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[目的]探讨Tomotherapy图像引导下多发性骨转移治疗中的单计划多靶区(A组)与多计划单靶区(B组)的配准精确度对比。[方法]采集在Tomotherapy治疗的15例多发性骨转移患者分次治疗中的配准数据,其中单计划多靶区患者(A组)8例,多计划单靶区患者(B组)7例。每次放疗前行MVCT扫描,均采用Bone Technique(骨性技术)为配准条件并结合人工校对,通过统计学软件的运用分析比较患者分次治疗中左右(X轴)、头脚(Y轴)、上下(Z轴)、旋转(Roll)方向的配准误差值。[结果]A组8例共200次在线配准数据与B组7例175次在线配准数据对比,摆位绝对误差只有在头脚方向(Y轴)A组大于B组,分别为(5.24±4.01)mm、(3.72±3.67)mm(P=0.041)。摆位相对误差只有在左右方向(X轴)A组大于B组,分别为(2.81±2.07)mm、(1.87±1.83)mm(P=0.008)。[结论]两种计划方法对多发性骨转移分次放疗的配准精度各有优劣,但均在可控范围内,可根据临床实际选用合适的计划方法。
[Objective] To compare the accuracy of registration of single-plan multi-target (group A) and multiple-plan single target (group B) in the treatment of multiple bone metastases guided by Tomotherapy images. [Methods] The registration data of 15 patients with multiple bone metastases treated by Tomotherapy were divided into groups. Among them, 8 were single-plan multi-target patients (group A), 7 were multi-plan single-target patients (group B) . Each radiotherapy before MVCT scan, using Bone Technique (Bone Technique) as the registration conditions combined with manual proofing, through statistical software analysis and comparison of patients with sub-treatment of left and right (X axis), head and foot (Y axis ), Up / down (Z axis), roll (Roll) registration error value. [Results] A total of 200 online registration data of 8 patients in group A were compared with 175 online registration data of 7 patients in group B, and the absolute error of positioning in group A was larger than that in group B only in the direction of head and foot (Y axis), which were (5.24 ± 4.01) mm, (3.72 ± 3.67) mm (P = 0.041). The relative error of positioning was only (2.81 ± 2.07) mm and (1.87 ± 1.83) mm (P = 0.008) in the left and right direction (X axis). [Conclusion] The accuracy of the two planning methods for radiographic grading of multiple bone metastases has advantages and disadvantages, but all are within the controllable range, and the appropriate planning methods can be selected according to the clinical practice.