可塑型自製頭枕對放射治療準確性影響之探討

The Impact of Plastic Customized Head Support on The Accuracy of Radiation Therapy

林其嶪(Chi-Yeh Lin) ； 林招膨(Chao-Peng Lin) ； 陳俊佑(Chun-You Chen) ； 張寶枝(Pao-Chick Chang) ； 周志成(Chih-Cheng Chou) ； 陳秋萍(Chiu-Ping Chen) ； 吳思遠(Szu-Yuan Wu) ； 楊友華(Yu-Hua Yang)

《北市醫放雜誌》 2卷1期 (2012/12) Pp. 8-17

https://doi.org/10.6663/TPART.2012.2.1.8

摘要

頭頸部癌症病患，在臨床上常接受放射治療，其位置的準確性是很重要的。本研究旨在探討頭頸部癌症病患整個治療療程之中，每次在接受模具固定擺位後，位置是否有差異，並比較不同類型的頭枕是否會對放射線治療之準確性有所影響。本研究收集2011年2月至2012年5月間，共有46位頭頸部癌症病患，藉由每日的影像導引放射線治療的方式收集共1538次cone beam computed tomography (CBCT)掃描資料，做回溯性的分析。結果顯示使用新型可塑型自製頭枕的病患(第二組)，皆比使用舊型制式頭枕的病患(第一組)，位移誤差平均值要小。Y軸方向在2組實驗中的位移誤差皆呈現較X軸與Z軸大，若轉換成三維平均位移向量平均值呈現第一組3.6 mm比第二組2.7 mm位移誤差還大。使用新型可塑型自製頭枕的病患比使用舊型制式頭枕，在整個治療過程當中，除了可使病患頭頸部接受到比較好的模具支撐和包覆性，還可以減少約25%的位移誤差。

關鍵字

影像導引放射治療 ； 錐型射束電腦斷層 ； 模具 ； 可塑型自製頭枕

並列摘要

Radiation therapy is a main treatment option for head and neck cancers .The importance of accuracy of the radiation location has never been overemphasized. The purpose of this study is to evaluate both the stability of patient fixation and the effect of plastic customized head support on the accuracy of radiation therapy for the head and neck cancer patients. From February 2011 to May 2012, 46 head and neck cancer patients with a total of 1538 times daily image-guided radiation therapy were enrolled. The patients were classified into two groups. Group I was using the classical standard head support; Group II was using novel plastic customized head support. Cone beam computed tomography (CBCT) scan data were analyzed retrospectively. The results showed the displacement error value was smaller in group II. The displacement error of the Y-axis direction were smaller than the X axis and Z axis in the two groups. If converted to the three-dimensional system, average displacement error was 3.6 mm in Group I and 2.7 mm in Group II. Patients who used new plastic customized head support in the entire course of treatment had better mold support and coating. The displacement error was also reduced about 25%.

並列關鍵字

image-guided radiation therapy ； cone beam computed tomography ； mold ； plastic customized head support