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目的:探讨超声引导摆位系统(BAT)引导放疗在前列腺癌调强放射治疗中的实用性和可行性。方法:8例前列腺癌患者实施调强放疗,每日放疗前进行BAT精度校准后,应用BAT引导摆位和调整靶区,计算BAT引导放射治疗所消耗的时间,比较BAT摆位前后,治疗床的移动偏差以及治疗期间前列腺特异抗原(PSA)水平变化。结果:BAT引导放疗时间分为每日BAT校准时间(8.32±5.53)min、BAT调整放疗靶区时间(6.83±4.59)min和照射时间(12.44±5.30)min,分别占总时间(27.59±6.61)min的30%、25%和46%。BAT验证后移动治疗床在左右方向(RL)为(3.29±2.87)mm,前后方向(AP)为(4.10±2.62)mm,头脚方向(SI)为(3.90±3.93)mm,各个方向上的偏差符合正态分布。单一方向上平均偏移>5mm的百分数,RL占24.2%,SI占25.9%,AP占27.2%。治疗前后总PSA(TPSA)和复合PSA(CPSA)显著降低,P值分别为0.008和0.044;TPSA降低与治疗呈正相关,r=0.863,P=0.006。结论:BAT引导前列腺癌调强放疗是可行的,可以减少摆位误差和器官移位,PSA水平变化和治疗相关,但是应用BAT摆位几乎使每个患者的治疗时间增加1倍。
Objective: To investigate the practicability and feasibility of guided guided radiotherapy (BAT) guided radiation therapy in intensity modulated radiation therapy of prostate cancer. Methods: 8 patients with prostate cancer underwent intensity-modulated radiotherapy and BAT accuracy calibration before daily radiotherapy. BAT was used to guide positioning and adjust the target area to calculate the time consumed by BAT-guided radiotherapy. Before and after BAT was set, And the change of prostate specific antigen (PSA) level during treatment. BAT-guided radiotherapy time was divided into daily BAT calibration (8.32 ± 5.53) min, BAT adjusted radiotherapy target time (6.83 ± 4.59) min and irradiation time (12.44 ± 5.30) min, accounting for 27.59 ± 6.61 ) min of 30%, 25% and 46%. After BAT verification, the mobile treatment bed was 3.29 ± 2.87 mm in RL, 4.10 ± 2.62 mm in AP, and 3.90 ± 3.93 mm in head-to-tail direction in all directions The deviations correspond to the normal distribution. In a single direction, the average deviation is> 5mm, RL accounts for 24.2%, SI accounts for 25.9% and AP accounts for 27.2%. Before and after treatment, total PSA (TPSA) and composite PSA (CPSA) decreased significantly, with P values of 0.008 and 0.044, respectively. TPSA reduction was positively correlated with treatment, r = 0.863, P = 0.006. CONCLUSIONS: BAT-guided IMRT is feasible and can reduce placement errors and organ transposition. Changes in PSA levels correlate with treatment-related outcomes, but using BAT placement almost doubled the treatment time per patient.