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聚氨酯发泡胶与负压真空垫在乳腺癌保乳根治术后IMRT体位固定精度初步研究
周常锋, 房建南, 黄晓波, 石俊田, 马玉家
中山大学孙逸仙纪念医院肿瘤放疗科,广州 510120
Preliminary study of accurate position fixation between polyurethane styrofoam and vacuum negative pressure pad in IMRT after radical mastectomy for breast cancer
Zhou Changfeng, Fang Jiannan, Huang Xiaobo, Shi Juntian, Ma Yujia
Department of Radiation Oncology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China
摘要目的 初步探究发泡胶与真空垫在乳腺癌保乳根治术后IMRT体位固定中的精度差异。方法 选取2017-2018月间本院收治保乳术后全乳大分割IMRT (42.56Gy分16次)的乳腺癌患者40例,随机均分为发泡胶组和真空垫组固定。分次治疗前使用瓦里安Trilogy机载图像验证系统拍摄患者正侧位照片,并与计划系统重建的数字重建图像进行匹配验证获得两组患者在左右、头脚、腹背方向摆位误差。每名患者验证10次,共获得400组数据。采用独立样本t检验获得组间摆位误差,并计算临床靶体积至计划靶体积分次间摆位误差的外扩值。结果 发泡胶固定组与真空垫组在左右、头脚、腹背方向摆位误差分别为(1.63±1.29) mm与(1.83±1.61) mm (P=0.18)、(1.46±1.51) mm与(2.26±2.03) mm (P=0.00)、(1.30±1.35) mm与(1.91±1.67) mm (P=0.00)。临床靶体积至计划靶体积分次摆位误差的外扩值分别为2.19、2.51、1.57mm与2.40、3.97、2.63mm。结论 两种固定方式均满足临床要求,但初步证明发泡胶固定摆位精度与重复性均优于真空垫组。
Abstract：Objective To preliminarily investigate the difference of position fixation accuracy between polyurethane styrofoam and vacuum negative pressure pad in intensity-modulated radiation therapy (IMRT) after radical mastectomy for breast cancer. Methods Forty breast cancer patients,who received breast-conserving surgery followed by hyper-fractionated IMRT of the whole breast (42.56 Gy for 16 times) in our hospital between 2017 and 2018 were recruited and randomly divided into the polyurethane styrofoam group and vacuum negative pressure pad group. Before IMRT treatment,the anterior and lateral films of patients were taken with kilovoltage digital radiographs (KVDRs) by Varian Trilogy machine-borne OBI KV image verification system. The KVDRs images were matched with the DRR images reconstructed by the planned system to obtain the setup errors in the left and right,head and foot,and ventral and back directions between two groups. Each patient was verified for 10 times to obtain 400 sets of data. The independent sample t-test was adopted to analyze the setup errors between two groups. The external expansion value of graded setup errors from clinical target volume (CTV) and planned target volume (PTV) was calculated. Results The setup errors in the left and right,head and foot,ventral and back directions between the styrofoam fixation and vacuum pad groups were (1.63±1.29) mm and (1.83 ±1.61) mm (P=0.18),(1.46±1.51) mm and (2.26±2.03) mm (P=0.00),and (1.30±1.35) mm and (1.91±1.67) mm (P=0.00), respectively. The external expansion values of setup errors from CTV to PTV were 2.19 mm,2.51 mm,1.57 mm and 2.40 mm,3.97 mm and 2.63mm,respectively. Conclusion Both two fixation methods meet the clinical requirements. However, the setup accuracy and reproducibility in the polyurethane styrofoam group are better than those in the vacuum negative pressure pad group.
Zhou Changfeng,Fang Jiannan,Huang Xiaobo et al. Preliminary study of accurate position fixation between polyurethane styrofoam and vacuum negative pressure pad in IMRT after radical mastectomy for breast cancer[J]. Chinese Journal of Radiation Oncology, 2019, 28(10): 776-779.
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2019, Vol. 28 
