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題名:IMPROVEMENT OF SETUP ACCURACY BY NECK-SHOULDER BAG DURING RADIOTHERAPY IN HEAD AND NECK CANCER PATIENTS     (18點)
以肩頸固定墊改善頭頸癌病患於放射治療中擺位之準確性
著者:Pei-Hua Fan(范佩華) ;Chen-Yuan Chen(陳臣苑) ;Yi-Chen Liu(劉義誠) ;Shiue-Shiun Chen(陳學勳) ;Yen-Chao Chen(陳彥超) ;Chieh-Sheng Tsai(蔡介生) ;Jih-Hong Hong(洪志宏) ;Wai-Man Leung(梁為民)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:頭頸癌 ; 擺位正確性 ; 肩頸固定墊 ; 頸椎角度 ; Head and neck cancer ; Setup accuracy ; Neck-shoulder bag ; Cervical spine angle
刊名:Therapeutic Radiology and Oncology
頁碼:143-151
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:藉由分析頸椎夾角於治療過程中之變化,評估肩頸固定墊對治療擺位正確性之改善。 材料與方法:自2008年3月至2009年3月,將66名接受強度調控放射治療之頭頸癌病患,依肩頸和治療床間距離分為兩組:距離小於三公分未使用肩頸固定墊為A組(37名)、距離大於三公分且使用肩頸固定墊為B組(29名);此外,回顧分析2007年3月至9月,31名病患為對照組,距離小於三公分為A'組(15名)、距離大於三公分為B組(16名),皆未使用肩頸固定墊用於評估單獨使用熱塑性面罩其頸椎角度之變異。分析頸椎角度為頸椎第二節投影與頸椎第五節後緣投影之夾角。利用Offline Review軟體,收集97位病患582張影像,量測第一次治療前之千伏影像與每週拍攝之常規照野驗證影像和參考影像間之頸椎角度差異,並記錄病患體重變化、治療前是否手術切除、肩頸和治療床間距離、是否使用肩頸固定墊;資料使用皮爾森相關係數及SPSS17進行單變數獨立樣本T檢定。 結果:本實驗共分析582張影像;其中肩頸和治療床間距離小於3公分之A組頸椎夾角變異為0.67±2.58度和A'組為1.03±3.48度(p=0.4840);而距離大於3公分且使用肩頸部固定墊之B組夾角變異為0.41±0.66度而未使用之B'組為1.52±3.63度(p=0.0462)。統計結果顯示病患放射治療前接受手術會使頸椎夾角變異增加(p=0.0436),而病患體重變化和頸椎夾角變異間不具相關性(r: 0.01 to -0.21)。 結論:本研究結果顯示對於肩頸和治療床間距離大於3公分之病患,使用肩頸固定墊可降低頸椎夾角變異,提升治療擺位正確性。
Purpose: To study how neck-shoulder bag (NSB) improve the setup accuracy among head and neck cancer patients during radiation therapy (RT) by analyzing the cervical spine curvature difference. Materials and Methods: Between March 2008 and March 2009, sixty-six consecutive head and neck cancer patients received RT with immobilization by thermoplastic mask and hollow-pillow. These 66 patients were divided into two groups. Group A (n=37) were those with a neck to couch perpendicular distance (NCD) <3 cm, measuring at the point just caudal to the hollow-pillow, and they did not use the NSB for neck support. Group B (n=29) were those with NCD equal to or larger than 3 cm, and all of them used NSB during RT. Another cohort of 31 cases treated in the year 2007, not using the NSB was used as the retrospective control group. Among these 31 cases, fifteen have NCD <3 cm (Group A') and sixteen cases were ≥3 cm (Group B'). Patient's cervical spine curvature was quantified by his/her second and fifth cervical vertebrae intersecting angle (cervical spine angle, CSA). It was measured weekly from patient's portal images and simulation films. A small difference between the weekly CSA indicated good setup accuracy. Body weight change, surgery prior to RT, NCD, and whether using a NSB or not were investigated correlating to CSA. Analyses were performed using the Pearson correlation coefficient and SPSS17 for independent univariate t test. Results: A total of 582 portal images were obtained. Patients with NCD <3 cm and not using the NSB have a CSA weekly difference of 0.67±2.58° for Group A, and 1.03±3.48° for Group A' (p=0.484). Those with NCD ≥3 cm, CSA weekly variation for Group B was 0.41±0.66°, and was 1.52±3.63° for Group B', (p=0.046). Surgery prior to RT significantly increased the CSA range of difference (p=0.0436). Body weight change had little to no correlation with CSA variation (r range: 0.01 to -0.21). Conclusions: Our results indicated using NSB in patients with NCD ≥3 cm significantly reduced CSA variation among RT fractionations, thus improved setup accuracy. Patients with NCD <3 cm had acceptable setup accuracy in the absence of NSB.


