3D打印个性化乳腺托架在乳腺癌调强放疗中应用初探

doi:10.3760/cma.j.cn113030-20211011-00399

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Objective By comparing the positioning errors caused by 3D printed personalized breast bracket and common headrest in intensity-modulated radiation therapy (IMRT), the fixation effect of 3D printed personalized breast bracket in IMRT was analyzed. Methods Thirty-two breast cancer patients from January to July 2021 were randomly divided into a the 3D printed breast bracket group and common headrest group. All patients in two groups were kept in supine position, head tilted to the healthy side, the affected hand held the grip bar on the same side of the horizontal bar, the healthy hand held the opposite side of the vertical bar, and the chest and mandible were fixed with thermoplastic film. CBCT scan was performed weekly, and gray level registration was carried out according to the three registration regions of interest: breast or chest wall field, supraclavicular and inferior field, and axillary field. The positioning errors in the left and right, head and foot, abdomen and back directions were analyzed between two groups. Results In the 3D printed breast bracket group, the positioning errors of breast or chest wall field, supraclavicular and inferior field and axillary field in the left and right, head and foot, abdomen and back directions were (1.75±1.26), (1.77±1.11) and (1.70±1.08) mm, (1.75±1.25), (1.72±1.09) and (1.70±1.05) mm,(1.86±1.34), (2.14±2.13) and (1.66±1.19) mm, respectively.In the common headrest group, the positioning errors of breast or chest wall field, supraclavicular and inferior field and axillary field in the left and right, the head and feet, the abdomen and back directions were (2.54±1.84), (2.73±3.62) and (2.18±2.45) mm, (3.25±2.02), (3.52±2.26) and (2.62±2.83) mm, (3.25±2.05), (4.44±2.90) and (3.10±3.18) mm, respectively.The positioning errors significantly differed between two groups (all P<0.05). Conclusions The positioning error of 3D printed personalized breast bracket fixation is less than that of common headrest fixation. The positioning consistency of 3D printed personalized breast bracket in the three target areas of breast or chest wall field, supraclavicular and inferior field and axillary field is better than that of common headrest.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Tang Xiaoyan
	Ye Rong
	Huang Fasheng
	Yan Yuying
	Zhang Weisha
	Huang Zuoyun
	Ling Rui

Key words： Breast neoplasms/intensity-modulated radiation therapy 3D printed breast bracket Positioning error Consistency

Received: 11 October 2021

Corresponding Authors: Ye Rong, Email: yerong7909@163.com

Cite this article:

Tang Xiaoyan,Ye Rong,Huang Fasheng et al. Application of 3D printed personalized breast bracket in IMRT for breast cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(7): 633-637.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20211011-00399 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2022/V31/I7/633

