Exploration of the impact of body mass index on radiotherapy setup error in nasopharyngeal carcinoma patients

张　萍; 虞维博; 许　青

doi:10.19401/j.cnki.1007-3639.2018.05.011

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Exploration of the impact of body mass index on radiotherapy setup error in nasopharyngeal carcinoma patients

更新时间：2026-01-27

- Exploration of the impact of body mass index on radiotherapy setup error in nasopharyngeal carcinoma patients
- China Oncology Vol. 28, Issue 5, Pages: 389-393(2018)
- 作者机构：
  
  复旦大学附属肿瘤医院放疗科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2018.05.011
  CLC： R730.55;R739.63
- Published Online：12 June 2018，
  
  Published：12 June 2018
- 稿件说明：
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张　萍,虞维博,许　青,等. 探究体质量指数对鼻咽癌患者放疗摆位误差的影响[J]. 中国癌症杂志, 2018, 28(5): 389-393.

张　萍, 虞维博, 许　青. Exploration of the impact of body mass index on radiotherapy setup error in nasopharyngeal carcinoma patients[J]. China Oncology, 2018, 28(5): 389-393.
张　萍,虞维博,许　青,等. 探究体质量指数对鼻咽癌患者放疗摆位误差的影响[J]. 中国癌症杂志, 2018, 28(5): 389-393. DOI： 10.19401/j.cnki.1007-3639.2018.05.011.

张　萍, 虞维博, 许　青. Exploration of the impact of body mass index on radiotherapy setup error in nasopharyngeal carcinoma patients[J]. China Oncology, 2018, 28(5): 389-393. DOI： 10.19401/j.cnki.1007-3639.2018.05.011.

摘要

背景与目的：放射治疗是鼻咽癌的主要治疗手段，该研究旨在探讨鼻咽癌患者放疗的摆位误差与体质量指数（body mass index，BMI）之间的关系。方法：选用复旦大学附属肿瘤医院2017年1月—2017年6月接受根治性放疗的鼻咽癌患者50例，在放疗前1天和放疗4周后测量患者体质量变化情况，分别在放疗前后对头颈区域进行锥形束CT（cone beam CT，CBCT）扫描，以获取患者的位置偏移数据，包括患者的头脚位（head pin，LNG）、左右位（lateral，LAT）和背腹位（dorsoventral，VRT）3个方向，通过相应CBCT图像采集计算出患者的摆位误差，判断放疗定位是否准确，合理计划放疗方案，分析其与实际检测的摆位误差是否存在相关性。结果：放疗前患者体质量平均为（53.27±3.79） kg，放疗4周后平均体质量为（49.37±3.29） kg，放疗后体质量明显降低，差异有统计学意义（P0.05）；三个方向的系统误差LNG、LAT和VRT检测结果分别为2.6、2.0和3.2 mm，随机误差分别为2.9、2.0和3.8 mm，以BMI=24为临界值，其中BMI≥24 kg/m

组在三维方向及水平面旋转摆位的系统误差分别为（2.80±0.35）、（2.30±0.17）和（3.90±0.42） mm，BMI＜24 kg/m

组的系统误差分别为（2.30±0.12）、（1.90±0.22）和（3.00±0.67） mm，两组间LNG、LAT和VRT指标比较差异均有统计学意义（P均0.05），相关性结果比较中LNG、LAT和VRT与BMI也不存在相关性（P＞0.05）。可见BMI≥24 kg/m

组患者的摆位误差较高，降低患者BMI会使三维摆位中心位置点向腹侧偏移和水平面逆向偏角度位移。结论：鼻咽癌患者经放疗时BMI与摆位误差无相关性，升高或降低不会使放疗适应性改变，而放疗引起患者体质量降低，进而使摆位误差与放疗剂量分布、疗效呈现相关性，需根据具体情况调整放疗方案，为精准摆位奠定基础。

Abstract

Background and purpose: Radiotherapy is the main treatment for nasopharyngeal carcinoma. This study aimed to investigate the potential association between body mass index (BMI) and setup error during daily delivery of radiotherapy in the patients with nasopharyngeal carcinoma. Methods: This study enrolled 50 patients with nasopharyngeal carcinoma

who were treated with radical radiation therapy in Fudan University Shanghai Cancer Center from January 2017 to June 2017. The body weight was measured before radiation and 4 weeks post-radiation. Cone beam CT was performed at the same time point to obtain position data of the patients

including the patient’s head pin (LNG)

lateral (LAT)

dorsoventral (VRT) directions. Based on these analyses

we evaluated the accuracy of patient setup

as well as the adequacy of margins during target volume contouring. Results: The average body weights of patients before radiotherapy and 4 weeks post-radiotherapy were (53.27±3.79) and (49.37±3.29) kg

respectively. There was significant decrease of body weight during radiotherapy (P0.05). System error at LNG

LAT and VRT detections were 2.6

2.0 and 3.2 mm

respectively. The random error of LNG

LAT and VRT were 2.9

2.0 and 3.8 mm

respectively. BMI 24 was chosen to be the cutting point. In the subgroup with BMI≥24 kg/m2

the system errors at three-dimensional direction and horizontal rotation position were (2.80±0.35)

(2.30±0.17) and (3.90±0.42) mm

respectively. In the subgroup with BMI24 kg/m2

the system errors at three directions were (2.30±0.12)

(1.90±0.22) and (3.00±0.67) mm

respectively. There was significant difference in LNG

LAT and VRT between the two subgroups (P0.05). The correlation analysis revealed no significant association between setup values and BMI (P0.05). In other words

the setup error was higher in the subgroups with BMI≥24 kg/ m2. Decreasing BMI shifted the central point of patient setup towards ventral side and rotated the patient setup point reversely. Conclusion: There was no significant association between BMI and setup error before radiotherapy in patients with nasopharyngeal carcinoma. However

weight loss during radiotherapy influenced accuracy of patient setup. To ensure the accuracy of radiation

certain corrections have to be made during radiotherapy.

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Related Institution

复旦大学附属肿瘤医院放射治疗中心，复旦大学上海医学院肿瘤学系

Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University

Department of Radiology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University

Department of Thoracic Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University

Department of Oncology, Taiyuan Central Hospital/The Ninth Clinical Medical College of Shanxi Medical University

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