,47 cases were fixed with vacuum pad device and 46cases were fixed with breast bracket combined styrofoam device.The preoperative and postoperative values were recorded by cone beam computed tomography(CBCT)to obtain the set-up displacement data,and set-up errors between 2 groups were compared.Results The set-up errors in anterior-posterior,left-right and superior-inferior direction of breast bracket combined styrofoam after breast conserving surgery were(0.10±0.16)cm,(0.05±0.26)cm,(0.08±0.11)cm,and the differences were statistically significant(P<0.05).The set-up errors in anterior-posterior,left-right and superior-inferior direction of vacuum pad after breast conserving surgery were(0.28±0.31)cm,(0.11±0.79)cm,(0.25±0.36)cm,and the differences were statistically significant(P<0.05).In vacuum pad fixation,the left-right,anterior-posterior and superior-inferior set-up errors of 60-69 years old group were(0.09±0.49)cm,(0.25±0.46)cm,(0.22±0.59)cm;the set-up error of left-right,anteriorposterior and superior-inferior in≥80 years old group was(0.18±0.52)cm,(0.33±0.55)cm,(0.33±0.42)cm,respectively,which were the largest.Similarly,in breast bracket combined styrofoam fixation,the set-up errors of 60-69 years old group was the smallest,left-right,anterior-posterior and superior-inferior set-up errors was(0.01±0.32)cm,(0.06±0.23)cm,(0.06±0.45)cm,the set-up errors of≥80 years old group were the largest,left-right,anterior-posterior and superior-inferior set-up errors was(0.08±0.41)cm,(0.11±0.26)cm and(0.14±0.26)cm,respectively.Conclusion It is demonstrated that in intensity modulated therapy after breast conserving surgery for breast cancer,the breast bracket combined styrofoam fixation has smaller set-up errors and higher postural fixation accuracy,which is recommended for clinical treatment.
作者
李行欢
孙丽
王家鹏
王伟
LI Xing-huan;SUN Li;WANG Jia-peng;WANG Wei(Jiangsu Cancer Hospital,Nanjing 210009,Jiangsu,China)
出处
《生物医学工程与临床》
CAS
2023年第1期61-65,共5页
Biomedical Engineering and Clinical Medicine
关键词
乳腺癌
真空垫
乳腺托架
发泡胶
摆位误差
breast cancer
vacuum pad
breast bracket
styrofoam
set-up error
