头颈部肿瘤调强放疗中摆位偏差测量及分析.docVIP

头颈部肿瘤调强放疗中摆位偏差测量及分析 　 作者：沈君姝，王健琪，张宜勤，翟振宇，荆西京 【关键词】 头颈部肿瘤；摆位误差；电子射野影像装置；数字重建图像 【Abstract】 AIM: To measure the setup error in the intensity modulated radiation therapy (IMRT) for headneck neoplasms, and to analyze the margin between the clinical target volume (CTV) and planning target volume (PTV). METHODS: Seventysix patients with headneck neoplasms were choosed at random. The portal films were screened using the electronic portal imaging device (EPID), and the error was analyzed through comparing the portal film with the digitally reconstruced radiographs (DRR) in the treatment planning system (TPS). RESULTS: The setup errors were (-0.62±1.46) mm,(-0.41±1.54) mm,(-0.31±1.67) mm and the margins were 2.27 mm, 1.87 mm, 1.98 mm in lateral, cranialcaudal and ventraldorsal directions respectively. CONCLUSION: For the patients with headneck neoplasms undergoing the IMRT, the margins between the CTV and the PTV should be 2.5 mm in the lateral direction, and 2 mm in cranialcaudal and ventraldorsal directions. Moreover, with the treatment time goes by, the error varied irregularly. 【Keywords】 head and neck neoplasms; setup error; electronic portal imaging device (EPID); digital reconstructedly radiograph (DRR) 【摘要】目的： 测定头颈部肿瘤在调强放射治疗中的摆位偏差，分析计划设计中从临床靶区（CTV）到计划靶区（PTV）的外扩边界. 方法： 随机抽取76名头颈部肿瘤患者，在治疗时用电子射野影像装置（EPID）拍摄射野片，将射野片和计划系统中的数字重建射野（DRR）图像片进行误差比较. 结果： 在左右、头脚、腹背方向的摆位误差分别是(-0.62±1.46) mm，(-0.41±1.54) mm，(-0.31±1.67) mm，外扩边界分别是2.27 mm，1.87 mm，1.98 mm. 结论： 对于头颈部调强治疗的患者，CTV到PTV的外放边界在左右方向需要2.5 mm，头脚方向和腹背方向需要2 mm.并且随着治疗时间的递进，摆位误差没有规律性的变化. 【关键词】 头颈部肿瘤；摆位误差；电子射野影像装置；数字重建图像 0引言 放射治疗过程中患者的摆位偏差是影响精确治疗的关键因素，越是精确的放射治疗，对照射体位和照射野的准确性要求越高. 了解摆位偏差的大小和来源对减少摆位偏差和确定照射野合适的外放边界是非常有意义的. 本研究对电子射野影像装置(electronic portal imaging device, EPID)拍摄的患者治疗射野图像与计划系统所生成的数字重建射野图像（digital reconstructed radiography, DRR）进行了比较,对调强放射治疗（intensity modulated radiation therapy, IMRT）的头颈部肿瘤的摆位偏差进行测量和误差分析，并且计算出计划设计时从临床靶区（clinical target volume ,CTV）到计划靶区（planning target volume, PTV）的外扩边界的具体数值. 1材料和方法 1.1材料200411/20