[1] 王平. 乳腺癌[M]// 王绿化,朱广迎.肿瘤放射治疗学.北京:人民卫生出版社,2005:249,260.Wang P. Breast cancer[M]// Wang LH, Zhu GY. Cancer Radiotherapy. Beijing: People's Medical Publishing House,2005:249,260.
[2] Morrow M, Strom EA, Bassett LW, et al.Standard for breast conservation therapy in the management of invasive breast carcinoma[J]. CA Cancer J Clin, 2002, 52(5):277-300. DOI: 10.3322/canjclin.52.5.277.
[3] 李琰, 潘华锋, 孙桂兰. 改进手术方法对乳腺癌改良根治术后皮下积液的预防效果研究[J]. 海南医学院学报, 2016, 22(2): 175-177,181. DOI: 10.13210/j.cnki.jhmu.20151014.006.
Li Y,Pan HF,Sun GL.Effect of modified surgical method on subcutaneous hydrops of patients with breast cancer after modified radical mastectomy[J]. J Hainan Med Univ,2016,22(2):175-177,181. DOI: 10.13210/j.cnki.jhmu.20151014.006.
[4] 徐朋琴, 蔡晶, 葛彬彬, 等. 食管癌放疗两种体位固定技术摆位误差的比较[J]. 临床肿瘤学杂志, 2018, 23(12): 1128-1130. DOI: 10.3969/j.issn.1009-0460.2018.12.014.
Xu PQ, Cai J, Ge BB, et al.A comparative study of set-up errors in two body position fixation techniques for esophageal cancer radiotherapy[J]. Chin Clin Oncol,2018,23(12):1128-1130. DOI: 10.3969/j.issn.1009-0460.2018.12.014.
[5] 曹井丽, 高文超, 秦琪, 等. 不同体位固定方式对乳腺癌放疗摆位精度的影响[J]. 现代肿瘤医学, 2021, 29(3): 507-511. DOI: 10.3969/j.issn.1672-4992.2021.03.032.
Cao JL, Gao WC, Qin Q, et al.Effects of different fixation methods on positioning error of breast cancer radiotherapy[J]. J Modern Oncol,2021,29(3):507-511. DOI: 10.3969/j.issn.1672-4992.2021.03.032.
[6] 申正文, 李师, 谭霞, 等. 乳腺癌根治术后放疗靶区外放边界的分析及验证[J]. 中国医学物理学杂志, 2021, 38(7): 804-808. DOI: 10.3969/j.issn.1005-202X.2021.07.003.
Shen ZW, Li S, Tan X, et al.Analysis and verification of target margin for post-mastectomy radiotherapy for breast cancer[J]. Chin J Med Phys,2021,38(7):804-808. DOI: 10.3969/j.issn.1005-202X.2021.07.003.
[7] 孔栋, 孔旭东, 惠琳, 等. 补偿膜下空腔对放疗计划系统计算浅层剂量的影响[J]. 肿瘤预防与治疗, 2021, 34(1): 64-69. DOI: 10.3969/j.issn.1674-0904.2021.01.011.
Kong D, Kong XD, Hui L, et al.Effect of cavity under bolus on shallow dose calculaled by radiotherapy planning system[J]. J Cancer Control Treat,2021,34(1):64-69. DOI: 10.3969/j.issn.1674-0904.2021.01.011.
[8] 林发生, 陈景强, 陈榕钦, 等. 基于3D打印制作放疗个性化头枕的剂量学测量研究[J]. 医疗装备, 2020, 33(3): 11-13. DOI: 10.3969/j.issn.1002-2376.2020.03.007.
Lin FS, Chen JQ, Chen RQ, et al.Dosimetric measurement of personalized headrest based on 3D printing[J]. Chin J Med Device,2020,33(3):11-13. DOI: 10.3969/j.issn.1002- 2376.2020.03.007.
[9] Hasan Y,Kim L,Martinez A,et al.Image guidance in exteral beam accelerated partial breast irradiation:comparison of surrogates for the lumpectomy cavity[J].Breast Dis,2008,19(3):268-268. DOI:https ://doi.org/10.1016/j.ijrobp.2007.08.079.
[10] 吴传锋, 吴锦昌, 顾科, 等. 利用CBCT研究乳腺托架固定下乳腺癌放疗下颈摆位误差及相应CTV外放边界[J]. 中华放射医学与防护杂志, 2016, 36(10): 753-756. DOI: 10.3760/cma.j.issn.0254-5098.2016.10.007.
Wu CF, Wu JC, Gu K, et al.Analysis of lower neck setup errors and planning target margin by CBCT for breast cancer radiation with breast bracket immobilized[J]. Chin J Radiol Med Protect,2016,36(10):753-756. DOI: 10.3760/cma.j.issn.0254- 5098.2016.10.007.
[11] 谢涛, 许青, 彭佳元, 等. 乳腺癌胸壁野结合锁骨上野放疗时头部固定的重要性研究[J]. 中华放射肿瘤学杂志, 2018, 27(5): 500-503. DOI: 10.3760/cma.j.issn.1004-4221. 2018.05.013.
Xie T, Xu Q, Peng JY, et al.Study of significance of head fixation in the chest wall field combined with supraclavicular field radiotherapy for breast cancer[J]. Chin J Radiat Oncol,2018,27(5):500-503. DOI: 10.3760/cma.j.issn.1004- 4221.2018.05.013.
[12] 张彦新, 郇福奎, 朱耿强, 等. 乳腺癌术后调强放疗颈胸一体固定的摆位误差分析[J].中华放射肿瘤学杂志, 2021, 30(8): 835-840. DOI: 10.3760/cma.j.cn113030-20200229-00081.
Zhang YX, Huan FK, Zhu GQ, et al.Analysis of setup errors of postoperative intensity-modulated radiotherapy immobilized with integrated cervicothoracic board (mask) system in breast cancer patients[J]. Chin J Radiat Oncol,2021,30(8):835-840. DOI: 10.3760/cma.j.cn113030-20200229-00081.
[13] 陈慧茹, 王石, 吴朝霞, 等. 乳腺癌保乳术后全乳及锁骨上下区三种调强剂量学分析[J]. 中华放射肿瘤学杂志, 2017, 26(7): 774-777. DOI: 10.3760/cma.j.issn.1004-4221. 2017.07.011.
Chen HR, Wang S, Wu ZX, et al.Dosimetric comparison between three radiotherapy regimens involving supraclavicular and infraclavicular regions in breast cancer patients after breast-conserving surgery[J]. Chin J Radiat Oncol,2017,26(7):774-777. DOI: 10.3760/cma.j.issn.1004-4221.2017.07.011.
[14] Porock D.Factors influencing the severity of radiation skin and oral mucosal reactions: development of a conceptual framework[J]. Eur J Cancer Care (Engl), 2002, 11(1):33-43.
[15] Naylor W, Mallett J.Management of acute radiotherapy induced skin reactions: a literature review[J]. Eur J Oncol Nurs, 2001, 5(4):221-233. DOI: 10.1054/ejon.2001.0145.
[16] Kirova YM, Fromantin I, De Rycke Y, et al.Can we decrease the skin reaction in breast cancer patients using hyaluronic acid during radiation therapy? Results of phase III randomised trial[J]. Radiother Oncol, 2011, 100(2):205-209. DOI: 10.1016/j.radonc.2011.05.014.
[17] 徐子海, 童蕾, 陈磊, 等. 基于CTvision图像引导的乳腺癌术后患者调强放疗摆位误差测量与分析[J]. 中国医学物理学杂志, 2015, 32(6): 870-873,877. DOI: 10.3969/j.issn.1005- 202X.2015.06.023.
Xu ZH, Tong L, Chen L, et al.Measurement and analysis of patients' set-up errors in CTvision images-guided radiotherapy after breast cancer operation[J]. Chin J Med Phys,2015,32(6):870-873,877. DOI: 10.3969/j.issn.1005-202X.2015.06.023.
[18] 赖德星, 黄家莲, 李燕红, 等. 真空袋联合乳腺托架应用固定乳腺癌放疗体位的分析[J]. 临床医学工程, 2015, 22(8): 978-979. DOI: 10.3969/j.issn.1674-4659.2015.08.0978.
Lai DX, Huang JL, Li YH, et al.Analysis on the Vacuum Bag Combined with Breast Bracket in the Fixation of Breast Cancer Radiotherapy Position[J]. Clin Med Engineer,2015,22(8):978-979. DOI: 10.3969/j.issn.1674-4659.2015.08.0978.