乳腺癌放射治疗中真空袋体位固定与真空袋加翼型板体位固定的应用及其摆位误差分析

吕得刚 张清圣 史亚斌

【摘要】 目的：探討乳腺癌放射治疗中真空袋体位固定与真空袋加翼型板体位固定的应用效果及其摆位误差。方法：选取2019年1月-2020年4月本院收治的乳腺癌放射治疗患者50例，根据固定方式的不同分为对照组与研究组，每组25例。对照组应用真空袋体位固定，研究组应用真空袋加翼型板体位固定。比较两组CBCT验证图像偏离值与中心点平均偏差。结果：研究组首次放射治疗CBCT验证图像的中X、Y轴偏离值均低于对照组（P<0.05），而两组Z轴偏离值比较，差异无统计学意义（P>0.05）。研究组第二周与末次放射治疗CBCT验证图像X、Y、Z轴的偏离值均低于对照组（P<0.05）。研究组X、Y、Z轴中心点平均偏差均低于对照组（P<0.05）。结论：乳腺癌放射治疗中，真空袋加翼型板体位固定可以有效减少摆位的误差，提高摆位的精准，更好的实施治疗，临床上应当进一步推广应用。

【关键词】 乳腺癌 放射治疗 真空袋 翼型板 摆位误差

The Application of Vacuum Bag and Vacuum Bag Aerofoil Plate in the Radiotherapy of Breast Cancer and Positioning Error Analysis/LYU Degang， ZHANG Qingsheng， SHI Yabin. //Medical Innovation of China， 2021， 18（07）： -166

[Abstract] Objective： To investigate the application effect of vacuum bag and vacuum bag with aerofoil plate in the radiotherapy of breast cancer and its positioning error. Method： A total of 50 patients with breast cancer treated by radiotherapy in our hospital from January 2019 to April 2020 were selected. They were divided into control group and study group according to different fixation methods， with 25 cases in each group. The control group was fixed with vacuum bag and the study group was fixed with vacuum bag with aerofoil plate. The CBCT image deviation and the center point average deviation were compared between the two groups. Result： The deviation values of X-axis and Y-axis in the CBCT verification images of the first radiotherapy in the study group were lower than those in the control group （P<0.05）， but there was no significant difference in the deviation values of Z-axis between the two groups （P>0.05）. The deviation values of X， Y， Z axis of CBCT verification images in the study group in the second week and the last radiotherapy were lower than those in the control group （P<0.05）. X， Y， Z axis center point average deviation of the study group were lower than those of the control group （P<0.05）. Conclusion： In breast cancer radiotherapy， vacuum bag with aerofoil plate can effectively reduce the positioning error， improve the accuracy of positioning， and better the implementation of treatment， which should be further promoted in clinical application.

[Key words] Breast cancer Radiotherapy Vacuum bag Aerofoil plate Positioning error

First-authors address： Shenzhen Peoples Hospital （The Second Clinical Medical College， Jinan University; The First Affiliated Hospital， Southern University of Science and Technology）， Shenzhen 518020， China

doi：10.3969/j.issn.1674-4985.2021.07.039

近年来，女性常见恶性肿瘤中乳腺癌的发病率较高，并且逐渐呈现上升趋势。放射治疗作为乳腺癌治疗的主要手段，对肿瘤靶区要求精准定位。本文基于直線加速器机载锥形束CT（cone-beam computer tomography，CBCT）比较了真空袋体位固定与真空袋加翼型板体位固定方式在乳腺癌保乳术后放射治疗中的摆位误差。不同体位固定方案的验证图像出现的偏离误差也会有一定的差异[1]。为了更好地帮助乳腺癌患者得到有效的治疗，并且保护肺组织及其他危及器官，需要保障体位的重复性和准确性[2]。真空袋固定患者的体位可以更好地符合身体特征，不仅操作简单，同时固定精准，加上翼型板体位共同固定，在放射治疗过程中有重要的意义[3]。在本次研究过程中，选取2019年1月-2020年4月本院收治的乳腺癌放射治疗患者50例，分别实施真空袋体位固定和真空袋加翼型板体位固定，对比其摆位误差，现报道如下。……