Doi Hiroshi, Tanooka Masao, Ishida Toshihisa, Moridera Kuniyasu, Ichimiya Kenji, Tarutani Kazuo, Kitajima Kazuhiro, Fujiwara Masayuki, Kishimoto Hiromitsu, Kamikonya Norihiko
Department of Radiology, Hyogo College of Medicine, Hyogo, Japan.
Department of Radiation Oncology, Meiwa Cancer Clinic, Hyogo, Japan.
Rep Pract Oncol Radiother. 2017 Jul-Aug;22(4):310-318. doi: 10.1016/j.rpor.2017.03.002. Epub 2017 May 8.
This study aimed to assess the utility and stability of intraoral stent during intensity-modulated radiation therapy (IMRT).
The benefits of intraoral stents in radiotherapy are unclear.
We analyzed 386 setup errors in 12 patients who received IMRT for head and neck cancers without intraoral stents (intraoral stent [-]) and 183 setup errors in 6 patients who received IMRT with intraoral stents (intraoral stent [+]). All patients were matched according to the immobilization method (masks and boards). Setup errors were measured as the distance from the initial setup based on the marking on the skin and mask to the corrected position based on bone matching on cone beam computed tomography.
The mean interfractional setup errors in the right-left, craniocaudal, anterior-posterior (AP), and three-dimensional (3D) directions were -0.33, 0.08, -0.25, and 2.75 mm in the intraoral stent (-) group and -0.37, 0.24, -0.63, and 2.42 mm in the intraoral stent (+) group, respectively ( = 0.50, 0.65, 0.01, and 0.02, respectively). The systematic errors for the same directions were 0.89, 1.46, 1.15, and 0.88 mm in the intraoral stent (-) group and 0.62, 1.69, 0.68, and 0.56 mm in the intraoral stents (+) group, respectively. The random errors were 1.43, 1.43, 1.44, and 1.22 mm in the intraoral stent (-) group and 1.06, 1.11, 1.05, and 0.92 mm in the intraoral stents (+) group, respectively.
Setup errors can be significantly reduced in the AP and 3D-directions by using intraoral stents.
本研究旨在评估口腔内支架在调强放射治疗（IMRT）期间的效用和稳定性。
口腔内支架在放射治疗中的益处尚不清楚。
我们分析了12例接受头颈部癌IMRT且未使用口腔内支架（口腔内支架[-]）患者的386次摆位误差，以及6例接受IMRT并使用口腔内支架（口腔内支架[+]）患者的183次摆位误差。所有患者均根据固定方法（面罩和固定板）进行匹配。摆位误差通过从基于皮肤上和面罩上标记的初始摆位到基于锥形束计算机断层扫描上骨匹配的校正位置的距离来测量。
口腔内支架（-）组在左右、头脚、前后（AP）和三维（3D）方向上的平均分次间摆位误差分别为-0.33、0.08、-0.25和2.75毫米，口腔内支架（+）组分别为-0.37、0.24、-0.63和2.42毫米（分别为P = 0.50、0.65、0.01和0.02）。相同方向上的系统误差在口腔内支架（-）组中分别为0.89、1.46、1.15和0.88毫米，在口腔内支架（+）组中分别为0.62、1.69、0.68和0.56毫米。随机误差在口腔内支架（-）组中分别为1.43、1.43、1.44和1.22毫米，在口腔内支架（+）组中分别为1.06、1.11、1.05和0.92毫米。
使用口腔内支架可在AP和3D方向上显著减少摆位误差。
