摘要
目的探讨鼻咽癌调强放疗中头、颈部配准对摆位精度的影响。方法回顾性收集2015年1月-2016年10月接受调强放疗的鼻咽癌患者101例,采用医院焦虑抑郁量表(HADS)评估患者的心理状态并进行分组,其中无焦虑抑郁组62例、焦虑抑郁组39例。在影像匹配工作站上分别选取头部和颈部区域进行配准,采用自动骨性配准+手动微调的配准方式获取X、Y、Z轴的摆位误差数据。采用Wilcoxon符号秩检验比较不同配准区域摆位误差的差异。结果101例患者颈部区域配准X、Y、Z轴的摆位误差差别均大于头部(P<0.001)。无焦虑抑郁组、焦虑抑郁组头部与颈部区域配准X、Y、Z轴的摆位误差差别比较均有统计学意义(P<0.001),Z值分别为(-4.276、-4.713、-5.576)和(-9.165、-10.055、-10.096)。结论鼻咽癌放疗中,颈部区域配准的摆位误差大于头部,焦虑抑郁患者尤为突出。临床上操作时应重点关注颈部配准精度,对焦虑抑郁患者应加强摆位验证。
Objective To investigate the impact of head and neck registration on positioning accuracy in intensity-modulated radiotherapy(IMRT)for nasopharyngeal carcinoma(NPC).Methods Data of 101 NPC patients treated with IMRT from January 2015 to October 2016 were retrospectively collected.Patients were assessed using the hospital anxiety and depression scale(HADS)and stratified into non-anxiety/depression(62 cases)group and anxiety/depression(39 cases)group.The head and neck regions were selected for alignment on the image matching workstation,using an automatic bony registration with manual refinement protocol to quantify setup errors along X,Y,and Z axes.The Wilcoxon signed-rank test was used to compare setup errors between different alignment regions.Results The difference in setup errors in the X,Y,and Z axes of alignment in the neck region was greater than that in the head in 101 patients(X,Y,Z;P<0.001).The comparison of the differences in the setup errors between the head and neck regions aligned to the X,Y,and Z axes in the non-anxiety/depression group and the anxiety/depression group were statistically significant(P<0.001),with Z-values of(-4.276,-4.713,-5.576)and(-9.165,-10.055,-10.096).Conclusion NPC radiotherapy demonstrates greater setup errors in neck versus head registration,particularly among patients with anxiety/depression.These findings suggest clinical protocols should prioritize neck registration accuracy and implement enhanced verification for psychologically distressed patients.
作者
吴建东
郭翌
林志斌
郭飞宝
薛万桂
吕文龙
WU Jiandong;GUO Yi;LIN Zhibin;GUO Feibao;XUE Wangui;L Wenlong(Department of Radiation Therapy,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Department of Radiation Therapy,National Regional Medical Center,Binhai Branch of the First Affiliated Hospital of Fujian Medical University,Fuzhou 350212,China;Key Laboratory of Radiation Biology of Fujian Higher Education Institutions,Fuzhou 350005,China)
出处
《福建医科大学学报》
2025年第3期175-179,共5页
Journal of Fujian Medical University
关键词
鼻咽癌
放射治疗
头部与颈部区域配准
摆位误差
nasopharyngeal carcinoma
intensity-modulated radiation therapy
head-neck region image registration
positioning errors
