[1]梁黎,李勇.体质量指数对锥形束CT引导的宫颈癌放疗分次间摆位误差的影响[J].中国医学物理学杂志,2023,40(2):144-148.[doi:DOI:10.3969/j.issn.1005-202X.2023.02.003]
　LIANG Li,LI Yong.Effect of body mass index on inter-fractional setup errors in cone beam CT-guided radiotherapy of cervical cancer[J].Chinese Journal of Medical Physics,2023,40(2):144-148.[doi:DOI:10.3969/j.issn.1005-202X.2023.02.003]
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体质量指数对锥形束CT引导的宫颈癌放疗分次间摆位误差的影响()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
40卷
期数:
2023年第2期
页码:
144-148
栏目:
医学放射物理
出版日期:
2023-03-03

文章信息/Info

Title:
Effect of body mass index on inter-fractional setup errors in cone beam CT-guided radiotherapy of cervical cancer
文章编号:
1005-202X（2023）02-0144-05
作者:
梁黎; 李勇
四川省肿瘤医院放疗中心， 四川 成都 610000
Author(s):
LIANG Li;  LI Yong
Radiotherapy Center, Sichuan Cancer Hospital, Chengdu 610000, China
关键词:
体质量指数; 锥形束CT; 宫颈癌; 放射治疗; 摆位误差
Keywords:
Keywords: body mass index cone beam CT cervical cancer radiotherapy setup error
分类号:
R815.6
DOI:
DOI:10.3969/j.issn.1005-202X.2023.02.003
文献标志码:
A
摘要:
目的：探讨体质量指数（BMI）对锥形束CT（CBCT）引导的宫颈癌放疗分次间摆位误差的影响。方法：选取2020年9月至2021年9月在四川省肿瘤医院进行治疗的90例宫颈癌患者为研究对象，根据患者BMI分为过轻组（BMI≤18.4 kg/m2）、正常组（18.5 kg/m2≤BMI≤23.9 kg/m2）、超重组（BMI≥24.0 kg/m2），各组例数均为30例，并将各组成员随机分为两组，分别为真空垫组（n=15）、热塑膜组（n=15），均在放疗前后对盆腔区域进行CBCT扫描，以获取患者摆位数据，判断放疗定位是否准确，并制定合理的放疗方案，分析不同BMI对宫颈癌放疗摆位误差的影响。结果：在不考虑BMI分组时，真空垫组及热塑膜组患者总体摆位误差比较，差异没有统计学意义（P>0.05）；骨性配准宫颈癌患者X轴、Y轴摆位误差明显高于灰度配准者，Z轴摆位误差低于灰度配准（P<0.05）；对BMI过轻患者摆位误差进行分析发现，过轻者真空垫固位X轴、Y轴摆位误差均小于热塑膜固位者（P<0.05），但真空垫固位及热塑膜固位者Z轴摆位误差比较，差异没有统计学意义（P>0.05），且真空垫固位者X轴、Y轴、Z轴MPTV均显著低于热塑膜固位者（P<0.05）；对BMI正常患者摆位误差进行分析发现，热塑膜固位者Z轴摆位误差明显低于真空垫固位者，但X轴、Y轴摆位误差明显高于真空垫固位者（P<0.05），且真空垫固位者X轴、Y轴MPTV均显著低于热塑膜固位者，Z轴MPTV高于热塑膜固位者（P<0.05）；对BMI超重患者摆位误差进行分析发现，热塑膜固位者X轴、Y轴摆位误差显著低于真空垫固位者，Z轴摆位误差显著高于真空垫固位者（P<0.05），且真空垫固位的患者X轴、Y轴、Z轴MPTV均显著高于热塑膜固位者（P<0.05）。结论：在宫颈癌患者放射治疗中，BMI过轻者及BMI正常者选择真空垫固位，超重者选择热塑膜固位，均采用灰度配准，更能减少对摆位误差的影响，确保放疗计划的顺利进行。
Abstract:
Abstract: Objective To explore the impact of body mass index (BMI) on inter-fractional setup errors in cervical cancer patients treated with cone beam CT-guided radiotherapy. Methods According to BMI, 90 cervical cancer patients treated in Sichuan Cancer Hospital from September 2020 to September 2021 were divided into underweight group (BMI≤18.4 kg/m2), normal group (18.5 kg/m2≤BMI≤23.9 kg/m2), and overweight group (BMI≥24.0 kg/m2), with 30 cases in each group. Patients in each group were further divided into vacuum pad group (n=15) and thermoplastic film group (n=15). Pelvic CBCT scanning was performed before and after radiotherapy to obtain the setup data, so as to determine the accuracy of radiotherapy localization, formulate a reasonable radiotherapy plan, and analyze the effect of BMI on setup errors in radiotherapy of cervical cancer. Results Without regard to BMI, there was no significant difference in the overall setup error between vacuum pad group and thermoplastic film group (P>0.05) and the cervical cancer patients with bone registration had larger X-axis and Y-axis setup errors, but smaller Z-axis setup errors than those with gray registration (P<0.05). The analysis on the setup errors in underweight group found that the X-axis and Y-axis setup errors in vacuum pad group were smaller than those in thermoplastic film group (P<0.05), but the difference in Z-axis setup errors between two groups was trivial (P>0.05) and the X-axis, Y-axis and Z-axis MPTV of vacuum pad group were significantly lower than those in thermoplastic film group (P<0.05). In normal group, thermoplastic film group has significantly smaller Z-axis setup errors, higher X-axis and Y-axis MPTV, larger X-axis and Y-axis setup errors, and lower Z-axis MPTV than vacuum pad group (P<0.05). In overweight group, compared with vacuum pad group, thermo plastic film group had smaller X-axis and Y-axis setup errors, but larger Z-axis setup errors (P<0.05) and the X-axis, Y-axis and Z-axis MPTV of vacuum pad group were significantly higher than those of thermoplastic film group (P<0.05). Conclusion In radiotherapy of cervical cancer, vacuum pad for patients with low and normal BMI, thermoplastic film for overweight patients, and gray registration in any cases (underweight, normal, and overweight) can reduce setup errors and ensure the successful completion of radiotherapy.

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备注/Memo

备注/Memo:
【收稿日期】2022-09-18 【基金项目】四川省科技计划项目（重点研发项目）（2020YFS0393） 【作者简介】梁黎，技师，研究方向：肿瘤放射治疗技术，E-mail: easonliang0830@126.com
更新日期/Last Update: 2023-03-03