记录验证系统中床位容差表的设定方法

摘要

Objective To evaluate the effect of the tolerance table of different couch positions in the record and verify system (R&V system) upon the setup accuracy.Methods Clinical data of 715 patients (15 743 fractions of treatment) were extracted from the R&V system database and assigned into four categories including thorax and abdomen,head and neck,breast,and rectum based on the disease site and immobilization device.The first day couch position (FstD) and cumulative average couch position (CumA)were utilized as the references to analyze the couch setup of each faction of treatment,and to establish the tolerance tables of different sites.The sensitivity and specificity of two methods were evaluated by the actual clinical treatment record of the patients.Results For the FstD as the reference,the couch tolerance in the breast was significantly higher than those in other parts.When the CumA was used as the reference,the couch tolerance tended to be stable after a certain fractions of treatment,and the tolerance of all sites was less than that of the FstD.The tolerance tables significantly differed between these two methods (P=0.000).Both two methods possessed high specificity,whereas the CumA method yielded higher sensitivity than the FstD approach.Conclusion Setting a reasonable tolerance table of couch position can effectively improve the setup accuracy.%目的 探讨记录验证系统中不同部位的床位容差表对摆位准确性的影响.方法 从记录验证系统数据库中提取715例已完成治疗肿瘤患者的数据,共15 743个治疗分次.根据不同部位和不同摆位辅助装置将其分为胸腹部、头颈部、乳腺、直肠4类.以首次治疗床位(FstD)和累计治疗床位(CumA)为参考分析各治疗分次的床位摆放,并创建不同部位的床位容差表.以患者的实际临床治疗记录评估2种方法的敏感性和特异性.结果 以FstD为参考时,乳腺患者的容差明显高于与其他部位.以CumA为参考时,床位容差在一定的治疗分次后趋于稳定,所有部位的容差均小于FstD容差.2种方法容差表比不同(P=0.000),均具有高度特异性,且CumA的敏感性高于FstD.结论 在记录验证系统中设定合理的床位容差表可有效提高摆位的准确性.