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目的:采用锥形束CT(CBCT)研究脊柱轻度畸形肿瘤患者调强放疗中两种固定方式对摆位精度的影响。方法:随机选取48例脊柱畸形轻度的患者,平均分成A、B两组。A组定位时采用热塑体膜固定,B组采用热塑体膜和负压真空垫协同固定。利用CBCT对每位患者前4次治疗前和第4次治疗后的摆位误差进行测量,SPSS 17.0软件统计分析。结果:A组在左右(X)、头脚(Y)、前后(Z)方向上测量的摆位误差分别为(0.23±0.47)cm、(0.36±0.08)cm、(0.27±0.07)cm,而B组为(0.16±0.06)cm、(0.23±0.12)cm、(0.17±0.04)cm,B组误差数据小于A组,并且差异有统计学意义(P<0.05),其中Y轴误差最大、Z轴次之、X轴最小。第四次治疗后的CBCT数据显示病人在治疗过程中存在位置移动,A组病人移动量大于2mm的占27.5%,B组为8.5%,B组好于A组。结论:热塑体膜协同真空垫固定技术能减少脊柱轻度畸形患者在放疗中的摆位误差。
OBJECTIVE: To study the effect of two fixation methods on the setting accuracy of IMRT patients with mild spinal deformity by cone beam computed tomography (CBCT). Methods: Forty-eight patients with mild spinal deformity were randomly divided into A and B groups. A group of positioning using thermoplastic film fixed, B group of thermoplastic film and negative pressure vacuum cushion synergistic fixation. Using CBCT before each patient 4 times before and after the fourth treatment error was measured, SPSS 17.0 software statistical analysis. Results: The setup errors of group A were (0.23 ± 0.47) cm, (0.36 ± 0.08) cm and (0.27 ± 0.07) cm respectively in left and right (X), head and front (Z) (0.23 ± 0.12) cm and (0.17 ± 0.04) cm in group B, and the difference between group B and group A was statistically significant (P <0.05). The error of Y axis was the largest , Followed by the Z axis, X axis minimum. CBCT data after the fourth treatment showed that there was a shift in the position of the patient during treatment. A group of patients with a movement greater than 2 mm accounted for 27.5% of patients in group B and 8.5% in group B, which was better than group A. CONCLUSIONS: The thermoplastics membrane and vacuum pad fixation technique can reduce the setting error of patients with mild spinal deformity in radiotherapy.