CN102058936A - Respiratory control locating device for breast tumor radiotherapy - Google Patents
Respiratory control locating device for breast tumor radiotherapy Download PDFInfo
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- CN102058936A CN102058936A CN 201010548461 CN201010548461A CN102058936A CN 102058936 A CN102058936 A CN 102058936A CN 201010548461 CN201010548461 CN 201010548461 CN 201010548461 A CN201010548461 A CN 201010548461A CN 102058936 A CN102058936 A CN 102058936A
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Abstract
The invention provides a respiratory control locating device for breast tumor radiotherapy. The locating body rack of the device is an approximate case body with a hollowed rear wall, a case inner wall comprising a front wall, a left wall, a right wall, an upper wall and a lower wall of the case body is connected with a latex water bag, the upper wall, the lower wall and the front wall of the case body can be regulated in respective axial directions, a liquid control device is communicated with the water bag through a case body wall, the port of a suction device is positioned on the inner side of the water bag, a sub-controller is arranged on the case body, a main controller is respectively connected with the suction device, the liquid control device and the sub-controller, the case body is a carbon fiber case body, the water bag is internally connected with f the front wall, the left wall, the right wall, the upper wall and the lower wall of the case body through a plurality of connecting points, the suction device comprises a suction pump and a gas delivery pipe connected with a gas valve, and the liquid control device comprises a liquid pump, a liquid delivery pipe connected with the liquid pump and a water container communicated with the liquid delivery pipe.
Description
Technical field:
The present invention relates to medical apparatus and instruments, more particularly relate to a kind of bigger radiocurable respiratory control positioner of breast tumor of moving degree that can be used for breathing.
Background technology:
Precise radiotherapy guarantees that again the absorbed dose of target area normal surrounding tissue reduce as far as possible when requiring target area of irradiation to receive high-dose irradiation, to improve the oncotherapy ratio of gains to greatest extent.But for thorax and abdomen malignant, owing to respiratory movement causes the continuous change of knub position, this has just caused in the tumour radiotherapy process the localized uncertainty of target area of irradiation.At present, if do not consider the respiratory movement of tumor target area is controlled, so when routine is worked out common three-dimensional conformal plan or the strong plan of 3 D stereo accent, just can only be on the basis on CTV (clinical target area) border put the border of certain limit outside again and become PTV (plan target area), its objective is in order to ensure target area of irradiation in respiratory movement or in other uncertain factors, still can not run off inside the plan irradiation high dose zone such as irradiation position scope under the influence of pendulum bit error or tumor tissues distortion, and the size of putting bounds outward depends primarily on the displacement of tumor target area respiratory movement maximum.Ekberg etc. utilize the method for X line perspective to measure the tumor motion scope of patients with lung cancer when the treatment position, under eupneic situation, the largest motion scope of front and back and left and right directions is 5mm, average 2.4mm, the largest motion scope of above-below direction is 12mm, average 3.9mm.According to above data analysis, the outer border of putting of PTV will enlarge much under the restriction of so big tumor target area respiratory movement scope, so just certainly will cause more extra normal structure also can be advanced inside the plan irradiation area by cropping, so can cause the absorbed dose of normal structure to increase greatly, can greatly reduce the radioactive dose upper limit of tumor tissues simultaneously again.
