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目的:通过锥形束CT(CBCT)扫描分析摆位误差,提高调强放疗(IMRT)的质量。方法:选择胸段食管癌调强放射治疗患者22例,利用体板和热塑体膜进行体位的精确固定,通过技术员细心规范的摆位以及首次治疗前对患者进行CBCT扫描,治疗过程中每周行1次CBCT扫描,记录左右、头脚、腹背3个方向的误差数值,进行判断和在线纠正摆位误差。结果:22例患者进行102例次CBCT扫描位置验证,其中首次摆位22例次,治疗过程中80例次,治疗过程中摆位误差数值减小,治疗体位重复率高,所有患者能顺利完成放疗计划,肿瘤局控率96.3%,部分缓解80.5%,不良反应明显下降。结论:通过质量控制和技术改进,可以保证治疗体位的重复性,使摆位误差降到最小,达到调强放疗的目的。
OBJECTIVE: To improve the quality of intensity modulated radiation therapy (IMRT) by analyzing the setup error by CBCT scan. Methods: Twenty-two patients with thoracic esophageal cancer IMRT were selected. The body plate and the thermoformed membrane were used for the accurate fixation of the position. The CBCT was scanned by the technician carefully and properly before setting up the CBCT. Week 1 CBCT scan, record the left and right, head and foot, abdomen back and forth three directions of the error value, to determine and correct positioning errors online. Results: Twenty-two patients underwent CBCT scanning in 102 cases. Among them, 22 cases were placed for the first time and 80 cases were treated during the treatment. The error of setting error during treatment was low and the repetition rate of treatment position was high. All patients successfully completed Radiotherapy plan, the tumor control rate of 96.3%, 80.5% partially relieved, adverse reaction decreased significantly. Conclusion: Through the quality control and technical improvement, the repeatability of position can be guaranteed and the setup error can be minimized to achieve the purpose of intensity modulated radiotherapy.