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目的 :应用螺旋断层放疗中的兆伏级CT(megavoltage CT,MVCT)图像引导技术对老年和非老年肝肿瘤患者进行放疗的摆位误差分析,评估年龄因素对放疗摆位误差的影响。方法 :研究对象为2014年2月—8月接受螺旋断层放疗的43例肝肿瘤患者,其中非老年组(<60岁)26例,老年组(≥60岁)17例。放疗前先进行MVCT扫描,并与CT扫描图像进行自动匹配和手动调整,分别记录X轴、Y轴和Z轴方向上的线性摆位误差以及倾斜、旋转和偏离的旋转摆位误差,之后调整摆位误差进行放疗。对2组的摆位误差数据进行比较和分析。结果 :非老年组和老年组线性摆位误差X轴方向上分别为(0.41±2.89)和(1.13±5.79)mm,Y轴方向上分别为(1.61±4.09)和(1.86±4.84)mm,Z轴方向上分别为(0.62±1.96)和(0.84±2.57)mm;旋转摆位误差倾斜方向上分别为(0.24±0.47)°和(0.42±0.87)°,旋转方向上分别为(0.47±0.95)°和(0.94±1.69)°,偏离方向上分别为(0.26±0.65)°和(0.72±0.86)°。两组X轴、倾斜和旋转方向上的差异均有统计学意义(P值均<0.05)。结论 :老年组在螺旋断层放疗中的摆位误差相对较大。利用图像引导技术在放疗前进行摆位误差校正,有助于提高老年患者的放疗精度。
OBJECTIVE: To evaluate the placement error of radiotherapy in senile and non-elderly liver tumor by megavoltage CT (MVCT) image guided spiral guided tomography (CT) and to evaluate the effect of age on radiotherapy setup error. Methods: Forty-three patients with hepatocellular carcinoma treated with helical CT were enrolled from February 2014 to August 2014. Among them, 26 were non-elderly patients (<60 years old) and 17 were elderly patients (≥60 years old). Before radiotherapy, MVCT scanning was performed and the images were automatically matched and manually adjusted with CT scan images to record the linear setup errors in the X axis, Y axis and Z axis, as well as the rotation setup errors of tilt, rotation and deviation, respectively, and then adjust Setting error for radiotherapy. The two groups of setup error data are compared and analyzed. Results: The linear misalignment errors in the non-elderly group and the elderly group were (0.41 ± 2.89) mm and (1.13 ± 5.79) mm in the X axis and (1.61 ± 4.09) and (1.86 ± 4.84) mm in the Y axis, (0.62 ± 1.96) and (0.84 ± 2.57) mm respectively in the Z axis direction; (0.24 ± 0.47) ° and (0.42 ± 0.87) ° in the tilt direction of the rotation and 0.47 ± 2.57 mm in the rotation direction 0.95) ° and (0.94 ± 1.69) ° and (0.26 ± 0.65) ° and (0.72 ± 0.86) ° respectively. There were significant differences in X-axis, tilt and rotation between the two groups (all P <0.05). Conclusion: The setting error of helical tomography in elderly patients is relatively large. The use of image-guided technology to position error correction before radiotherapy, help to improve the accuracy of radiotherapy in elderly patients.