Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada.
Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada.
J Med Imaging Radiat Sci. 2022 Jun;53(2 Suppl):S56-S62. doi: 10.1016/j.jmir.2022.04.004. Epub 2022 May 3.
Palliative patients are living longer thanks to advancements in systemic therapies and radiotherapy technologies. Prior to image guided radiotherapy, permanent ink tattoos were used to ensure set up accuracy. Permanent marks can cause psychological damage, physical pain and can reduce a patient's quality of life. In recent years, image guided radiation therapy (IGRT) has become standard practice and may eliminate the need for permanent tattoos in this patient population.
Twenty-five patients were consecutively chosen from the Palliative Radiation Oncology Program (PROP). Each received 5 fractions of radiotherapy commencing within 72 hours of CT simulation. In place of permanent tattoos, patients were marked with permanent marker and an adherent transparent film dressing (Tegaderm TM ) was placed over the mark. Patients were educated on maintaining the marks and dressing. Daily cone beam CT (CBCT) isocentre mismatch values were compared with 25 patients who received tattoos for radiotherapy to similar body regions. Radiation therapist concerns, cost, variations in isocentre shift values and additional imaging requirements were obtained.
Isocentre shift values were similar (p<0.05) for Tegaderm TM vs. tattoo patients in the anterior-posterior (AP) and right-left (RL) directions. The mean shift value in the superior-inferior (SI) direction was larger for Tegaderm TM than for tattoos (p=0.01), however the magnitude was only 2 mm, which is clinically insignificant as these shifts were prior to IGRT guided correction. No patient required a repeat CBCT or a resimulation. The cost of the Tegaderm TM dressing was substantially less than the tattoo group. Radiation Therapists' satifaction with Tegaderm TM was overall high, however some expressed concerns with their durability and longevity.
We found that the use of Tegaderm TM dressing did not result in increased set-up time, mismatch error or additional imaging procedures (CBCT or CTsimulation) and moreover cost substantially less than permanent ink tattoos.
由于系统治疗和放射治疗技术的进步，姑息治疗患者的寿命得以延长。在图像引导放射治疗之前，永久墨水纹身被用于确保设置的准确性。永久标记会造成心理伤害、身体疼痛，并降低患者的生活质量。近年来，图像引导放射治疗（IGRT）已成为标准实践，可能使这一患者群体无需使用永久纹身。
从姑息放射肿瘤计划（PROP）中连续选择了 25 名患者。每位患者在 CT 模拟后 72 小时内开始接受 5 次放射治疗。替代永久纹身，患者使用永久性标记，并在标记上放置透明的粘性薄膜敷料（Tegaderm TM ）。向患者进行了有关保持标记和敷料的教育。比较了每日锥形束 CT（CBCT）等中心失准值与接受类似身体区域放射治疗的 25 名纹身患者。获得了放射治疗师的关注、成本、等中心移位值的变化以及额外的成像要求。
在前后（AP）和左右（RL）方向上，Tegaderm TM 与纹身患者的等中心移位值相似（p<0.05）。在上下（SI）方向上，Tegaderm TM 的平均移位值大于纹身（p=0.01），但幅度仅为 2 毫米，在 IGRT 引导校正之前，这在临床上无意义。没有患者需要重复进行 CBCT 或重新模拟。Tegaderm TM 敷料的成本大大低于纹身组。放射治疗师对 Tegaderm TM 的总体满意度很高，但有些人对其耐用性和耐久性表示担忧。
我们发现，使用 Tegaderm TM 敷料不会导致设置时间延长、失准误差或增加成像程序（CBCT 或 CTsimulation），而且成本大大低于永久墨水纹身。
