摘要: |
目的 通过锥形束CT (cone-beam computed tomography,CBCT)图像引导技术,探讨乳腺癌患者调强放疗摆位误差的影响因素。方法 随机选取2020年8月至2021年5月于复旦大学附属中山医院放疗科接受放疗的51例乳腺癌患者,分别根据患者手术方式、年龄、肿瘤位置进行分组,比较手术方式、年龄、肿瘤位置在左右(X轴)、头脚(Y轴)、腹背(Z轴)方向上对摆位误差的影响。多元线性回归分析不同方向的摆位误差与手术方式、年龄及肿瘤位置之间的关系。结果 以手术方式分组,保乳术组和改良根治术组在X、Y、Z轴方向上的摆位误差无统计学意义。按同种手术方式,不同年龄、不同肿瘤位置进行亚组分析,在同种手术方式不同年龄组对比中,接受保乳术的老年组患者在Y轴方向上的摆位误差大于中年组患者(P=0.044),而其他方向上的摆位误差差异无统计学意义。在同种手术方式不同肿瘤部位对比中,改良根治术组左侧乳腺癌患者在Y轴方向上的摆位误差大于右侧乳腺癌患者(P=0.008),其他方向上的摆位误差无统计学意义。回归分析发现,肿瘤位置对Y轴摆位误差的影响有统计学意义(P=0.024)。结论 肿瘤位置可能会使乳腺癌头脚方向上摆位误差值增大,在放射治疗时需对左侧乳腺癌患者紧张情绪加大关注。而对于老年患者应当增加图像引导频率,提高治疗精准度。 |
关键词: 锥形束CT 年龄 乳腺癌 调强放疗 摆位误差 |
DOI:10.12025/j.issn.1008-6358.2022.20220479 |
分类号:R815 |
基金项目: |
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Exploration of impact factors on set-up errors in IMRT for breast cancer |
DING Wei-jie1, SUN Jing1,2, LIN Gen-lai1, MA Gui-fen1
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1.Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China;2.Department of Radiation Oncology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen 361006, Fujian, China
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Abstract: |
Objective To explore the factors influencing set-up errors of intensity modulated radiotherapy (IMRT) for breast cancer by image guided technique of cone-beam computed tomography (CBCT). Methods 51 patients with breast cancer who received radiotherapy in the Radiotherapy Department of Zhongshan Hospital, Fudan University from August 2020 to May 2021 were randomly selected, all patients were divided into three groups by surgical procedures, ages and tumour site. Values of set-up errors caused by these factors were compared among these groups in the longitude (X axis), latitude (Y axis) and vertical (Y axis) directions. The relationship between the three factors and set-up errors data were analysed by multiple linear regression analysis. Results No statistical significant were found between groups of surgical procedures in X, Y and Z axis directions. The subgroup analysis was carried out according to the surgical procedures at different ages and different tumour site. It was found that the set-up error in the head-foot direction of the elderly group receiving breast conserving surgery was significantly greater than that of the middle-aged group (P=0.044). No statistical significant was found in the rest of directions for this group. The set-up errors for left-side patients receiving modified radical mastectomy were higher than the right-side ones in Y axis (P=0.008). No statistical significant was found in the rest of directions for this group. Statistical significant relationship was identified between of set-up errors in Y axis direction and tumour site (P=0.024) analyzed by regression analysis. Conclusion Tumour site may increase set-up errors in Y axis direction. It is necessary to reduce the tension of the left breast cancer patients during radiotherapy, while the elderly patients should increase the frequency of image guidance to improve the accuracy of treatment. |
Key words: cone-beam computed tomography ages breast cancer IMRT set-up error |