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

doi:10.16352/j.issn.1001-6325.2022.01.023

基础医学与临床 ›› 2022, Vol. 42 ›› Issue (1): 131-135.doi: 10.16352/j.issn.1001-6325.2022.01.023

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^*

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放疗科,北京 100021

收稿日期:2021-08-10 修回日期:2021-11-04 出版日期:2022-01-05 发布日期:2022-01-05
通讯作者: ^* yanxin_zhang@163.com

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

WAN Bao, HUAN Fu-kui, ZHAO Yu, CHEN Huan, GENG Song-song, YAN Hui, ZHANG Yan-xin^*

Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, CAMS & PUMC, Beijing 100021, China

Received:2021-08-10 Revised:2021-11-04 Online:2022-01-05 Published:2022-01-05
Contact: ^* yanxin_zhang@163.com

摘要/Abstract

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射治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(0.10±0.10)cm和(0.08±0.08)cm、(0.14±0.13)cm和(0.11±0.11)cm、(0.16±0.12)cm和(0.11±0.12)cm。肩锁关节的三维空间位移是(0.27±0.14)cm和(0.20±0.14)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, 肩锁关节动度, 摆位误差分析, 放射治疗

Abstract: Objective To compare the setup errors provided by the chest and abdomen flat frame fixation device and integral cervico-thoracic fixation device in supraclavicular regions of locally advanced esophageal cancer patients. Methods The cone beam computed tomography (CBCT) images of 50 patients with locally advanced esophageal cancer and received radiotherapy in supraclavicular region were retrospectively analyzed. The chest and abdomen flat frame fixation device (group A) or the integral cervicothoracic fixation device (group B) were used respectively with 25 in each.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 significantly different between group A and group B. The P value in X axis (left-right) and Z axis (anterior-posterior) were both 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 (0.10±0.10)cm and (0.08±0.08)cm in X axis, (0.14±0.13)cm and (0.11±0.11)cm in Y axis, (0.16±0.12)cm and (0.11±0.12)cm in Z axis. The three-dimensional displacement of groups A and B were (0.27±0.14)cm and (0.20±0.14)cm, (P＜0.001). Conclusions If the influence of rotation angle is well 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, acromioclavicular joint mobility, setup error analysis, radiotherapy

中图分类号:

R815.6

万宝, 郇福奎, 赵宇, 陈欢, 耿松松, 阎辉, 张彦新. 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[J]. 基础医学与临床, 2022, 42(1): 131-135.

WAN Bao, HUAN Fu-kui, ZHAO Yu, CHEN Huan, GENG Song-song, YAN Hui, ZHANG Yan-xin. Comparative analysis of supraclavicular area mobility in locally advanced esophageal cancer radiation therapy with two different fixed ways[J]. Basic & Clinical Medicine, 2022, 42(1): 131-135.

参考文献

[1]中国食管癌放射治疗指南(2020年版)[J]. 国际肿瘤学杂志,2020,47:641-655.
[2]Tachimori Y. Pattern of lymph node metastases of squamous cell esophageal cancer based on the anatomical lymphatic drainage system: efficacy of lymph node dissection according to tumor location[J]. Thorac Dis,2017,9:S724-S730.
[3]Tachimori Y, Ozawa S, Numasaki H, et al. Registration committee for esophageal cancer of the Japan esophageal society. supraclavicular node metastasis from thoracic esophageal carcinoma: a surgical series from a Japanese multi-institutional nationwide registry of esophageal cancer[J]. J Thorac Cardiovasc Surg, 2014,148:1224-1229.
[4]Ezzell GA,Galvin JM,Low D,et al.Guidance document on delivery,treatment planning. and clinical implementation of IMRT: report of the IMRT Subcommittee of the AAPM Radiation Therpy Committee[J]. Med Phys,2012,30:2009-2115.
[5]徐浩然,孙显松,王欣海,等.Halcyon 医用电子直线加速器对142例肺癌患者常规分割治疗模式下靶区外放边界的分析[J].基础医学与临床,2020,40:1692-1694.
[6]Stroom JC, de Boer HC, Huizenga H, et al. Inclusion of geometrical uncertainties in radiotherapy treatment plann-ing by means of coverage probability[J]. Int J Radiat Oncol Biol Phys, 1999,43:905-919.
[7]Hugo GD, Yan D, Liang J. Population and patient-specific target margins for 4D adaptive radiotherapy to account for intra- and inter-fraction variation in lung tumour position[J]. Phys Med Biol, 2007,52:257-274.
[8]Van Herk M.Errors and margins in radiotherapy[J].Semin Rasiat Oncol,2004,14:52-64.
[9]Van Herk M,Remeijer P,Rasch C,et al. The probability of correct target dosage:dose-population histograms for deriving treatment margins in radiotherapy[J].Int J Radiat Oncol Biol Phys,2000,47:1121-1135.
[10]Finnigan R, Lamprecht B, Barry T, et al. Inter- and intra-fraction motion in stereotactic body radiotherapy for spinal and paraspinal tumours using cone-beam CT and positional correction in six degrees of freedom[J]. J Med Imaging Radiat Oncol, 2016,60:112-118.
[11]王丹,沙翔燕,林海磊.中上段食管癌图像引导放疗中摆位误差及靶区外放边界的确定[J].中华放射医学与防护杂志,2014,34:610-612.
[12]徐浩然,孙显松,王欣海,等.应用锥形束CT对157例儿童腹部肿瘤摆位误差及靶区外放边界的分析[J].基础医学与临床,2019,39:1175-1177.

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

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

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 3

编辑推荐

Metrics

本文评价

[1]	白静, 刘娜, 丁力, 雷丽, 倪瑞, 闫少春, 邵国. 放射治疗后宫颈癌组织内差异表达基因鉴定[J]. 基础医学与临床, 2022, 42(2): 215-220.
[2]	王子晗马晓璇孙鹏齐朝月周华闫小彬时惠平. 表观扩散系数在胰腺癌放疗疗效定量评价中的应用[J]. 基础医学与临床, 2020, 40(6): 817-821.
[3]	李洪明于浪黎蕊沈捷张福泉吴松. 膀胱癌TURBT术后螺旋断层放射治疗与容积旋转调强放射治疗剂量学比较[J]. 基础医学与临床, 2020, 40(11): 1529-1533.