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【目的】探讨螺旋断层放疗(TOMO)时行不同频次图像引导之间的差异,探寻合适的图像引导策略。【方法】选取我中心2015年1月1日~2016年5月15日收治的头颈部肿瘤患者88例、胸腹部肿瘤患者63例、盆腔肿瘤患者19例,均接受TOMO治疗,每次治疗前均行兆伏级CT(MVCT)扫描进行,收集前五次和每周第一次的摆位误差,分别和整个疗程的摆位误差进行比较研究。【结果】胸腹组和盆腔组不同频次扫描之间的摆位误差比较无统计学差异,头颈组前五次扫描和整个疗程的比较中前后方向的摆位误差有统计学意义(P<0.05),其他对比的差异无统计学意义。【结论】胸腹部肿瘤和盆腔肿瘤放射治疗时,可考虑前五次扫描或每周一次扫描的方式来代替每天一次扫描,减少患者受到的额外辐射剂量。头颈部肿瘤放射治疗时,前五次的扫描的前后方向误差跟整个疗程误差比较存在明显差异,不能以此为据来指导后续的日常摆位,可以考虑采用每周扫描一次MVCT的方案来代替每天扫描一次的方案。
【Objective】 To explore the differences between different frequency images guided by TOMO and explore the suitable image guidance strategy. 【Methods】 Eighty-eight patients with head and neck cancer, 63 patients with thoracoabdominal tumor and 19 patients with pelvic tumor who were admitted to our center from January 1, 2015 to May 15, 2016 were enrolled in this study. All patients underwent TOMO treatment. Each treatment Before MVCT scan, the first five errors and the first error every week were collected and compared with the setup errors of the whole course of treatment respectively. 【Results】 There was no significant difference in the setup error between different frequency scans in the thoracoabdominal group and the pelvic group, and the error in the anteroposterior direction in the first five scans of the head and neck group and the whole course of treatment was statistically significant (P <0.05 ), The other differences were not statistically significant. 【Conclusion】 In the radiotherapy of thoracoabdominal tumors and pelvic tumors, the first five scans or weekly scans can be considered in place of the daily scans to reduce the patient’s additional radiation dose. Head and neck cancer radiotherapy, the first five times the scan before and after the direction of the error compared with the entire course of treatment there is a significant difference in error can not be used as a guide to the follow-up of daily placement can be considered once a week scan MVCT program to Instead of scanning once a day program.