[1]丘敏敏,徐圆,钟嘉健,等.鼻咽癌放疗中T形口腔固定器的研制及其摆位误差和剂量影响研究[J].中国医学物理学杂志,2020,37(11):1367-1372.[doi:DOI:10.3969/j.issn.1005-202X.2020.11.005]
　QIU Minmin,XU Yuan,ZHONG Jiajian,et al.Development of T-shaped oral fixator and its effects on setup errors and dosimetric change in nasopharyngeal carcinoma radiotherapy[J].Chinese Journal of Medical Physics,2020,37(11):1367-1372.[doi:DOI:10.3969/j.issn.1005-202X.2020.11.005]
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鼻咽癌放疗中T形口腔固定器的研制及其摆位误差和剂量影响研究()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第11期
页码:
1367-1372
栏目:
医学放射物理
出版日期:
2020-12-02

文章信息/Info

Title:
Development of T-shaped oral fixator and its effects on setup errors and dosimetric change in nasopharyngeal carcinoma radiotherapy
文章编号:
1005-202X（2020）11-1367-06
作者:
丘敏敏1; 徐圆1; 钟嘉健2; 邓永锦2; 周凌宏1
1.南方医科大学生物医学工程学院， 广东 广州 510515； 2.中山大学附属第一医院放射治疗科， 广东 广州 510080
Author(s):
QIU Minmin1;  XU Yuan1;  ZHONG Jiajian2;  DENG Yongjin2;  ZHOU Linghong1
1. College of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China 2. Department of Radiotherapy, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
关键词:
鼻咽癌; 自制T形口腔固定器; 摆位误差; 剂量学变化
Keywords:
Keywords: nasopharyngeal carcinoma self-made T-shaped oral fixator setup errors dosimetric change
分类号:
R811.1
DOI:
DOI:10.3969/j.issn.1005-202X.2020.11.005
文献标志码:
A
摘要:
【摘要】目的：探讨自制T形口腔固定器在鼻咽癌放疗中对摆位误差，以及对靶区和危及器官受照剂量的影响。方法：选择40例鼻咽癌放疗患者，随机分成两组，每组20例。A组为常规热塑膜固定器组，B组为热塑膜联合自制T形口腔固定器组，应用锥形束CT（CBCT）比较两组头部和颈部的平移误差及旋转误差；将误差带入计划系统重新计算模拟计划，得到靶区和危及器官体积剂量参数，与原始计划比较。结果：两组平移误差接近，而旋转误差明显减少，其中颈部≤2°的误差，A组在Cor、Sag、Tra方向上分别占88.7%、83.4%、80.5%；B组占98.4%、95.3%、96.9%，且具有统计学意义（P均<0.01）。靶区体积剂量百分比，A组的GTVnx-D98%、GTVnd-D98%、CTV1-D95%、CTV2-D95%在±3%内占87.5%、88.3%、98.5%、98.5%，B组占100%、96.8%、100%、100%，B组剂量变化范围明显变小且全部具有统计学意义（P均<0.01）。结论：热塑膜联合自制T形口腔固定器可有效减少摆位误差，提高摆位重复性，提高靶区剂量准确性，尤其对于颈部，保障调强放疗的疗效，可在临床中推广应用。
Abstract:
Abstract: Objective To explore the effects of the self-made T-shaped oral fixator on the setup errors and the PTV and organ-at-risk (OAR) dose in radiotherapy for nasopharyngeal carcinoma. Methods 40 cases of nasopharyngeal carcinoma were randomly divided into two groups, with 20 patients in each group. Group A was immobilized by conventional thermoplastic mask, and group B was immobilized by thermoplastic maskplus self-made T-shaped oral fixator. Cone beam CT was used to compare the linear errors and rotation errors in the head and neck between those two groups. The PTV and organ-at-risk (OAR) dose were recalculated based on the above setup errors in planning system, and were compared with the original plan. Results The linear errors of two groups were very close, but the rotation errors were reducedin the group B, among which, the rotation errors in neck reduced to within 2°. In group A, the errors ratesin Cor, Sag and Tra axis were 88.7%, 83.4% and 80.5% respectively, while that of group B were 98.4%, 95.3% and 96.9%, which has a statistically significant difference (P<0.01, P<0.01, P<0.01). As for the percentage of gross target volume dose in PTV, Group As GTVnx-D98%, GTVnd-D98%, CTV1-D95% and CTV2-D95% within ±3% occupied 87.5%, 88.3%, 98.5% and 98.5% respectively, but that of group B were 100%, 96.8%, 100% and 100% respectively, which also have their statistical differences （P<0.01, P<0.01, P<0.01, P<0.01）. Conclusions Thermoplastic mask plus self-made T-shaped oral fixator can effectively reduce the setup errors, enhance therepeatability of setup, improve the accuracy of dosage in PTV, especially on neck. It can be popularized in clinical practice.

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备注/Memo

备注/Memo:
【收稿日期】2020-05-13 【作者简介】丘敏敏，技师，研究方向：从事CT模拟定位机和医用直线加速器的操作，E-mail: qiumm@mail.sysu.edu.cn 【通信作者】周凌宏，教授，博士生导师，研究方向：肿瘤放射物理学和智能医学仪器，E-mail: smart@smu.edu.cn
更新日期/Last Update: 2020-12-02