Therefore, the respiratory movement of tumor target area becomes the bottleneck of restriction precise radiotherapy effect.In order to solve the difficult problem on this radiotherapy technology, numerous tumor target area respiratory movement control methods are arisen at the historic moment.At present, the respiratory control technology that applies to radiotherapy mainly contains following several: passive pressurization technology, the dark technology of holding one's breath after air-breathing, initiatively respiratory control technology, respiratory gating technology, real-time tracking radiation technique, CT scan, 4D CT etc. at a slow speed.Studies show that, these methods can both reduce respiratory movement effectively the adverse effect that causes is accurately shone in the tumor target area, compare with the final result of not taking the respiratory control technology to carry out radiotherapy, finally can both improve TCP (local control rate) to a certain extent or reduce NTCP (normal structure complication probability).But this several method all respectively has deficiency, before initiatively the shortcoming of respiratory control technology is each respiratory control, because of patient's functional residual capacity difference, repeat air-breathing control and cause fatigue and lung tumor patient many to cause patient tolerability with the breathing equipment symptom relatively poor; The real-time tracking radiation technique, the patient can freely breathe, by monitoring motion external or that plant the mark in tumor, come into effect irradiation when making patient respiratory or knub position be in a certain particular range, its shortcoming is to need extra equipment, patient's internal anatomy mutually existing report of discordance during with the motion of external mark is implanted mark for the wound operation is arranged, and number that need be suitable and position are discerned the distortion of tumor fully and rotatablely moved; CT scan can better be rebuild the target area than standard scan at a slow speed, and its shortcoming is a phase in the time of can not catching each of breathing, scans length consuming time, and the pseudo-shadow of image motion is heavy, and is relatively poor to the demonstration of mediastinum structure, is only applicable to the peripheral focus.4DCT scanning is meant when certain area-of-interest of the patient body longitudinal axis scans a large amount of CT images, extract patient's breath signal, after image acquisition is finished, with the classification mutually on time of institute's images acquired, phase when the CT image being assigned to different breathings according to corresponding breath signal, the three dimensional CT image set of phase when obtaining not share a common fate, each three dimensional CT image set is gone up the 4DCT image that comprises the whole breathing cycle mutually continuously with regard to the formation time, and delineates patient's the interior target area of individuation on this basis.But the acquisition time much longer (3～5 times) of 4DCT image acquisition time ratio diagnosis CT, this has just increased patient's the X line amount of being subjected to inevitably.In addition, respiratory movement is a kind of half autonomic movement, gathers the CT scan that the 4DCT image need carry out a plurality of breathing cycles, and irregular breathing meeting obviously increases the motion artifacts of 4DCT.Therefore, to carry out suitable respiratory training before gathering, breathe guiding in the gatherer process, to guarantee that patient's breathing patterns has good repeatability when the radiotherapy localization.
Summary of the invention:
Purpose of the present invention is intended to overcome above-mentioned the deficiencies in the prior art, provides a kind of simple in structure, easy to use, can locate accurately, fast and reduce normal structure impaired be used for the radiocurable respiratory control positioner of breast tumor.
Purpose of the present invention can realize by following technical measures:
The positioning rack of this device is the approximate casing that rear wall is left a blank, before the casing, the chamber interior wall that constitutes of left and right, upper and lower wall is connected with water pocket, upper and lower, the antetheca of casing can be in axial adjusted separately, hydraulic control unit is communicated with water pocket by box body wall, the port of air extractor is positioned at the intracavity of water pocket inboard, casing is provided with sub-controller, and master controller connects with air extractor, hydraulic control unit and sub-controller respectively.
Purpose of the present invention also can realize by following technical measures:
Before described water pocket is connected in casing by several junction points, the chamber interior wall that constitutes of left and right, upper and lower wall; Described water pocket is the latex water pocket; Described casing is the carbon fiber casing; Described air extractor is made up of air pump and the air shooter that is connected with gas valve; Described hydraulic control unit by liquor pump, be connected with the liquid delivery tube of liquor pump and the water container that is communicated with liquid delivery tube is formed.
Positioning rack is the approximate casing that rear wall is left a blank, and tank material is a carbon fiber, upper and lower, antetheca can separately axially adjusted to adapt to different body dimension.The latex water pocket by several junction points and casing before, left and right, upper and lower wall links.Be connected on the Liquid valve and continue to be connected to water tank by liquid conduits, this Liquid valve is two-way, automatically controlled, measurable, precision valve, this Liquid valve can openly by main controller controls, closed also can be set a threshold value, and valve is open automatically when pressure surpasses this threshold value; Has liquor pump on the water tank.This liquor pump is by main controller controls, can realize the pouring and sucking-off accurately and fast of liquid.
