摘要
目的探讨应用俯卧体架的直肠癌患者下肢衣物对放疗效果的影响。方法选取160例应用俯卧体架的直肠癌患者，分成对照组和试验组，每组80例。对照组患者在CT定位和实施放疗时仅将其裤子（包括内裤、保暖裤及外裤）褪至俯卧体架下缘下，试验组患者则完全脱掉。应用锥形束CT测量两组患者在治疗时的摆位误差，同时记录两组患者的急性放疗不良反应情况。结果两组在X、Y和Z3个轴向的摆位误差及综合误差，差异均有统计学意义（P〈0．05）。≤3mm的误差值统计比较，两组差异无统计学意义（P〉0．05），≤5mm的误差值统计差异有统计学意义（P〈0．05）。两组患者在血象（包括白细胞和血小板）的改变、≤1级的急性皮肤不良反应的对比中差异无统计学意义（x2=0．23、0．24、2．18，P〉0．05），≤1级的急性直肠黏膜不良反应的对比中差异有统计学意义（x2=5．94，P〈0．05）。试验组在X、Y和Z3个轴向的M PTV值分别为4．76、5．65和3．81。结论直肠癌患者在应用俯卧体架治疗时将裤子完全脱掉，此体位固定方式可提高摆位的可重复性，降低摆位误差，减轻直肠黏膜不良反应，值得在今后的临床工作中推广和应用。
Objective To investigate the impact of lower limbs clothes of patients with rectal cancer who using prone body frame on radiotherapy effect. Methods Totally 160 patients with rectal cancer who using prone body frame were randomly divided into two groups, both control group and experimental group were arranged 80 patients. The patients in the control group only turned their trousers including underwear, warm pants and pants off to under the lower edge of prone body frame, the patients in the experimental group absolutely turned their trousers including underwear,warm pants and pants off. To evaluate setup errors in radiotherapy for the two groups by cone-beam CT,and record the acute radiotherapy reaction for the two groups. Results The setup errors in X,Y and Z axial directions and comprehensive error between control group and experimental group were statistically significant（P〈0.05）. The differences of the error in less than 3 mm between the two groups had no statistical significance（P〉0.05）, the differences of the error in less than 5 mm between the two groups had statistical significance（P〈0.05） ,both the differences in the hematological changes including white blood cells and platelets and in Iess than I level of acute skin side effects between the two groups had no statistical significance（x2= 0.23,0. 24,2.18 ; P〉0.05）, the differences in less than 1 level of acute mucous membrane of rectum side effects between the two groups had statistical significance（x2 =-5.94, P〈0.05）. The M PTV value in X, Y and Z axial directions of exprimental group were 4.76,5.65,3.81. Conclusion Make the patients with rectal cancer who using prone body frame turn off their trousers, this position fixing method has improved the positioning repeatability, reduce the position error and reduced the side reaction of mucous membrane of rectum, the clinical treatment efficiency has been greatly improved, it is worthy to be popularized and appied in the future clinical work.
出处
《重庆医学》
CAS
北大核心
2016年第22期3063-3065,共3页
Chongqing medicine
关键词
直肠肿瘤
锥形束CT
俯卧体架
热塑体模
摆位误差
综合误差
rectal neoplasms
cone-beam CT
prone body frame
thermoplastic phantom
setup errors
comprehensive error
作者简介
屈超（1987-），技师，本科，主要从事放射治疗工作。
