評估頭頸癌患者以熱塑性面模輔以外科口罩放射治療之可行性

執行放射治療時，放射師會與病患有近距離之接觸，因此在嚴重特殊傳染性肺炎流行期間，感染傳播的風險將更大幅增加，尤以頭頸癌患者為最。本研究評估頭頸癌患者以熱塑性面模輔以外科口罩放射治療之可行性。選取2019年11月至2020年9月執行頭頸癌放射治療病患。分析頭頸肩熱塑性固定模具搭配不同頭枕高度（B型頭枕／C型頭枕）及分別有無外科口罩遮蓋鼻口處之四組固定模式擺位誤差。利用獨立樣本t檢定（Independent Sample t test）分析使用不同固定模式各軸向擺位誤差是否有差異，若p＜0.05則具統計意義。B型頭枕組中，所測得X、Y、Z、rot.、pitch五軸平均位移於無口罩與有口罩結果分別為1.3mm、2.0mm、2.3mm、0.61°、0.90°與1.5mm、2.0mm、1.8mm、0.67°、0.50°，且在Z軸（p＜0.003）與pitch（p＜0.001）軸的誤差絕對值都顯著差異，C型頭枕無口罩與有口罩所測得五軸平均位移分別為1.5mm、2.1mm、2.2mm、0.63°、0.66°及有1.5mm、1.6mm、1.7mm、0.58°、0.55°，在Y軸（p＜0.001）、Z軸（p＜0.003）與pitch（p＜0.044）軸的誤差絕對值都顯著的差異，但各軸平均位移向仍皆符合臨床規範。四組固定模具之X、Y、Z軸與rot.、pitch在系統誤差和隨機誤差皆小於3.0mm與0.70°。因此於嚴重特殊傳染性肺炎流行期間病患輔以外科口罩遮蓋鼻口處進行治療，將提高病患及醫護人員的保護，且對於治療之精準度並無影響皆符合臨床規範。

關鍵字

放射治療；特殊傳染性肺炎；外科口罩

並列摘要

During COVID-19 pandemic, the risk of infection transmission will increase, especially for patients with head and neck cancer. This study evaluated the feasibility of using thermoplastic masks with surgical masks for radiotherapy for patients with head and neck cancer. 2D-kV OBI images were acquired on 39 head-and-neck patients undergoing volumetric modulated arc therapy (VMAT), and divided into four groups based on different fixation patterns (two types head support head with and without wearing medical mask). Setup correction the mean displacement (M) , systematic (Σ), random variation (σ), 3D vector were analyzed after automatic image registration. The Independent Sample t test was used to analyze whether there is a difference in the set up error. There was a significant difference of shift between two groups (p ＜0.05). In the B-type headrest group, the measured average displacements of X, Y, Z, rot. , and pitch are 1.3 mm, 2.0 mm, 2.3 mm, 0.61°, 0.90° and 1.5 mm, 2.0 mm, 1.8 mm, 0.67°, 0.50° for B-type headrest without mask and with mask, respectively, and the absolute values of the errors on the Z (p＜0.003) and pitch (p＜0.001) are significantly different. The five-axis measurement of C-type headrest without mask and with mask the average displacement is 1.5 mm, 2.1 mm, 2.2 mm, 0.63°, 0.66° and 1.5 mm, 1.6 mm, 1.7 mm, 0.58°, 0.55° respectively. On the Y (p＜0.001), Z (p＜0.003) the absolute value of the error between the axis and the pitch ( p＜0.044 ) is significantly different, and the average displacement of each axis is in line with clinical specifications. The systematic and random errors of the X, Y, Z and rot. and pitch of the four types of fixation patterns are all less than 3mm and 0.70°. Therefore, during COVID-19 pandemic, patients will be treated with a surgical mask to cover the nose and mouth, which will improve the protection of patients and medical staff, and will not affect the accuracy of treatment.

並列關鍵字

Radiotherapy ； Pandemic ； Medical Mask

國際替代計量

評估頭頸癌患者以熱塑性面模輔以外科口罩放射治療之可行性

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