【摘要】 目的 探讨固定体板联合颈胸膜体位固定在乳腺癌根治术后放射治疗中的应用及其摆位误差分析。方法 选取2020年3月至2021年7月云南省肿瘤医院放疗科收治的10例乳腺癌根治术后螺旋断层放射治疗患者作为研究对象。放疗前，所有患者均采用固定体板联合颈胸膜体位固定，每次治疗前行兆伏级高能X线计算机体层摄影（MVCT）扫描，用螺旋断层放射治疗系统自带的OBI软件系统与定位CT图像进行配准融合获取摆位误差数据，记录左右（X）、头脚（Y）、腹背（Z）及横断面方向旋转（Roll）的误差值，并对10例患者235次配准数据进行统计和分析。结果 经统计，10例乳腺癌术后患者共进行235次治疗前MVCT扫描，其中X、Y、Z和Roll方向上的摆位误差分别为（2.85±1.58）、（2.15±1.48）、（1.44±1.23）mm及（0.63°±0.61°）。乳腺癌根治术患者在X、Y、Z方向<3 mm误差区间的MVCT扫描百分比分别为48.5%(114/235)、71.9%(169/235)、87.7%(206/235)；在3～5 mm误差区间的MVCT扫描百分比分别为46.8%(110/235)、27.2%(64/235)、10.6%(25/235)；在> 5mm误差区间的MVCT扫描百分比分别为4.7%(11/235)、0.9%(2/235)、1.7%(4/235)。结论 采用固定体板联合颈胸膜体位固定对乳腺癌根治术后患者放射治疗的体位固定性和重复性好，能更好地减小摆位误差，提高放疗的精确性，用于临床精确治疗有较好的质量保证。更多还原

【Abstract】 Objective To investigate the application of fixed body plate combined with cervical pleural position fixation in radiotherapy after radical mastectomy for breast cancer, and analyze the position error. Methods Ten patients treated with helical tomotherapy after radical mastectomy for breast cancer in the radiotherapy department of Yunnan Cancer Hospital from March 2020 to July 2021 were selected as the research objects. Before radiotherapy, all patients used fixed body plate combined with cervical pleural position fixation. Before each treatment, meta-voltage computed tomography(MVCT) were scanned. The positioning error data were obtained by registration and fusion of the OBI software system of the helical tomography system and the positioning CT images. The error values of left and right(X), head and foot(Y),abdomen and back(Z) and cross-sectional direction rotation(Roll) were recorded, and 235 registration data of 10 patients were counted and analyzed. Results According to statistics, 10 patients with breast cancer underwent 235 pre-treatment MVCT scans. The positioning errors in the X, Y, Z and Roll directions were(2.85±1.58),(2.15±1.48),(1.44±1.23) mm and(0.63° ±0.61°) respectively. The percentage of MVCT scan in the error interval of <3 mm in X, Y and Z directions in patients underwent radical mastectomy for breast cancer was 48.5%(114/235), 71.9%(169/235) and 87.7%(206/235),respectively; the percentage of MVCT scan in the error range of 3-5 mm was 46.8%(110/235), 27.2%(64/235) and 10.6%(25/235) respectively; the percentage of MVCT scan in the error range of >5 mm was 4.7%(11/235), 0.9%(2/235) and1.7%(4/235) respectively. Conclusion Fixed body plate combined with cervical pleural position fixation has good position fixation and repeatability for radiotherapy of patients with breast cancer after radical mastectomy. It can better reduce the positioning error and improve the accuracy of radiotherapy. It has good quality assurance for clinical accurate treatment.更多还原