摘要
目的:通过对比采用或不采用定位孔安装3D打印补偿物对其贴合性、患者剂量分布的影响,来评估2种安装方式在乳腺癌根治术后放疗应用中的优劣势,为临床应用提供参考。方法:回顾性选取2022年12月至2024年8月于遂宁市中心医院接受乳腺癌放疗的48例女性患者,分为有定位孔组34例,无定位孔组14例。对患者体表与3D打印补偿物的空气间隙进行三维重建,并统计各组患者的组织剂量分布。采用t检验对两种安装方式补偿物的贴合性、靶区与危及器官关键剂量学指标的差异性进行对比分析。结果:有定位孔组补偿物与患者体表的最大空气间隙高度、空气间隙区面积、空气间隙体积的均值均小于无定位孔组(P<0.05),且贴合性表现出更好的一致性;有定位孔组患者的靶区适形度指数(conformity index,CI)、均匀性指数(heterogeneity index,HI)、患侧肺受量(V_(20)、V_(5))均优于无定位孔组患者(P<0.05);两组患者处方剂量靶区覆盖率、心脏受量D_(mean)、脊髓受量D_(max)无显著性差异(P>0.05)。结论:有定位孔组3D打印补偿物的贴合性、患者靶区与危及器官剂量学指标方面均优于无定位孔组,在临床应用上表现出明显优势。
Objective:By comparing the effects of installing 3d-printed bolus with or without positioning holes on the skin fit and patient dose distribution,the advantages and disadvantages of the two installation methods in the application of radiotherapy after radical breast cancer surgery were evaluated,and the reference was provided for clinical application.Methods:A total of 48 patients(34 patients with and 14 patients without positioning holes)who received radiotherapy for breast cancer in Suining Central Hospital from December 2022 to August 2024 were randomly selected.Three dimensional reconstruction of the air gap between the patient body surface and the 3d-printed bolus was conducted,and the tissue dose distribution of each case was analyzed.Comparative analysis was conducted using t-test to analyze the differences of the skin fit and the key dosimetric indexes of target areas and organs at risk between the two bolus installation methods.Results:The mean values of the maximum air gap height,air gap area and air gap volume of the group with positioning holes were lower than those of the group without positioning holes(P<0.05),and the skin fit showed better consistency.The target area conformity index(CI),homogeneity index(HI),and affected lung radiation acceptance(V_(20),V_(5))of patients with positioning holes were better than those of patients without positioning holes(P<0.05).There was no significant difference in target area coverage of prescription dose,cardiac dose D_(mean)and spinal cord dose D_(max)between two groups(P>0.05).Conclusions:The skin fit,dosimetric indexes of patient target area and organs at risk of 3d-printed bolus with positioning holes were superior to those without positioning holes,showing significant advantages in clinical applications.
作者
刘睿
罗桃红
曹宗宝
柯小林
凌瑞
李雪文
Rui Liu;Taohong Luo;Zongbao Cao;Xiaolin Ke;Rui Ling;Xuewen Li(Department of Radiation Oncology,Cancer Center,Suining Central Hospital,Suining 629018,China;Sichuan Farsoon Turing Additive Manufacturing Technology Co.,Ltd.,Chengdu 610096,China)
出处
《中国肿瘤临床》
北大核心
2025年第3期140-143,共4页
Chinese Journal of Clinical Oncology