The positioning rack of this positioner is box, and it adopts carbon fibre material, and all with filling the latex water pocket, emulsion thickness is about 3mm to this body frame except that rear wall.The cavity that forms between latex water pocket outer wall and the body frame inwall can hold human body from shoulder to perineum.This cavity communicates through a tube chamber and the external world and can link to each other with air pump, this cavity can be reduced to negative pressure so that latex water pocket outer wall and human body skin are combined closely and also can be resisted the two that cause owing to air-breathing motion and separate strength when air pump work.The latex water pocket is connected to a liquor pump via two-way, automatically controlled, measurable, an accurate Liquid valve by liquid conduits, and this liquor pump is by master controller (for example, computer) control, can realize the pouring and sucking-off accurately and fast of liquid.Like this, the respiratory movement of human body can be converted into the minimizing and the increase of liquid in the latex water pocket, and the quantity that liquid reduces, increases has reflected the size of amplitude of respiration, phase time when suitable breathing, valve-off will be ended patient's respiratory movement, reach amplitude when amount of liquid is the breathing of record patient this moment in the record this moment latex water pocket mutually, when reaching amplitude mutually in the time need reaching the breathing of patient this moment once more, the effect by valve and liquor pump repeats amount of liquid in latex water pocket this moment.
Carry out CT when location simulation, the patient puts down naturally and crouches on bed, and this positioning rack is buckled on one's body the patient from the top, advises its eupnea, marks respectively in patient's side, front, and patient and this positioning rack spatial relation are fixed.This moment, Liquid valve was in open state,, made to stop to bleed and closing gas valve after forming negative pressure between water pocket outer wall and the patient skin and reaching certain numerical value with the sucking-off of trying one's best of the gas in the air cavity with air pump.This moment, the patient still can freely breathe, and the size of amplitude of respiration, breathing position can also can show on computers through the Liquid valve metering mutually.After preparation was finished before CT scan, after allowing the patient independently select to breathe to hold one's breath mutually when any by talkback unit, initiatively or passive closing liquid valve, record water pocket capacity (being finished automatically by computer) carried out CT scan.Open valve after scanning is finished (first liquid, back gas) is advised patient's autonomous respiration.Every data record is on record.(opening Liquid valve by patient's controller any time of scan period device permission patient) CT data are transmitted through the network to plan making device (TPS) and formulate radiotherapy planning.Radiotherapy planning transfers to accelerator after improving.One same size positioner is arranged in accelerator room in addition, same procedure when adopting the location, when patient respiratory position phase, range parameter are identical during with the location, adopt initiatively or passive mode closing liquid valve, implement irradiation, irradiation time is controlled at when Liquid valve pressure meets or exceeds 3/4 threshold pressure and stops.After (at the open Liquid valve of any time of radiation period device permission patient) patient freely breathes a period of time, under identical respiration parameter, repeat said process until finishing whole radiotherapy planning.
The present invention is simple in structure, and is easy to use, can realize accurately, locate fast, and it is impaired to reduce normal structure.Use by this positioner, patient's respiratory movement when irradiation is in halted state in a period of time, can significantly reduce normal lung tissue's exposure volume, can reach and improve the tumor radioactive dose, improve the purpose that local control rate improves long term survival rate then.
Description of drawings:
Fig. 1 is the front view of the embodiment of the invention;
Fig. 2 is the lateral cutaway view of Fig. 1;
Fig. 3 is the profile of positioning rack.
The specific embodiment;
Embodiment 1:
The approximate casing that the positioning rack 10 of this device is left a blank for rear wall, casing is made by carbon fibre material, before the casing, a left side, right, on, the chamber interior wall that lower wall constitutes is connected with latex water pocket 11 by several junction points, on the casing, down, antetheca can separately axially adjusted to adapt to different body dimension, by liquor pump 6, the hydraulic control unit that the water container 7 that is connected with the liquid delivery tube 8 of Liquid valve 4 and is communicated with liquid delivery tube 8 is formed is communicated with latex water pocket 11 by box body wall, Liquid valve 4 is two-way, automatically controlled, measurable, precision valve, this Liquid valve 4 is open by master controller 5 controls, closure also can be set a threshold value, valve is open automatically when pressure surpasses this threshold value, by air pump 1 and the port that is connected with the air extractor that the air shooter 3 of gas valve 2 forms be positioned at latex water pocket 11 inboards, casing is provided with sub-controller 9, master controller 5 respectively with air pump 1, liquor pump 6 and sub-controller 9 connect, and realize the accurate of liquid, pour fast and sucking-off.
