【摘要】 目的探讨光学表面监测系统(OSMS)在重度幽闭恐惧症患者头颈部放射治疗中的应用价值。方法选取2019年6—11月于华中科技大学同济医学院附属同济医院行放射治疗的4例患重度幽闭恐惧症的头颈部肿瘤患者,首先利用颅脑模体在OSMS下进行反复模拟摆位测试,并使用锥形束CT(CBCT)校正摆位误差,观察OSMS的适用性,共获取OSMS与CBCT验证数据7组;随后对4例患者采用头颈肩固定架联合发泡胶垫及OSMS辅助固定方式进行模拟定位和放射治疗,采集验证对比数据20组。结果在颅脑模体测试中,OSMS与CBCT在X、Y轴的旋转误差分别为(0.37±0.16)°、(0.45±0.15)°与(0.61±0.22)°、(0.78±0.31)°,两者比较,差异均有统计学意义(P<0.05);4例患者治疗前的OSMS与CBCT验证摆位误差结果显示,两者在X、Y、Z轴的平移误差及旋转误差比较,差异均无统计学意义(P>0.05);记录4例患者经CBCT校正摆位误差后OSMS残余监测值(A组)与治疗前OSMS实际监测值(B组),结果显示,A组与B组在X、Y、Z轴的平移误差及旋转误差比较,差异均无统计学意义(P>0.05)。结论 OSMS可解决重症幽闭恐惧症患者头颈部放射治疗时的体位固定难题,同时结合CBCT影像验证系统可确保患者放射治疗精度。更多还原

【Abstract】 Objective The application value of optical surface monitoring system(OSMS) in radiotherapy of head and neck for patients with severe claustrophobia was explored. Methods Four severe claustrophobia patients with head and neck tumor who underwent radiotherapy in Tongji Hospital, Tongji Medical College of HUST from June to November in 2019 were selected. Firstly, the craniocerebral model was used in the application of OSMS to perform repeated simulated positioning tests, cone-beam CT(CBCT) was used to correct the positioning error, the applicability of OSMS was observed, and 7 groups of validation data of OSMS and CBCT were obtained. Subsequently, four patients were also treated with head-neck-shoulder anchor and foam combined with OSMS for simulated positioning and radiotherapy, and 20 groups of comparative data were collected and verified. Results In the test of craniocerebral model, the corresponding rotation errors of X and Y axis that from OSMS and CBCT system were(0.37±0.16)°,(0.45±0.15)° and(0.61±0.22)°,(0.78±0.31)° respectively,when they were compared, the differences were statistically significant(P<0.05); When the translation and rotation errors of X, Y and Z axes between OSMS and CBCT(verified positioning errors) before treatment of the four patients were compared, the differences were all not statistically significant(P>0.05); The OSMS residual monitoring data(Group A) after positioning correction by CBCT and the actual monitoring data before treatment(Group B) of the four patients were recorded, and the results showed that when the translation errors of X, Y and Z axes and rotation errors were compared between Group A and B, the differences were all not statistically significant(P>0.05). Conclusion The OSMS can effectively solve the problem of body position fixation for patients with severe claustrophobia during radiotherapy, and can effectively control the positioning accuracy of radiotherapy when combined with the CBCT imaging verification system.更多还原