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王雯1,郭琛2,王越2,王娟3,马隆波1,兰卫光1,徐守俭1,孙晓娟1▲.乳腺癌放疗应用3D打印补偿膜的摆位误差及安全性影响[J].中国医药科学,2024,14(9):174-178        基金项目:滨州医学院附属医院科研计划项目(BY2022KJ46)
乳腺癌放疗应用3D打印补偿膜的摆位误差及安全性影响
Influence of positioning error and safety of 3D printing compensation film in breast cancer radiotherapy
  
DOI:
中文关键词:  乳腺肿瘤;放射治疗;锥形束CT;摆位误差;边界外扩;3D打印
英文关键词:Breast tumors; Radiotherapy; Conical beam CT; Positioning error; Boundary expansion; 3D printing
作者单位
王雯1,郭琛2,王越2,王娟3,马隆波1,兰卫光1,徐守俭1,孙晓娟1▲ 1.滨州医学院附属医院肿瘤放疗科,山东滨州 256600;2.滨州医学院附属医院肿瘤科,山东滨州 256600;3.山东省阳信县人民医院超声医学科,山东阳信 251800 
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中文摘要:
      [摘要] 目的 探讨乳腺癌根治术后放射治疗体表覆盖3D打印补偿膜后的摆位误差及安全性。 方法 收集滨州医学院附属医院2023年1—6月收治的29例乳腺癌放疗患者,治疗方式分为先后应用3D组织补偿膜两种方法。利用锥形束CT(CBCT)采集的图像分析三维方向上的摆位误差大小并计算计划靶区(PTV)的外放范围,以及急性放射性皮炎的发生率。 结果 X、Y、Z方向临床靶区(CTV)外扩至PTV边界分别为0.94、0.84、0.52 cm。X轴方向上身体质量指数(BMI)24 kg/m2的摆位误差大于其余两组,差异有统计学意义(P < 0.05);Z轴方向上≥28 kg/m2的摆位误差24~28 kg/m2组,差异有统计学意义(P < 0.05);X轴方向上首次摆位误差显著小于分次间,差异有统计学意义(P < 0.05)。先后应用补偿膜2级放射性皮炎发生率分别为3.45%、13.79%,差异有统计学意义(P < 0.05)。 结论 对于BMI 24 kg/m2的患者要关注X轴方向的摆位。为避免放射性皮炎的发生,尽量在治疗前15次添加补偿膜。
英文摘要:
      [Abstract] Objective To explore the positioning error and safety of the body surface covered with 3D printing compensation film after radiotherapy for breast cancer after radical surgery. Methods A total of 29 patients with breast cancer who received radiotherapy at the Binzhou Medical University Hospital from January to June 2023 were collected. The treatment methods included applying 3D tissue compensation membrane successively. The positioning error in the three-dimensional direction using images collected by the cone beam CT (CBCT) was analyzed and the external radiation range of the planned target volume (PTV) was calculated, as well as the incidence of acute radiation dermatitis. Results The clinical target volume (CTV) in the X, Y, and Z directions expanded to the PTV boundary at 0.94, 0.84, and 0.52 cm, respectively. The positioning error of body mass index (BMI) < 24 kg/m2 in the X-axis direction was greater than that in the other two groups, with statistically significant difference (P < 0.05). The positioning error of ≥28 kg/m2 in the Z-axis direction was smaller than that in the 24-28 kg/m2 group, with statistically significant difference (P < 0.05). The initial positioning error in the X-axis direction was significantly smaller than that in the interval, with statistically significant difference (P < 0.05). The incidence of grade 2 radiation dermatitis caused by the successive use of compensation films was 3.45% and 13.79%, respectively, with statistically significant difference (P < 0.05). Conclusion For patients with a BMI < 24 kg/m2, attention should be paid to the positioning in the X-axis direction; To avoid the occurrence of radiation dermatitis, try to add compensation film 15 times before the treatment.
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