Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Med Dosim. 2022;47(4):325-328. doi: 10.1016/j.meddos.2022.06.002. Epub 2022 Jul 14.
Performance of thoracic radiotherapy may be assisted by the use of thoracoabdominal flat immobilization devices (TAFIDs) and integrated cervicothoracic immobilization devices (ICTIDs). This study was performed to compare setup errors of TAFIDs and ICTIDs. Forty-four patients with lung cancer were retrospectively reviewed; 22 patients were immobilized with a TAFID and 22 with an ICTID. In total, 343 cone-beam computed tomography images of these patients were collected for radiotherapy setup. The 3-dimensional setup errors and the displacement of the acromioclavicular joint against the supraclavicular region were calculated. An independent-samples t-test and rank-sum test were used for statistical analyses. The translational setup errors of the TAFID group vs ICTID group in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions were 0.14 ± 0.17 vs 0.14 ± 0.16 cm (p = 0.364), 0.23 ± 0.26 vs 0.15 ± 0.15 cm (p = 0.000), and 0.16 ± 0.15 vs 0.12 ± 0.14 cm (p = 0.049), respectively. The relative displacement of the acromioclavicular joint against the supraclavicular joint in the LR, SI, and AP directions were 0.10 ± 0.12 vs 0.09 ± 0.10 cm (p = 0.176), 0.13 ± 0.13 vs 0.11 ± 0.12 cm (p = 0.083), and 0.17 ± 0.16 vs 0.12 ± 0.11 cm (p = 0.001), respectively. The overall displacement of the supraclavicular region was 0.28 ± 0.19 vs 0.23 ± 0.15 cm (p < 0.001). The recommended planning target volume margins in the LR, SI, and AP directions were 0.46 vs 0.74 cm, 0.51 vs 0.47 cm, and 0.49 vs 0.41 cm, respectively. For patients with lung cancer, using an ICTID can reduce setup errors in the SI direction and displacements of the acromioclavicular joint and supraclavicular region compared with a TAFID. Therefore, an ICTID is preferred for patients with lung cancer with supraclavicular target volume.
胸腹部平板固定装置（TAFIDs）和颈胸一体化固定装置（ICTIDs）的使用可以辅助胸放疗。本研究旨在比较 TAFIDs 和 ICTIDs 的摆位误差。回顾性分析了 44 例肺癌患者，其中 22 例采用 TAFIDs 固定，22 例采用 ICTIDs 固定。共采集了这些患者 343 次锥形束 CT 图像进行放疗摆位。计算了三维摆位误差和锁骨肩峰关节相对于锁骨上区域的位移。采用独立样本 t 检验和秩和检验进行统计学分析。TAFID 组和 ICTID 组在左右（LR）、上下（SI）和前后（AP）方向的平移摆位误差分别为 0.14 ± 0.17 cm 和 0.14 ± 0.16 cm（p = 0.364），0.23 ± 0.26 cm 和 0.15 ± 0.15 cm（p = 0.000），0.16 ± 0.15 cm 和 0.12 ± 0.14 cm（p = 0.049）。锁骨肩峰关节相对于锁骨上关节在 LR、SI 和 AP 方向的相对位移分别为 0.10 ± 0.12 cm 和 0.09 ± 0.10 cm（p = 0.176），0.13 ± 0.13 cm 和 0.11 ± 0.12 cm（p = 0.083），0.17 ± 0.16 cm 和 0.12 ± 0.11 cm（p = 0.001）。锁骨上区域的整体位移分别为 0.28 ± 0.19 cm 和 0.23 ± 0.15 cm（p < 0.001）。LR、SI 和 AP 方向的推荐计划靶区边缘分别为 0.46 cm 和 0.74 cm，0.51 cm 和 0.47 cm，0.49 cm 和 0.41 cm。对于肺癌患者，与 TAFIDs 相比，使用 ICTIDs 可减少 SI 方向的摆位误差以及锁骨肩峰关节和锁骨上区域的位移。因此，对于锁骨上靶区的肺癌患者，推荐使用 ICTIDs。
