Li Y B, Wang Y L, Zhuo Y H
Department of Tumor Radiotherapy, Zhangzhou Municipal Hospital of Fujian Province, Zhangzhou 363000, China.
Zhonghua Zhong Liu Za Zhi. 2017 Jun 23;39(6):467-470. doi: 10.3760/cma.j.issn.0253-3766.2017.06.012.
To compare the difference of displacement between the vacuum bag fixation and the Orfit rack with thermoplastic membrane fixation of the cervical cancer patients, and to explore the individual fixation of the patients. We retrospectively analyzed the clinical data of 66 patients diagnosed as cervical cancer in Zhangzhou Municipal Hospital of Fujian Province from December 2014 to April 2016. Among them, 33 patients were fixed with vacuum bag, 33 patients were fixed with the Orfit rack with thermoplastic membrane. The cone-beam computed tomography (CBCT) images were acquired daily for the first three times of the radiotherapy, followed by once every other day for a total of 15 times. The CBCT scan images were matched with the CT scan images, and the matching results were recorded and analyzed. The absolute value of the displacement in the left and right directions of the vacuum bag group was (0.28±0.30) cm, significantly lower than (0.38±0.46) cm in the Orfit rack with thermoplastic membrane group(<0.001). The absolute value of the displacement in the anteroposterior direction of the vacuum bag group was (0.28±0.32) cm, with no significant difference of (0.27±0.23) cm in the Orfit rack with thermoplastic membrane group (=0.580). The absolute value of the displacement in the up and down directions was (0.33±0.60) cm, with no statistically significant difference of (0.27±0.48) cm in the Orfit rack with thermoplastic membrane group (=0.150). During the three times of CBCT scans, the differences of displacement in the left and right directions of the vacuum bag group were negligible, while apparently varied in the anteroposterior and up and down directions, however, the differences were not statistically significant (>0.05). The change of the displacement in the three-dimensional direction in the Orfit rack with thermoplastic membrane group was marginal, and all of the differences were not significant(all >0.05). Both the vacuum bag fixation and the Orfit rack with thermoplastic membrane fixation are suitable for the cone-beam CT image-guided radiotherapy of cervical cancer patients. However, the displacement in the left and right directions of the vacuum bag fixation is smaller than the Orfit rack with thermoplastic membrane fixation. During the period of treatment, the mean value of the difference of displacement in the anterior and posterior directions of the Orfit rack with thermoplastic membrane fixation is mild, which can be used individually by the patients with a flexible body and good tolerance.
比较宫颈癌患者真空袋固定与Orfit架加热塑性膜固定的位移差异，探讨患者的个体化固定方式。回顾性分析2014年12月至2016年4月福建省漳州市医院确诊为宫颈癌的66例患者的临床资料。其中，33例患者采用真空袋固定，33例患者采用Orfit架加热塑性膜固定。放疗前三次每天采集锥束计算机断层扫描（CBCT）图像，之后每隔一天采集一次，共采集15次。将CBCT扫描图像与CT扫描图像进行匹配，并记录和分析匹配结果。真空袋组左右方向位移绝对值为（0.28±0.30）cm，显著低于Orfit架加 热塑性膜组的（0.38±0.46）cm（<0.001）。真空袋组前后方向位移绝对值为（0.28±0.32）cm，与Orfit架加热塑性膜组的（0.27±0.23）cm无显著差异（=0.580）。上下方向位移绝对值为（0.33±0.60）cm，与Orfit架加热塑性膜组的（0.27±0.48）cm无统计学差异（=0.150）。在三次CBCT扫描期间，真空袋组左右方向的位移差异可忽略不计，而前后和上下方向明显不同，但差异无统计学意义（>0.05）。Orfit架加热塑性膜组三维方向的位移变化很小，所有差异均无统计学意义（均>0.05）。真空袋固定和Orfit架加热塑性膜固定均适用于宫颈癌患者的锥束CT图像引导放疗。然而，真空袋固定的左右方向位移小于Orfit架加热塑性膜固定。在治疗期间，Orfit架加热塑性膜固定前后方向位移差异的平均值较小，可以供身体灵活、耐受性好的患者单独使用。
