目的：分析盆腔肿瘤调强放疗的摆位误差，找出误差原因，以提高放疗准确度。方法将我院接受调强放疗的盆腔肿瘤患者77例作为研究对象，通过热塑膜使患者处于仰卧位，按系统设计计划放疗，每周拍摄靶区位置确认片，并与原计划靶区拍摄片进行对比，测量摆位误差。结果77例患者共拍摄310张验证片，与原计划靶区影像图骨性标志进行配准比较，结果显示，Z 轴误差高于 Y 轴及 X 轴，差异均有统计学意义（ P<0.05）。各方向摆位误差均以<3 mm最为多见，Z轴摆位误差在≥3mm之间的患者明显高于X轴及Y轴，差异有统计学意义（ P<0.05）。结论盆腔肿瘤调强放疗的摆位误差可能与患者原因、设备精度及操作误差等多种因素有关，临床工作中需积极做好质控，以减少误差，提高放疗准确性。%Objective To analyze the setup error of intensity-modulated radiotherapy (IMRT) for pelvic tumors, and find out the reasons of the error, so as to improve the accuracy of the radiotherapy. Methods Seventy-seven cases in our hospital were selected as the research objects. To make the patients supine position through the thermal plastic film, and to plan the radiotherapy according to system design. The target position was shot every week, which was confirmed and compared with planned target radiography, and the setup errors were measured. Results Three hundred and ten radiographies were shot in 77 patients, which were compared with the bony landmarks of original plan targets. The results showed that the Z axis error was higher than that of the Y axis and X axis (P<0.05). <3 mm was the most common setup error of all directions, and the patients whose Z axis error was≥3 mm were more than those of the X axis and Y axis (P<0.05). Conclusion The setup error of intensity-modulated radiotherapy for pelvic tumors may be associated with factors of patients, precision equipment, operation errors, etc. Clinical work should pay attention to a good quality control, to reduce the error and improve accuracy of radiotherapy.
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