摘要
目的:回顾比较分析三种头部固定技术在首次放射治疗中的摆位误差,为颅内肿瘤放射治疗选择理想的体位固定技术提供临床依据,以提高放射治疗精确度。方法:随机抽取94例行放射治疗的颅内肿瘤患者,按照体位固定技术的不同将其分为三组,采用头颈肩板+真空袋+头颈肩热塑膜固定的患者为头颈肩组(34例);采用Brainlab头架+热塑头膜固定的患者为无鼻托组(30例);采用Brainlab头架+鼻托+热塑头膜固定的患者为鼻托组(30例)。从Eclipse11.0计划系统中调取患者验证片,采用骨性配准方式获取每例患者腹背方向(VRT)、头脚方向(LNG)及左右方向(LAT)的误差值,并进行比较分析。结果:三组的摆位误差在VRT方向分别为(0.07±0.09)cm、(0.06±0.08)cm和(0.07±0.08)cm;LNG方向分别为(0.11±0.12)cm、(0.08±0.10)cm和(0.12±0.10)cm;LAT方向分别为(0.10±0.09)cm、(0.03±0.05)cm和(0.07±0.07)cm;三组在VRT及LNG方向均无明显差异(F=0.267,F=0.966;P>0.05),无鼻托组在LAT方向上固定效果优于头颈肩组和鼻托组,差异有统计学意义(F=6.968,P<0.05);鼻托组在此方向上亦有优于头颈肩组的趋势,差异无统计学意义(F=6.968,P>0.05)。结论:三种固定技术均可起到良好的固定效果,其中无鼻托+热塑头膜固定技术较其他两种在LAT方向误差更小,临床上对治疗精度有严格要求的建议推荐使用。
Objective:To retrospectively analyze and compare the poistioning errors of three kinds of fixation techniques for head in radiotherapy of the first time so as to provide clinical base for selecting the ideal positioning fixation techniques in the radiotherapy of intracranial tumors and to further improve accuracy of radiotherapy.Methods:94 patients with intracranial tumors received radiotherapy were randomly selected in this research.And all of them were divided into three groups according to different positioning fixation technique.Among them,34 cases were treated by adopting"head-neck-shoulder plate+vacuum bag+head–neck-shoulder thermoplastic film"fixation(named Head-neck-shoulder group),and 30 cases were treated by adopting"Brainlab head shelf+thermoplastic head film"fixation(named None-nose pad group),and 30 cases were treated by adopting"Brainlab head shelf+nose pad+thermoplastic head film"fixation(named Nose pad group).The verification picture of patients were acquired from the Eclipse 11.0(VARIAN,USA)planning system and the rectification method of diffuse idiopathic skeletal hyperostosis was adopted to obtain the error values of VRT,LNG and LAT,and then these data were compared and analyzed.Results:The positioning errors of Head-neck-shoulder group,No nose pad group and Nose pad group were(0.07±0.09)cm,(0.06±0.08)cm and(0.07±0.08)cm at VRT direction,and all of them were(0.11±0.12)cm,(0.08±0.10)cm and(0.12±0.10)cm at LNG direction,and all of them were(0.10±0.09)cm,(0.03±0.05)cm and(0.07±0.07)cm at LAT direction,respectively.There was no significant difference among three groups at the direction of VRT and LNG(F=0.267,F=0.966,P>0.05),while the fixation effect of No nose pad group at LAT direction was significantly better than that of the other two groups(F=6.968,P<0.05),respectively.And the fixation effect of nose pad group at this direction showed a trend that it was better than that of Head-neck-shoulder group,although the difference between them was no significant(F=6.968,P>0.05).Conclusion:All of the three fixation techniques can achieve good fixation effect,and the fixation technique of"Brainlab head shelf+thermoplastic head film"has less error than other two techniques at LAT direction,and it has strict requirements for radiotherapy accuracy.Therefore,it is recommended in clinical application.
作者
罗日顺
戴鹏
张平
周巧敏
金健
蔡林波
LUO Ri-shun;DAI Peng;ZHANG Ping(Comprehensive Therapeutic Center for Cancer,Guangdong 999 Brain Hospital,Guangzhou 510510,China)
出处
《中国医学装备》
2018年第9期18-21,共4页
China Medical Equipment
关键词
颅内肿瘤
固定技术
热塑膜
摆位误差
放射治疗
Intracranial tumor
Fixation technique
Thermoplastic film
Positioning error
Radiotherapy
作者简介
罗日顺,男,(1986-),本科学历,技师,从事肿瘤放射治疗技术方面的研究工作;通信作者:蔡林波56909387@qq.com。