    

本卷期目次
Therapeutic Radiology and Oncology
COMPARING STEREOTACTIC BODY RADIOTHERAPY WITH THREE-DIMENSIONAL CONFORMAL RADIOTHERAPY FOR PATIENTS WITH UNRESECTABLE OR RECURRENT HEPATOCELLULAR CARCINOMA/ Jang-Chun LinYee-Min JenWen-Yen HuangChang-Min ChenHsing-Lung ChaoChun-Shun LinYu-Fu SuKuen-Tze LinWei-Yuan NienMiao-Jung Lin
TREATMENT OUTCOMES FOR SYNCHRONOUS OR METACHRONOUS HYPOPHARYNGEAL/LARYNGEAL/OROPHARYNGEAL CANCER AND ESOPHAGEAL CANCER/ Che-Yu HsuJason Chia-Hsien ChengSung-Hsin KuoYu-Hsuan ChenChiao-Ling TsaiKeng-Hsueh LanWan-Yu ChenChun-Wei Wang
EVALUATE THE ACCURACY OF VMAT FOR CLINICAL USE-THE INITIAL EXPERIENCE OF SMARTARC APPLICATION/ Su-Hua LoYu-Wen WangCyong-Lian GuoChing-Yu ChangSung-Wei Lee
IMPROVEMENT OF SETUP ACCURACY BY NECK-SHOULDER BAG DURING RADIOTHERAPY IN HEAD AND NECK CANCER PATIENTS/ Pei-Hua FanChen-Yuan ChenYi-Chen LiuShiue-Shiun ChenYen-Chao ChenChieh-Sheng TsaiJih-Hong HongWai-Man Leung
SIMULTANEOUS INTEGRATED BOOST INTENSITY-MODULATED RADIOTHERAPY FOR LOCALLY ADVANCED ANAPLASTIC THYROID CANCER/ Yu-Ming WangChun-Chieh HuangHui-Min TingChong-Jong Wang
OSTEOSARCOMA AFTER IRRADIATED NASOPHARYNGEAL CARCINOMA: A CASE REPORT/ I-Chun YehMing-Yang LeeJenn-Ren HsiaoSen-Tien TsaiHelen H. W. ChenJin-Ching Lin
EVALUATION OF LUNG VOLUME/DOSE IN BREAST CANCER IRRADIATION AFTER MODIFIED RADICAL MASTECTOMY VERSUS BREAST CONSERVATIVE SURGERY/ Li-Min SunJi-An LiangFan-Yun MengTsung-Han YangMin-Jen Tsao
CLINICAL CHARACTERISTICS, IMAGE FINDINGS, AND TREATMENT MODALITIES ASSOCIATE WITH OUTCOMES OF PATIENTS WITH GLIOBLASTOMA MULTIFORME/ Hsiang-Kuang LiangChao-Yuan HuangChun-Wei WangYu-Hsuan ChenSung-Hsin KuoJason Chia-Hsien Cheng
 
   
 
   

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