不同骨盆腔固定器在攝護腺癌三度空間立體順形放射治療技術之評估

A Comparison of Different Pelvic Immobilization Devices in the Treatment of Prostate Cancer with Three-Dimensional Conformal Radiotherapy

賴朝宗(Chao-Tsung Lai) ； 劉裕明(Yu-Ming Liu) ； 吳曉萍(Shiau-Ping Wu) ； 蕭正英(Cheng-Ying Shiau) ； 李玉麟(Yuh-Lin Lee) ； 季匡華(Kwan-Hwa Chi) ； 顏上惠(Sang-Hue Yen)

《放射治療與腫瘤學》 7卷3期 (2000/09) Pp. 177-185

https://doi.org/10.6316/TRO/200007(3)177

摘要

Purpose: To determine the variability of patient setup errors during three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer treatment without immobilization or with different immobilization devices.
Materials and Methods : Forty-eight prostate cancer patients treated with 3D-CRT were prospective evaluated. They were treated by the same physician, technician and machine. Five groups of patients and technique were compared: (A) supine position without immobilization; (B) prone position without immobilization, but with belly-board; (C) prone position with belly-board and cast immobilization; (D) supine position with alpha cradle from waist to below knee immobilization; (E) supine position with stereotactic body frame immobilization. Serial portal films were recorded and compared with simulation films. The deviation in each axis and rotation angle were compared.
Results: Group A has the least deviation in X-axis of anterior-posterior view CAP-X; p = 0.044); group B has the least deviation in Z-axis of anterior-posterior view (AP-Z; p = 0.065); group 0 has the least deviation in rotation angle of anterior-posterior view (AP-Ang.; p = 0.067); group E has the least deviation in rotation angle of lateral view (Lat-Ang. ; p = 0.078). There is no significant difference in deviation both in each directions and angles according to body habitus as normal or obese. Heavier weight has less AP-Z and Lat-Z deviation (p = 0.011 and p = 0.108); the deviation of Lat-Z has positive correlation with AP-Z (p ＜ 0.001), deviation AP-X has positive correlation with deviation Lat-Z and Lat-Ang. (p = 0.037 and p = 0.05 ). For patients with thickness of pelvic circumference (PC-AP) ＜ 19.0 cm have the least deviation in AP-Z (p = 0.034), Lat-Ang. (p = 0.034) in group B and the least AP-Ang. (p = 0.031) in group D; for patients with width of pelvic circumference (PC-Lat) ＜ 35.0 cm have the least deviation in AP-X (p = 0.013) in group A, Lat-Z in group C; for patients with body weight ＜ 67.5 kg have the least deviation in AP-X (p = 0.039) in group A.
Conclusion: Group A has better setup error in AP-X and Lat-Z with statistics significant (p ＜ 0.05), group B has better setup error in AP-Z; group D and E have better setup error in rotation angle; group C has less setup error in Lat-Y, but without statistical significance. We conclude supine position without immobilization fixation technique seems to be a suitable method for treating patients with localized prostate cancer either in accuracy or conveniency.

關鍵字

骨盆腔固定器,三度空間立體順形放射治療技術,擺設位置誤差,驗證片,模擬定位片

並列摘要

Purpose: To determine the variability of patient setup errors during three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer treatment without immobilization or with different immobilization devices.
Materials and Methods : Forty-eight prostate cancer patients treated with 3D-CRT were prospective evaluated. They were treated by the same physician, technician and machine. Five groups of patients and technique were compared: (A) supine position without immobilization; (B) prone position without immobilization, but with belly-board; (C) prone position with belly-board and cast immobilization; (D) supine position with alpha cradle from waist to below knee immobilization; (E) supine position with stereotactic body frame immobilization. Serial portal films were recorded and compared with simulation films. The deviation in each axis and rotation angle were compared.
Results: Group A has the least deviation in X-axis of anterior-posterior view CAP-X; p = 0.044); group B has the least deviation in Z-axis of anterior-posterior view (AP-Z; p = 0.065); group 0 has the least deviation in rotation angle of anterior-posterior view (AP-Ang.; p = 0.067); group E has the least deviation in rotation angle of lateral view (Lat-Ang. ; p = 0.078). There is no significant difference in deviation both in each directions and angles according to body habitus as normal or obese. Heavier weight has less AP-Z and Lat-Z deviation (p = 0.011 and p = 0.108); the deviation of Lat-Z has positive correlation with AP-Z (p ＜ 0.001), deviation AP-X has positive correlation with deviation Lat-Z and Lat-Ang. (p = 0.037 and p = 0.05 ). For patients with thickness of pelvic circumference (PC-AP) ＜ 19.0 cm have the least deviation in AP-Z (p = 0.034), Lat-Ang. (p = 0.034) in group B and the least AP-Ang. (p = 0.031) in group D; for patients with width of pelvic circumference (PC-Lat) ＜ 35.0 cm have the least deviation in AP-X (p = 0.013) in group A, Lat-Z in group C; for patients with body weight ＜ 67.5 kg have the least deviation in AP-X (p = 0.039) in group A.
Conclusion: Group A has better setup error in AP-X and Lat-Z with statistics significant (p ＜ 0.05), group B has better setup error in AP-Z; group D and E have better setup error in rotation angle; group C has less setup error in Lat-Y, but without statistical significance. We conclude supine position without immobilization fixation technique seems to be a suitable method for treating patients with localized prostate cancer either in accuracy or conveniency.

並列關鍵字

Pelvic immobilization devices,Three-dimensional conformal radiotherapy (3D-CRT),Setup error,Portal film,Simulation film