【摘要】 目的 利用锥形束CT(CBCT)研究肺癌患者调强放疗时应用多模块板外加背托、臀托及臂托辅助定位的优势。方法 回顾性分析2016年1月至2021年6月该科使用体膜外加普通体板固定及体膜+多模块体板(臀托、背托及臂托)固定肺癌患者行调强放疗治疗时的摆位数据。分别收集2种固定方式在治疗前及治疗期间CBCT拍摄的验证图像与定位时的CT图像进行匹配的验证数据。分别统计其X(左右)、Y(头脚)、Z(腹背)轴3个方向的误差数据，并进行统计分析。结果 360例患者共收集1 863幅CBCT图像数据。普通体板外加体膜固定及多模块体板固定在首次治疗前的摆位误差数据分别为左右方向(1.01±2.28)mm和(0.18±1.37)mm、头脚方向(0.91±2.78)mm和(0.65±2.03)mm、腹背方向(1.58±1.80)mm和(0.74±1.57)mm。其中在腹背方向差异有统计学意义(P<0.001)。治疗期间的摆位误差数据分别为左右方向(0.02±1.83)mm和(0.01±2.13)mm、头脚方向(0.51±2.76)mm和(0.30±2.20)mm、腹背方向(0.57±1.59)mm和(0.39±1.22)mm。其中腹背方向、左右方向比较，差异有统计学意义(P=0.020、0.009)。结论 多模块体板外加背托、臀托及臂托辅助定位固定的肺癌调强放疗的患者相对于普通体板固定能够提高摆位精度，特别能减少腹背方向的摆位误差。更多还原

【Abstract】 Objective To study the advantages of multi-module plate plus back, hip and arm support in intensity modulated radiotherapy for lung cancer patients by conical beam CT(CBCT).Methods The position data of patients with lung cancer who received intensity modulated radiotherapy from January 2016 to December 2021 were analyzed retrospectively when they were fixed with body membrane plus ordinary body plate and body membrane plus multi-module plate(hip, back and arm support).The verification data of the matching between the verification images taken by CBCT before and during the treatment and the CT images at the time of positioning were collected respectively.The error data of X(left and right),Y(head and foot) and Z(abdominal and dorsal) axis were respectively collected, and statistical data were analyzed.Results A total of 1 863 CBCT images were collected from 360 patients.The positioning errors of conventional body plate with external body membrane fixation and multi-module fixation before the first treatment were(1.01±2.28) mm and(0.18±1.37) mm in the left and right direction,(0.91±2.78) mm and(0.65±2.03) mm in the head and foot direction, and(1.58±1.80) mm and(0.74±1.57) mm in the abdominal and dorsal direction, respectively.The difference in the abdominal and dorsal direction was statistically significant(P<0.001).The positioning errors during the treatment were(0.02±1.83) mm and(0.01±2.13) mm in the left and right direction,(0.51±2.76) mm and(0.30±2.20) mm in the head and foot direction, and(0.57±1.59) mm and(0.39±1.22) mm in the abdominal and dorsal direction, respectively.There were significant differences in the direction of abdominal and dorsal, left and right(P=0.020,0.009).Conclusion Multi-module plate plus back support, hip support and arm support assisted positioning fixation for lung cancer patients with intensity modulated radiotherapy can improve the positioning accuracy, especially reduce the positioning error in the abdominal and dorsal direction.更多还原