中国医学装备2025，Vol.22Issue(12)：14-18,5.DOI:10.3969/j.issn.1672-8270.2025.12.003
光学定位系统摆位误差对胸部肿瘤患者放射治疗剂量分布的影响
Impact of setup errors of optical positioning system on distribution of radiotherapy dose for patients with thoracic tumors
摘要
Abstract
Objective:To research the impact of setup errors of optical positioning system(OPS)on distribution of the dose of the target volume and normal organs in radiotherapy for thoracic tumors.Methods:A retrospective analysis was conducted on 67 patients with thoracic tumor(including esophageal cancer and lung cancer)who admitted to The Second People's Hospital of Lianyungang.All of them underwent intensity-modulated radiation therapy(IMRT)on a Varian Clinac iX accelerator,and used OPS to conduct verification for setup.For each patient,two plans were formulated:an original plan and error plan(with OPS error).The original plan that was the optimal radiotherapy plan was designed on the initial images,which was obtained through directly calculated dose distribution.The error plan was generated by importing each patient's each setup OPS error data into the Eclipse TPS 11.0,without positioning optimization for radiation field and Multi-Leaf Collimator(MLC),and then accumulated the dose distribution of each fraction.The dose parameters and exposure dose of organ at risk(OAR)of patients with esophageal cancer and lung cancer between original plan and error plan were compared and analyzed.Results:The setup errors of patients with esophageal and lung cancer were at the millimeter level on the(x,y,z)directions.On z direction,the errors of esophageal cancer and lung cancer were largest,and they were respectively(-2.12±1.36)mm and(-1.75±1.16)mm.There was not significant difference in D98%and conformity index(CI)between original plan and error plan of esophageal cancer(P＞0.05),while there were significant differences in D2%,D50%and homogeneity index(HI)between them(Z=-6.39,-6.39,-6.39,P＜0.05).There were significant differences in V5,V10,V20,V30 and Dmean of OAR lung between two kinds of plans(Z=-5.40,-5.54,-5.11,-5.49,-5.95,P＜0.05).There were significant differences at Dmax and Dmean of spinal cord,and V30 and Dmean of heart between two kinds of plans(Z=-6.20,-6.38,-2.69,-3.63,P＜0.05).There was not significant difference in heart V40 between two kinds of plans(P＞0.05).In the comparison of each dosimetric parameters of lung cancer,there were not significant differences in D98%and CI at target area between two kinds of plans(P＞0.05),but there were significant differences in D2%,D50%and HI between two kinds of plans(Z=-3.04,-3.38,-3.32,P＜0.05).There were significant differences in the OAR dose,V5,V10,V20,V30 and Dmean between two kinds of plans(Z=-3.27,-2.67,-2.93,-1.79,-3.38,P＜0.05).There were significant differences in Dmax and Dmean of spinal cord between two kinds of plans(Z=-3.21,-3.04,P＜0.05),as well as the V30,V40 and Dmean(Z=-2.53,-2.27,-3.18,P＜0.05).Conclusion:The setup error of using OPS is smaller,which is millimeter level,and can meet clinical requirements for setup error.Setup error has little impact on the dose CI of the target volume,but it has bigger effect on dose HI.The dose error caused by setup errors cannot be ignored.It is necessary to carefully calibrate the setup error,and minimize dose errors as much as possible.关键词
光学定位系统(OPS)/摆位误差/食管癌/肺癌放射治疗/剂量分布Key words
Optical positioning system(OPS)/Set-up error/Esophageal cancer/Lung cancer radiotherapy/Dose distribution分类
医药卫生引用本文复制引用
严维江,杨云云,曹琪,李明..光学定位系统摆位误差对胸部肿瘤患者放射治疗剂量分布的影响[J].中国医学装备,2025,22(12):14-18,5.基金项目
江苏省基础研究计划自然科学基金(BK20241848) （BK20241848）
连云港市科技计划项目(JCYJ2310) （JCYJ2310）
连云港市癌症防治科技发展规划(ZD202307) （ZD202307）
南京医科大学康达学院科研发展基金(KD2023KYJJ056) Natural Science Foundation of Jiangsu Province(BK20241848) （KD2023KYJJ056）
Lianyungang Science and Technology Plan Project(JCYJ2310) （JCYJ2310）
Lianyungang Cancer Prevention and Treatment Science and Technology Development Plan(ZD202307) （ZD202307）
Research and Development Fund of Kangda College,Nanjing Medical University(KD2023KYJJ056) （KD2023KYJJ056）
