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目的:利用锥形束CT(CBCT)研究不同的体位固定方式对食管癌放射治疗时摆位准确性的影响。方法:随机选取30例食管癌患者分成2组(真空垫组,真空气垫+翼形板固定组),每组治疗时利用CBCT进行扫描,共扫描150次,获取150组CT数据,利用XVI软件将CBCT扫描图像与计划CT图像进行自动骨性配准,分别得出X、Y、Z共3个线性方向上的摆位误差值,对获得的2组数据进行比较,采用t检验比较数据差异有无统计学意义。结果:真空垫固定体位组摆位后行CBCT扫描,在X、Y、Z方向上进行配准所得的平均误差分别为:X方向(2.19±1.62)mm,Y方向(2.92±2.13)mm、Z方向(2.83±2.17)mm;而翼形板+真空垫固定组摆位后行CBCT扫描,在X、Y、Z方向上进行配准所得的平均误差分别为:X方向(1.89±0.83)mm、Y方向(2.33±1.29)mm、Z方向(1.54±0.93)mm。两组误差数据差异均有统计学意义(P<0.05)。结论:翼形板联合真空垫固定体位技术更能减少食管癌放疗时的摆位误差,更能体现恶性肿瘤的“三精”放疗。
OBJECTIVE: To study the effect of different position fixation methods on the placement accuracy of esophageal cancer during radiotherapy by cone beam computed tomography (CBCT). Methods: Thirty patients with esophageal cancer were randomly divided into two groups (vacuum pad group, vacuum pad + wing plate fixation group). Each treatment group was scanned by CBCT and scans 150 times to obtain 150 groups of CT data. Using XVI software The automatic bone registration of CBCT scan images and planned CT images were carried out. The error values of the setup in three linear directions of X, Y and Z were obtained, and the two groups of data were compared. The t-test was used to compare the data differences There is no statistical significance. Results: The average error of the CBCT scanning in the fixed position of the vacuum pad was as follows: X direction (2.19 ± 1.62) mm, Y direction (2.92 ± 2.13) mm, Z direction (2.83 ± 2.17) mm; meanwhile, the average errors in the X, Y and Z directions of the CBCT scan after setting of the wing plate and the vacuum pad fixation group are: X direction (1.89 ± 0.83) mm, Y direction (2.33 ± 1.29) mm, Z direction (1.54 ± 0.93) mm. There was significant difference between the two sets of error data (P <0.05). Conclusion: The combination of the wing plate and the vacuum pad fixed position technique can reduce the setting error of esophageal cancer radiotherapy, and can better reflect the malignant tumor “three fine” radiotherapy.