不同部位肿瘤螺旋断层放射治疗校正误差分析

Analysis of the Corrected Error for Different Parts of the Tumor with Helical Tomotherapy

  • 摘要: 目的:研究不同部位肿瘤在螺旋断层放射治疗前的校正误差。方法:选取74例不同部位肿瘤患者,其中头颈部肿瘤20例,胸部肿瘤17例,上腹部肿瘤22例,盆腔肿瘤15例。放疗前行MVCT扫描共1 757 次,扫描次数范围10~33次,平均每例扫描24次。结果:各部位肿瘤校正误差Z 轴相对较小,<3mm误差范围在82.35%~95.99% 之间。其次是X 轴方向,<3mm误差范围是51.45%~74.67%。Y 轴误差相对较大,误差<3mm除头颈部位是 68.63%外,其它三个部位分别为 41.81%、42.47%和31.90%;而>5mm误差Y 轴在盆腔部位高达47.96% ;其次是腹部和胸部,分别为34.89% 和30.69% ,头颈部位最小,占10.64% 。结论:螺旋断层放射治疗纠正了治疗误差,做到了真正意义上的精确放疗;Y 轴治疗误差较大,提示制定治疗计划时特殊考虑PTV 边界的外放;同时重视治疗中计划的更改和进一步提高技术员摆位的准确性。

     

    Abstract: Objective: To investigate the impact of uncorrected setup errors of helical tomotherapy for the different parts of tumors. Methods:A total of74patients were treated with helical tomotherapy, among which there were 20head and neck tumors, 17thoracic tumors, 22upper abdominal tumors and 15pelvic tumors. All patients received MVCT scan prior to treatment delivery. A combined total of 1757 scans were analyzed. The range of the scanning fractions was be-tween 10and 33. The average value was 24. Results: For different parts of tumors, the corrected error rate for the Z-axis was the smallest, with a ratio for <3mm of 82.35%-95.99%. For the X-axis, the ratio for <3mm was 51.45%-74.67%. The er-ror rate for the Y-axis was the largest, with a ratio for <3mm of 68.3% for head and neck tumor. The ratios of corrected error for the other parts were 41.81%,42.47% and 31.90%, respectively. The ratio for the Y-axis for >5mm on pelvic tumors was 47.96% , and the others on thoracic and abdominal tumors were 34.89% and 30.69% . The ratio for >5mm on head and neck tumors was only10.64% .Conclusion: With helical tomotherapy technique, the corrected error could be used as a guide to greatly improve the precision of the treatment area by allowing the technician to correctly design the planning tar-get volume (PTV) and then modify the plan accordingly during treatment.

     

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