- 期刊
比較乳癌病患不同定位姿勢接受放射線治療之擺位誤差
Comparison of Setup Errors in Different Immobilization Position Methods for Breast Radiation Therapy
摘要
本研究以回溯性分析40位接受放射治療之乳癌病患以平躺（supine）姿勢或反向半側臥位（reverse semi-decubitus, RSD）姿勢之擺位誤差。藉由每日影像導引電腦斷層掃描取得三維位移修正數據，計算系統誤差、隨機誤差、三維平均位移向量及計畫靶體積所需安全範圍值，並分析影響位移之相關因子，找出是否具有統計學上之差異（p＜0.05）。平躺與反向半側臥位姿勢在X軸的位移平均值與標準差為-0.11±2.92 mm和2.44±5.06 mm；Y軸為0.31±3.39 mm和1.0±3.62 mm；Z軸為-0.04±2.45 mm和-0.9±3.15 mm。平躺姿勢位移平均值與標準差明顯小於反向半側臥位姿勢，並在X軸方向位移達統計顯著差異性（p=0.004）。三維平均位移向量在病患平躺姿勢為4.55 mm，小於反向半側臥位6.67 mm。安全範圍參考建議值在平躺姿勢X、Y、Z軸方向為5.14 mm、6.96 mm、5.4 mm；在反向半側臥位姿勢X、Y、Z軸方向為10.98 mm、6.92 mm、7.29 mm。在使用強度調控放射線治療技術時，病患可以採用平躺姿勢，使擺位穩定性高，提升位置再現性，並改善病患舒適度。而在未使用影像導引技術之病患應參考計畫靶體積所需安全範圍建議值，做為臨床治療的依據。
並列摘要
This study retrospectively analyzed the positioning errors of forty breast radiation therapy patients in two different immobilization positions including supine posture or the reverse semi-decubitus (RSD) posture using image guide radiotherapy. We obtained three-dimensional displacement correction data, and we calculated system error, random error, 3D vector and recommended PTV safe margins. In the study, we analyzed the factors which influenced setup errors when there was a statistically significant difference (p ＜ 0.05). The mean and standard deviations of the X-axis displacement of the supine posture and RSD posture were -0.11±2.92 mm and 2.44±5.06 mm ; the Y-axis were 0.31±3.39 mm and 1.0±3.62 mm ; the Z-axis were -0.04±2.45 mm and -0.9±3.15 mm respectively. The mean and standard deviations of supine posture were significantly smaller than the RSD posture, and there was a statistically significant difference in the X directions (p =0.004). The mean 3D vector displacement was 4.55 mm in the supine posture, which was less than the RSD posture of 6.67 mm. It was recommended value that PTV safe margins in the X, Y and Z directions were 5.14 mm, 6.96 mm and 5.4 mm in the supine posture, 10.98 mm, 6.92 mm, and 7.29 mm in the RSD posture. It is recommended that patients can adopt supine posture to provide high stability, improve positional reproducibility and comfort when using the intensity-modulated radiotherapy technique. The patients without using image-guided techniques should refer to the recommended value of the PTV safe margin. It could be a reference in clinical treatment.
延伸閱讀
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- 周淳娟、陳妙芬、林坤生、陳信雄（2019）。探討乳癌病患於錐狀射束電腦斷層旋轉軸與平移軸擺位誤差轉換之可行性。中華放射線技術學雜誌，43(2)，62-70。https://www.airitilibrary.com/Article/Detail?DocID=16849418-201906-201910180006-201910180006-62-70
- 邱筱文（2018）。不同乳癌放射治療技術在心臟劑量之探討〔碩士論文，中臺科技大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0099-2705202017052646
- 宋國強、李財福、吳鴻源、阮國榮（2019）。影響乳癌患者接受強度調控放射治療後產生放射線皮膚炎之因子分析。中華放射線技術學雜誌，43(1)，27-32。https://www.airitilibrary.com/Article/Detail?DocID=16849418-201903-201907220004-201907220004-27-32
- 康誠麟、陳文凱、蔡正祥、張軒銘、廖宗義、阮國榮（2011）。Comparison of Two Different Type Chest Fixation Devices Positioning Accuracy in Radiation Therapy。中華放射線技術學雜誌，35(2)，99-103。https://doi.org/10.30045/CJRT.201106.0005