基础医学与临床 ›› 2022, Vol. 42 ›› Issue (1): 131-135.

• 临床研究 • 上一篇    下一篇

局部晚期食管癌放射治疗两种固定方式的锁骨上区动度比较分析

万宝,郇福奎,赵宇,陈欢,耿松松,阎辉,张彦新   

  1. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院
  • 收稿日期:2021-08-10 修回日期:2021-11-03 出版日期:2022-01-05 发布日期:2022-01-05
  • 通讯作者: 张彦新 E-mail:yanxin_zhang@163.com

Comparative analysis of supraclavicular area mobility in locally advanced esophageal cancer radiation therapy with two different fixed ways

  • Received:2021-08-10 Revised:2021-11-03 Online:2022-01-05 Published:2022-01-05

摘要: 目的 比较使用胸腹平架和颈胸一体架固定装置的局部晚期食管癌放疗患者锁骨上区的摆位误差的差异,分析两种装置固定效果的优劣。方法 回顾性分析50例局部晚期食管癌含锁骨上区放射治疗的患者锥形束计算机断层(CBCT)图像,分别使用胸腹平架(A组)和颈胸一体架(B组)固定,两组均含25例病例,其中A组获取175次CBCT图像,B组获取230次CBCT图像。分别分析两组病例摆位误差的大小,并分别测量肩锁关节的移动幅度和三维空间位移。结果 胸腹平架组(A组)和颈胸一体架组(B组)的摆位误差的差异明显,尤其平移误差 X(左右方向)和Z(腹背方向),(P<0.001);旋转误差 Rx(矢状面),(P<0.001);Ry(横断面),(P<0.05)。胸腹平架组和颈胸一体架组的肩锁关节动度ΔX、ΔY、ΔZ,分别是(0.100.10)cm和(0.080.08)cm、(0.140.13)cm和(0.110.11)cm、(0.160.12)cm和(0.110.12)cm。肩锁关节的三维空间位移是(0.270.14)cm和(0.200.14)cm,(P<0.001)。结论 在控制旋转角度对靶区的影响后,对于局部晚期的食管癌患者,应用颈胸一体架固定装置能更好地固定肩锁关节,体位重复性更优。

关键词: 局部晚期食管癌放疗, 肩锁关节动度, 摆位误差分析

Abstract: Objective To compare the setup errors provided by the chest and abdomen flat frame fixation device and integral cervicothoracic fixation device in supraclavicular regions of locally advanced esophageal cancer patients. Methods The cone beam computed tomography (CBCT) images of 50 locally advanced esophageal cancer patients who received radiotherapy in supraclavicular region were retrospectively analyzed. Each group of using the chest and abdomen flat frame fixation device (group A) or the integral cervicothoracic fixation device (group B) included 25 patients .There were 175 CBCT images in group A and 230 CBCT images in group B. The setup errors of the two groups were analyzed, and the movement and displacement of acromioclavicular joint in three-dimensions were measured. The differences were compared by independent sample t test and rank sum test. Results The setup errors were significant difference between group A and group B. The P value in X axis (left-right) and Z axis (anterior-posterior) both were less than 0.001 (P<0.001);The P value in pitch was less than 0.001 (P<0.001),and roll was less than 0.05 (P<0.05). The movement amplitude of acromioclavicular joint (ΔX, ΔY, ΔZ) of groups A and B were (0.100.10)cm and (0.080.08)cm in X axis, (0.140.13)cm and (0.110.11)cm in Y axis, (0.160.12)cm and (0.110.12)cm in Z axis. The three-dimensional displacement of groups A and B were (0.270.14)cm and (0.200.14)cm, (P<0.001). Conclusions When the influence of rotation angle is properly controlled, the application of the integral cervicothoracic fixation device is better to immobilize the acromioclavicular joint and reproduce the setup position for locally advanced esophageal cancer patients .Special attention should be paid for the influence of rotation angle on the location accuracy of target.

Key words: locally advanced esophageal cancer radiotherapy, acromioclavicular joint mobility, setup error analysis