张超强

[摘要] 目的 探究自制的辅助设备、增加摆位辅助线定位在盆腔恶性肿瘤患者放疗精准治疗摆位误差的改进效果。方法 方便选取2016年9月—2017年7月在该院接受治療的100例盆腔恶性肿瘤患者，按照入院顺序随机分为观察组与对照组，各50例。观察组采用体部真空垫和自制辅助装置加以固定，对照组采用体部真空垫固定。放疗前患者均行CBCT扫描，经过在线匹配，得出左右、上下、前后方向摆位误差。结果 观察组患者左右、上下、前后方向摆位误差分别为（1.49±1.00）、（1.62±1.28）、（1.35±1.01）mm，对照组分别为（1.75±1.32）、（2.75±1.68）、（1.93±0.92）mm（t=3.222、3.514、3.067，P=0.552、0.008、0.042）。 结论 采用自制辅助装置增加摆位辅助定位，解决了体部真空垫固定在上下方向上误差，能够有效解决患者不自主的下肢活动问题，减少危及器官的照射剂量，提高治疗效果。

[关键词] 自制辅助装置;精确放射疗法;锥形束;摆位误差

[中图分类号] R730.55          [文献标识码] A          [文章编号] 1674-0742（2018）08（c）-0194-03

Study on Correction of Position Error of Pelvic Malignant Tumor with Improved Body Fixture

ZHANG Chao-qiang

Department of Radiotherapy， Cancer Hospital of the First Affiliated Hospital of Xiamen University， Xiamen， Fujian Province， 361000 China

[Abstract] Objective To explore the improvement effect of self-made auxiliary equipment and positioning of auxiliary line positioning in the pelvic cavity cancer patients with accurate treatment of errors in radiotherapy. Methods A total of 100 patients with pelvic malignant tumors who were treated in the hospital from September 2016 to July 2017 were convenient selected and randomly divided into the observation group and the control group according to the admission order， with 50 cases in each group. The observation group was fixed with a body vacuum pad and a self-made auxiliary device， and the control group was fixed with a body vacuum pad. All the patients before radiotherapy underwent CBCT scan. After on-line matching， errors in left， right， up， and backward directions were found. Results In the observation group， the left， right， up， and back yaw errors were （1.49±1.00）， （1.62±1.28）， （1.35±1.01） mm， and the control group were （1.75±1.32）， （2.75±1.68）， （1.93±0.92）mm（t=3.222，3.514，3.067，P=0.552，0.008，0.042）. Conclusion Self-made auxiliary device was used to increase the position of assisted positioning， which solved the problem that the body vacuum pad was fixed in the up and down direction. It can effectively solve the patient's involuntary lower limb movement problem， reduce the radiation dose of endangering organs， and improve the treatment effect.

[Key words] Self-made assist device; Precise radiation therapy; Cone beam; Position error

放射治疗是治愈恶性肿瘤最主要的方法之一。肿瘤放射治疗通常由医生与物理师制定完整的治疗方案，由放疗技师在一定时间内通过对病人精准的照射摆位完成治疗方案。定位性摆位是患者在CT模拟定位机接受定位时设计所需并实施的一个体位，在这一过程中体位随意性比较大，占据主导地位，体位确定后，治疗要求必须完全按照定位时的体位复原。定位过程中，要根据患者部位、年龄、身体情况等选择适当的体位[1]。对于放疗患者定位与治疗摆位必须具有高度的一致性，由此才能够确保准确性与放疗预后的效果。……