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| 摆位误差对左乳癌术后放射治疗剂量分布的影响 |
| The influence of setup errors on the dose distribution of postoperative radiotherapy for left breast cancer |
| 投稿时间：2023-06-26 |
| DOI：10.3969/j.issn.1000-0399.2024.02.007 |
| 中文关键词: 左乳癌 放射治疗 千伏级锥形束CT 摆位误差 剂量分布 |
| 英文关键词: Left breast cancer Radiation therapy Kilovolt cone-beam CT Setup error Dose distribution |
| 基金项目:宣城市卫生健康科研项目（编号：2022070） |
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| 中文摘要: |
| 目的 使用千伏级锥形束计算机断层扫描(kV-CBCT)技术测量左乳癌术后放射治疗摆位误差,探讨摆位误差对剂量分布的影响。方法 选取2021年9月至2022年12月在宣城市人民医院接受放射治疗的左乳癌术后患者30例为研究对象,提取每位患者前3次放射治疗前的kV-CBCT图像,分别与计划CT图像配准,由配准系统计算获得患者左右(X)、头脚(Y)、胸背(Z)方向摆位误差。以第1次配准结果作为校正前的误差,以第2、3次配准结果作为校正后的误差,在治疗计划系统中按校正前、后误差大小平移计划中心点,计算校正前的计划(S-Plan)和校正后的计划(C-Plan)的剂量,并与治疗计划(T-Plan)进行比较,分析3者在计划靶区(PTV)、浅表区域、危及器官方面的剂量差异,以及计划的伽马通过率差异。结果 校正前摆位误差分别为(1.85±3.76) mm、(-1.80±3.25) mm、(-2.10±3.99) mm,校正后摆位误差平均值分别为(0.04±1.59) mm、(0.10±1.55) mm、(-0.01±1.47) mm。3组计划的PTV D98、D95、Dmean、均匀性指数(HI)、适形性指数(CI)和浅表区域Dmean间差异均具有统计学意义(P<0.05),两两比较显示,S-Plan和T-Plan、CPlan间差异均具有统计学意义(P<0.05),3组计划患侧肺的V5、V20、V30、Dmean、心脏的Dmean、V5和脊髓Dmax间差异均具有统计学意义(P<0.05),两两比较显示,S-Plan和T-Plan、C-Plan间差异均具有统计学意义(P<0.05),3组计划的伽马通过率间差异具有统计学意义(P<0.05),两两比较显示,S-Plan和T-Plan、C-Plan间差异均具有统计学意义(P<0.05)。结论 使用kV-CBCT测量并校正左乳癌术后放射治疗患者摆位,能有效减少摆位误差及其对剂量分布的影响,具有良好的可靠性和可重复性。 |
| 英文摘要: |
| Objective This study aims to use kilovoltage cone-beam computed tomography(kV-CBCT)to measure thesetup errors in postoperative radiotherapy for left breast cancer and investigate the influence of setup errors on dose distribution.Methods Thirty postoperative patients with left breast cancer who received radiation therapy in Xuancheng People's Hospital from September 2021 to December 2022 were selected,and the kV-CBCT images of each patient before the first three radiation treatments were extracted and registered with the planning CT images,respectively.And the patient's setup errors in the left-right(X),superior-inferior(Y),and anterior-posterior(Z)directions were calculated by the registration system.Using the first time's registration result as the setup error before correction,and the second and third registration results as the setup error after correction,the treatment plan system translated the isocenter of the plan based on the magnitude of the errors before and after correction.The doses of the simulated plan(S-Plan)and correction plan(C-Plan)were calculated and compared with the treatment plan(T-Plan)to analyze the differences in dose distribution in the planning target volume,surface margin,and organs at risk,as well as the differences in the gamma passing rates of the plans.Results The setup errors in the X,Y,and Z directions before correction were(1.85±3.76)mm,and the setup errors after correction were(0.04±1.59)mm,(0.10±1.55)mm,and(-0.01±1.47)mm,respectively.The differences in D98,D95,Dmean,HI,CI of planning target volume,and surface margin's Dmean among the three plans were statistically significant(P<0.05),and the comparison results showed that the differences between S-Plan and C-Plan,T-Plan were statistically significant(P<0.05).The differences in V5,V20,V30,Dmean of the ipsilateral lung,Dmean,V5 of the heart,and Dmax of the spinal cord among the three plans were all statistically significant(P<0.05).The comparison results showed that the differences between S-Plan and C-Plan,T-Plan were statistically significant(P<0.05).The differences in gamma passing rate among the three plans were statistically significant(P<0.05),and the comparison results showed that the differences between S-Plan and C-Plan,T-Plan were statistically significant(P<0.05).Conclusions Using kV-CBCT to measureandcorrect the patient's treatment position can reduce setup errors,has good reliability and repeatability,and can reduce the influence on the dose distribution of setup errors |
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