Comparative analysis ofapplication value and setup error between two setup methods in proton and carbon ion therapy for prostate cancer
Song Huaguo,Bu Ruirui,Li Yongqiang,Ren Wei,Fu Shen
Department of Medical Physics (Song HG,Bu RR,Li YQ,Ren W),Department of Radiation Oncology (Fu S),Proton and Heavy Ion Center,Shanghai 201315,China;Department of Radiation Oncology,Cancer Hospital of Fudan University,Shanghai 200233,China (Fu S)
摘要目的 总结腹板热塑膜加真空垫与个体化定位泡沫垫在前列腺癌西门子质子重离子放疗六维治疗床中的使用价值及摆位误差,分析2种固定装置使用六维治疗床放疗的适用性。方法 采用腹板热塑膜加真空垫固定的患者(19例)作为真空垫组,采用个体化定位泡沫垫固定的患者(19例)作为泡沫垫组。2组患者每次治疗前均通过西门子放疗设备的千伏级X线成像系统采集正、侧位正交野图像,与计划的数字重建图像手动配准。通过六维治疗床的移动获得侧向(治疗床面短轴方向)、头脚(治疗床面长轴方向)、前后(垂直与治疗床面方向)、等中心旋转(治疗床面沿等中心水平旋转)、横滚(以治疗床面长轴为中心的旋转)及俯仰(以治疗床面短轴为中心的旋转)6个方向的误差数据,并对6个方向上的误差数据进行双独立样本t检验。结果 真空垫组和泡沫垫组得到的误差数据分别为452和436组。真空垫组和泡沫垫组在侧向、头脚、前后、等中心旋转、俯仰以及横滚6个方向的误差均值和标准差分别为(0.63±0.48) cm∶(0.33±0.24) cm (P=0.000)、(0.40±0.3) cm∶(0.31±0.25) cm (P=0.0001)、(0.69±0.61) cm∶(0.82±0.69) cm (P=0.006)、0.65°±0.47°∶0.32°±0.25°(P=0.000)、1.05°±0.95°∶1.16°±0.94°(P=0.100)以及0.67°±0.56°∶0.40°±0.36°(P=0.000)。2个组误差均值和标准差的最大值均是俯仰方向。结论 使用六维治疗床放疗时建议根据患者的实际情况将腹板热塑膜加真空垫与个体化定位泡沫垫2种固定方式优势互补,互相结合,并使用个性化足部固定器固定足部以进一步减小股骨头区域的不确定性。
Abstract： Objective To compare the application values and setup errors between vacuum bag plus body mask and customized alpha cradle duringproton and carbon therapy using Siemens 6D robotic couch in prostate cancer patients. Methods Nineteen patients received vacuum bag plus body mask setup were allocated into the vacuum bag group and19 patients with alpha cradle were assigned into the alpha cradle group. Orthogonal X-ray portals were performed to verify the treatment position before beam delivery in every fraction. The couch correction between the portal and reference DRR through manual image registration was recorded as setup errors in 6 directions including the lateral, supine-inferior, anterior-posterior, yaws, roll and pitch,respectively. Two-tail t-test was used to analyze the setup error data from each direction between two groups. Results In total, 452 and 436 sets of data errors were collected from the vacuum bag and alpha cradle groups. The average setup errors and standard deviation in the vacuum bag and alpha cradle groups in the lateral, supine-inferior, anterior-posterior, yaws, roll and pitch directions were (0.63±0.48) cm vs. (0.33±0.24) cm (P=0.000),(0.40±0.3) cm vs. (0.31±0.25) cm (P=0.000),(0.69±0.61) cm vs. (0.82±0.69) cm (P=0.006),0.65°±0.47°vs 0.32°±0.25°(P=0.000),1.05°±0.95°vs 1.16°±0.94°(P=0.100) and 0.67°±0.56°vs 0.40°±0.36°(P=0.000),respectively. The maximum setup errors were detected in the pitch direction for both groups. Conclusions During the proton and carbon therapy using Siemens 6D robotic couch, two setup Methods using vacuum bag plus body mask and customized alpha cradle should be selected according to the individual conditions of patients. A customized foot fixer should be utilized to reduce the uncertainty in the femoral head region.
Song Huaguo,Bu Ruirui,Li Yongqiang et al. Comparative analysis ofapplication value and setup error between two setup methods in proton and carbon ion therapy for prostate cancer[J]. Chinese Journal of Radiation Oncology, 2018, 27(4): 382-386.
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2018, Vol. 27 
