俯卧位碳纤维腹板加热塑膜固定技术在直肠癌放疗中的临床应用

摘要

Objective To study the prone position of carbon fiber web heating plastic film fixation technique on radiotherapy posture of rectal cancer, and its protection on the organs at risk.Methods A total of 50 postoperative patients with rectal cancer were randomly divided into two groups, with 25 cases in each group.The observation group underwent prone carbon fiber web heating plastic film fixed Intensity-modulated radiation therapy (IMRT), while the control group was treated with supine thermoplastic film and special plate fixation IMRT.The mean dose (Dmean) and total volume (VT) of the planned target area (PTV), the small bowel and bladder irradiation dose and volume were compared between two groups;the setup errors and incidence of acute radioactive reaction were compared between two groups.Results There were no significant difference of Dmean and VT in PTV between the two groups(P>0.05);the Dmean and irradiation volume in the small bowel and bladder of the observation group were significantly lower than those in the control group (P<0.05).There were no significant difference of displacement error of head-foot, left-right, and front-back between the two groups (P>0.05).The severity of gastrointestinal reactions and urinary tract reactions in the observation group was significantly lighter than those of the control group during the treatment period and after treatment (P<0.05).Conclusions The prone position of carbon fiber web heating plastic film fixation technique used in radiotherapy after radical resection of rectal cancer can ensure the efficacy of radiotherapy, protect the small intestine and bladder, and has good position repeatability and high safety.%目的 探讨俯卧位碳纤维腹板加热塑膜固定技术对直肠癌患者放疗摆位重复性的影响及对危及器官的保护作用. 方法 选择直肠癌术后患者50例作为研究对象,采用抽签法随机分为两组,每组25例.观察组患者行俯卧位碳纤维腹板加热塑膜固定三维适形调强放疗(IMRT),对照组行仰卧位加热塑体膜固定IMRT.比较两组患者计划靶区(PTV)平均剂量(Dmean)和总体积(VT)、小肠和膀胱照射剂量和体积;比较两组患者的摆位误差及急性放射反应发生情况.结果 两组患者PTV的VT和Dmean比较、小肠和膀胱的VT比较差异无统计学意义(P>0.05);观察组患者小肠和膀胱的照射体积和Dmean显著低于对照组,差异均有统计学意义(P<0.05).两组患者头-脚、左-右及前-后方向位移误差比较差异无统计学意义(P>0.05).观察组患者治疗期间和治疗后胃肠道反应和泌尿系反应严重程度显著低于对照组,差异有统计学意义(P<0.05).结论 将俯卧位碳纤维腹板加热塑膜固定技术应用于直肠癌根治术后放疗能保证放疗疗效,保护小肠和膀胱等危及器官,摆位重复性良好,安全性高.