摘要
目的探讨放射治疗盆腔肿瘤时摆位误差的影响因素,有助于提高放射治疗的精度。方法回顾性分析63例盆腔肿瘤患者,放射治疗前三次以及随后每周至少进行一次锥形束CT(cone beam computed tomography,CBCT)扫描进行摆位验证,将三维重建的摆位图像与定位获取的CT图像进行匹配,获取前后、头脚和左右三个方向的摆位误差,利用图像引导的在线校正系统纠正患者的摆位误差。分析年龄、性别、肿瘤原发部位、体质量指数(body mass index,BMI)、体位固定方式和文化水平对摆位误差的影响。结果前后、头脚和左右三个方向的摆位误差进行比较,头脚方向误差大于其余两个方向(χ^(2)=92.221,P<0.001)。在前后、头脚和左右方向的摆位误差分别为[0.17(0.11,0.26)]、[0.26(0.18,0.45)]和[0.20(0.10,0.32)]cm。在前后方向,年龄<60岁、宫颈癌患者以及文化水平<初中的分组患者摆位误差更大(P<0.001);在头脚方向,年龄≥60岁、BMI≥24 kg/m^(2)以及体膜固定方式的分组患者摆位误差更大(P<0.05或<0.01);在左右方向,文化水平<初中的分组患者摆位误差更大(P<0.05)。结论在放射治疗过程中,盆腔肿瘤患者的年龄、肿瘤原发部位、BMI、体位固定方式和文化水平会对摆位误差产生一定的影响。因此,需制定个性化的治疗方案来确保精准治疗的实施。
Objective To explore the factors that influence setup errors during pelvic tumor radiotherapy,which is helpful for improving the precision of radiation treatment.Methods We conducted a retrospective analysis of 63 patients with pelvic tumors.Before the radiotherapy,we performed Cone Beam Computed Tomography(CBCT)scans on each patient three times,and then at least once a week thereafter for setup verification.We matched the 3D reconstructed images of the patients′positions with locally acquired CT images to assess setup errors in vertical translation(Vrt),longitudinal translation(Lng),and lateral translation(Lat).An image-guided online correction system was then used to correct any setup errors for the patients.The influence was analyzed of age,gender,tumor primary site,body mass index(BMI),positioning method and educational level on positioning errors.Results Setup errors were compared across three vertical,longitudinal,and lateral directions.It was found that the errors in longitudinal translation were greater than those in the other two directions(χ^(2)=92.221,P<0.001).And the absolute setup errors in Vrt,Lng,and Lat directions were[0.17(0.11,0.26)]cm,[0.26(0.18,0.45)]cm,and[0.20(0.10,0.32)]cm,respectively.In vertical translation,the setup errors were notably higher in certain subgroups:patients aged under 60 years old,those with cervical cancer,and individuals with a literacy level below junior high school(P<0.001).In longitudinal translation,greater setup errors were observed in subgroups of patients aged 60 years old and older,those with a BMI of 24 kg/m^(2)or higher,and those with the body-membrane fixation method(P<0.05 or<0.01).Finally,in lateral translation,the setup error was more significant in patients with a literacy level below junior high school(P<0.05).Conclusion During radiotherapy for patients with pelvic tumors,factors such as age,tumor location,BMI,body posture fixation technique,and cultural background can have a certain impact on setup errors.Therefore,individualized treatment plans need to be formulated to ensure the implementation of precise treatment.
作者
赵新雨
王峰
苏浩
王雯
ZHAO Xinyu;WANG Feng;SU Hao;WANG Wen(Department of Oncology,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China;Department of Radiation Oncology,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China)
出处
《滨州医学院学报》
2026年第1期36-40,共5页
Journal of Binzhou Medical University
关键词
盆腔肿瘤
摆位误差
放射治疗
锥形线束CT
pelvic tumor
setup error
radiotherapy
cone beam computed tomography
