基于CBCT影像研究胸部肿瘤放疗中手臂位置对于摆位及治疗的影响

何　叶; 许　青; 胡晓钰; 朱正飞

doi:10.19401/j.cnki.1007-3639.2019.12.007

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基于CBCT影像研究胸部肿瘤放疗中手臂位置对于摆位及治疗的影响

更新时间：2026-01-27

- 基于CBCT影像研究胸部肿瘤放疗中手臂位置对于摆位及治疗的影响
- The effect of arm position on placement and treatment in chest tumor radiotherapy based on CBCT imaging
- 中国癌症杂志 2019年29卷第12期页码：961-964
- 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.1007-3639.2019.12.007
  中图分类号：
- 网络出版：2020-01-08，
  
  纸质出版：2020-01-08
- 稿件说明：
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何　叶, 许　青, 胡晓钰, 朱正飞. 基于CBCT影像研究胸部肿瘤放疗中手臂位置对于摆位及治疗的影响[J]. 中国癌症杂志, 2019, 29(12): 961-964.

HE Ye, XU Qing, HU Xiaoyu, et al. The effect of arm position on placement and treatment in chest tumor radiotherapy based on CBCT imaging[J]. China Oncology, 2019, 29(12): 961-964.
何　叶, 许　青, 胡晓钰, 朱正飞. 基于CBCT影像研究胸部肿瘤放疗中手臂位置对于摆位及治疗的影响[J]. 中国癌症杂志, 2019, 29(12): 961-964. DOI： 10.19401/j.cnki.1007-3639.2019.12.007.

HE Ye, XU Qing, HU Xiaoyu, et al. The effect of arm position on placement and treatment in chest tumor radiotherapy based on CBCT imaging[J]. China Oncology, 2019, 29(12): 961-964. DOI： 10.19401/j.cnki.1007-3639.2019.12.007.

摘要

背景与目的：准确的靶区位置是胸部立体定向放疗的重要因素。分析胸部肿瘤放疗中患者手臂的稳定性对于摆位及治疗的影响。方法：选取复旦大学附属肿瘤医院放疗科2018年4月—10月收治的胸部肿瘤且符合纳入标准的40例胸部肿瘤患者分成两组，每组各20例。两组患者在同样热塑膜固定胸部的同时，A组患者给予手臂支撑，B组患者手臂不给予有效支撑，让患者双手抱肘置于额头。每例患者每次治疗前后行锥形射束电脑断层扫描（cone beam computed tomography，CBCT）扫描，将得到的数据与计划CT图像配准，以获取患者在X、Y、Z轴上的摆位误差和治疗中位移误差并行单因素方差分析。结果：40例患者共获得619幅CBCT图像。A组患者和B组患者治疗前摆位误差分别为头脚方向（2.10±1.67）mm和（2.90±2.05）mm，左右方向（1.15±.0.96）mm和（1.59±1.51）mm，腹背方向（1.52±1.22）mm和（2.10±1.67）mm；治疗后摆位误差分别为头脚方向（1.05±0.89）mm和（1.12±0.94）mm，左右方向（0.65±0.75）mm和（0.69±0.71）mm，腹背方向（0.63±0.68）mm和（0.71±0.78）mm，得出的结果是治疗前A组患者摆位误差均小于B组患者，两组间在3个轴向上摆位误差对比差异均有统计学意义（P均0.05）；治疗后在胸部固定良好的情况下A组位移误差仍小于B组。结论：在胸部放疗中，同样固定胸部的情况下，手臂固定的患者在治疗过程中更放松舒适，使得摆位的重复性与准确性更高。

Abstract

Background and purpose: Accurate target location is an important factor in stereotactic radiotherapy of the chest. The aim of this study was to analyze the effects of patient’s arm stability on placement and treatment in chest tumor radiotherapy. Methods: Forty patients with chest tumors were selected from Apr. 2018 to Oct. 2018 in Department of Radiation Oncology

Fudan University Shanghai Cancer Center in this study

were divided into two groups (20 in each group). In the two groups of patients

the same thermoplastic film was used to fix the chest

and the patients in group A were given arm support. In group B

the arm was not effectively supported

and the patient's elbow was placed on the forehead. Each patient underwent cone beam computed tomography (CBCT) scan before and after each treatment

and the data were registered with the planned CT image to obtain the patient's placement error on the X

and Z axes and the parallel error in the treatment. Results: A total of 619 CBCT images were obtained from 40 patients. The pre-treatment placement errors of group A patients and group B patients were head and foot direction ［(2.10±1.67) mm

(2.90±2.05) mm］

left and right direction［(1.15±.0.96) mm

(1.59±1.51) mm］ and ventral direction ［(1.52±1.22) mm

(2.10±1.67) mm］; the position errors after treatment were head and foot direction ［(1.05±0.89) mm

(1.12±0.94) mm]

left and right direction ［(0.65±0.75) mm

(0.69± 0.71) mm］ and ventral direction ［(0.63±0.68) mm

(0.71±0.78) mm］. The results showed that the placement error of group A patients before treatment was smaller than that of group B

and the three groups were placed in three axial directions. After the error comparison

the P value was less than 0.05

which was statistically significant. In the case of good chest fixation after treatment

the displacement error of group A was still smaller than that of group B. Conclusion: In chest radiotherapy

when the chest is also fixed

the patient with arm fixation is more relaxed and comfortable during the treatment

which makes the placement more repeatable and accurate.

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