宮頸癌放療患者體重指數(shù)變化對(duì)擺位誤差的影響

　　[摘要] 目的 探討體重指數(shù)變化對(duì)宮頸癌患者放療擺位誤差的影響，利用體重指數(shù)變化評(píng)估熱塑體膜的松緊度，判斷是否需重新制作體膜。 方法 收集2014年1月～2015年6月接受外照射放療、使用體膜體位固定技術(shù)的宮頸癌患者60例，監(jiān)測(cè)患者在第1、6、11、16、21、25次放療時(shí)的體重，計(jì)算體重指數(shù)。在相應(yīng)的體重指數(shù)放療時(shí)應(yīng)用EPID影像和計(jì)劃系統(tǒng)所重建的DRR影像比較，得出相應(yīng)的擺位誤差，分析兩者的相關(guān)性。 結(jié)果 患者的體重隨著放療進(jìn)程的深入，體重逐漸減輕，以最初2周最為明顯，之后趨勢(shì)漸緩至趨于穩(wěn)定�；颊唧w重指數(shù)的變化和放療的擺位誤差呈正相關(guān)，變化越大則擺位誤差就越大。結(jié)果顯示：不同體重指數(shù)變化組間的左右方向、上下方向、前后方向擺位誤差存在統(tǒng)計(jì)學(xué)差異，兩兩比較顯示體重指數(shù)變化>10%組的患者在左右方向、上下方向、前后方向平均擺位誤差大于5%～10%組患者，5%～10%組患者在左右方向、上下方向、前后方向平均擺位誤差大于<5%組患者。結(jié)論 宮頸癌放療患者的體重指數(shù)變化和放療的擺位誤差呈正相關(guān)，在臨床實(shí)踐中可利用患者的體重指數(shù)變化評(píng)估是否需要重新制作熱塑體膜。
　　[關(guān)鍵詞] 宮頸癌；調(diào)強(qiáng)放療；體重指數(shù)變化；擺位誤差
　　[中圖分類號(hào)] R737.33 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-9701（2018）08-0028-04
　　Effect of body mass index changes on setup error in the patients with cervical cancer after radiotherapy
　　FANG Linming YAN Guiming ZHANG Feiyan CHEN Guofu
　　Room of Radiological Physics， Zhejiang Cancer Hospital， Zhejiang Key Laboratory of Radiological Oncology， Hangzhou 310022， China
　　[Abstract] Objective To investigate the effect of changes of body mass index on the setup error in cervical cancer radiotherapy， and to use the changes of body mass index to evaluate the tightness of the thermoplastic film， so as to determine whether to re-make the body film. Methods Patients who underwent external beam radiotherapy from January 2014 to June 2015 were selected. 60 cases of cervical cancer patients were given body membrane position fixation technique， and patients" body weight in the 1st， 6th， 11st， 16th， 21st， 25th radiotherapy was monitored. The body mass index was calculated. During radiotherapy of the corresponding body mass index， EPID images and reconstructed DRR images by planning system were compared， and the corresponding setup error was obtained. The correlation between the two was analyzed. Results With the process of radiotherapy， the body weight of patients was gradually reduced， which was most significant in the first two weeks， and was gradually stabilized afterwards. The changes of patients" body mass index was positively correlated with the setup error of radiotherapy， and the greater the changes， the greater the setup error. The results showed that there were statistically significant differences in the setup error of different body mass index in the left and right directions， up and down directions and forward and backward directions between the two groups. Pairwise comparisons showed that for the patients with >10% changes of body mass index， the average setup error was more than the patients in the 5%-10% group in the left and right directions， up and down directions and forward and backward directions. The average setup error in the 5%-10% group was more than <5% group in the left and right directions， up and down directions and forward and backward directions. Conclusion The changes of body mass index in patients with cervical cancer undergoing radiotherapy are positively correlated with the setup error of the radiotherapy. In clinical practice， changes in the patient"s body mass index can be used to evaluate whether a thermoplastic film needs to be re-made.

相關(guān)熱詞搜索：放療 宮頸癌 誤差 體重 患者