Before the use, latex water pocket 11 is in emptying state, and the patient is flat naturally to crouch on the CT scan bed, adopts laser locating apparatus with the fixed-site of patient on three-dimensional, and makes marks the relative position of patient and CT scan bed on the record head foot direction at patient's body surface.Buckle positioning rack 10, transfer upper and lower, the antetheca position of integrated stand, make it to adapt with patient body, open Liquid valve 4 allows liquid freely enter latex water pocket 11, keep Liquid valve 4 under open state, the gas in the air cavity to be tried one's best sucking-off to necessarily closing gas valve 2 after the negative pressure with air pump 1, so far still keep Liquid valve 4 open, the patient still can freely breathe, under this state, carry out preparation before the CT scan, injection such as contrast agent, the scanning of location phase, preparation or the like before the patient holds one's breath.Link up by talkback unit and patient, and phase during the patient's who shows on the observation computer breathing, determine when closing liquid valve 4 by main control unit 5 closing liquid valves 4 or by the patient by sub-controller 9 at air-breathing end, force the patient to be in the respiratory movement halted state thus, carry out many row's CT scan immediately, the patient can freely be breathed for open immediately Liquid valve 4 behind the end of scan.In scanning process, if when having unexpected situation to take place, go out a uncontrollable cough such as the patient and cause unexpected rising of water pocket pressure or reduction, surpass predefined Liquid valve 4 open threshold values, this valve can be opened automatically, in case unexpected the generation.Open gas valve 2 takes off this positioning rack 10, writes down various parameters, and the patient leaves scanning bed, finishes position fixing process.
The CT image is transmitted through the network to plan making device (TPS) formulates radiotherapy planning, should note making at least the time of finishing an irradiation field to be shorter than breath holding time of patient when making a plan.Plan is confirmed after network transfers to accelerator.The positioner that one cover same size is arranged in the accelerator machine room in addition, with liquid in the Liquid valve 4 open back emptying latex water pockets 11, identical position was flat when the patient adopted with the location crouches on the accelerator therapy bed, eupnea, the parameter that writes down during reference location and with laser locating apparatus with the fixed-site of patient on three-dimensional, buckle positioning rack 10, transfer that integrated stand is upper and lower, the antetheca position to be to adapt to different patient body sizes.Open Liquid valve 4 allows liquid freely enter latex water pocket 11.Keep Liquid valve 4 under open state, the gas in the air cavity to be tried one's best sucking-off to necessarily closing gas valve 2 after the negative pressure with air pump 1, so far still keep Liquid valve 4 open, the patient still can freely breathe, under this state, carry out preparation before the radiotherapy, link up by talkback unit and patient, and phase when observing the patient's who shows on the master controller 5 breathing, when patient respiratory when identical with when location by control device closing liquid valve 4, force the patient to be in identical respiratory movement halted state, implement irradiation immediately.The patient can freely be breathed for open immediately Liquid valve 4 after irradiation finished.In irradiation process, if when having unexpected situation to take place, go out a uncontrollable cough such as the patient and cause unexpected rising of water pocket pressure or reduction, surpass predefined Liquid valve 4 open threshold values, this Liquid valve 4 can be opened automatically, in case unexpected the generation.During multifield radiation, the process of shining second open country is identical with last open country, by that analogy.Open gas valve 2 after finishing radiotherapy, take off this positioning rack 10, the patient leaves therapeutic bed, finishes therapeutic process.
Claims (6)
1. one kind is used for the radiocurable respiratory control positioner of breast tumor, the positioning rack that it is characterized in that this device is the approximate casing that rear wall is left a blank, before the casing, the chamber interior wall that constitutes of left and right, upper and lower wall is connected with water pocket, upper and lower, the antetheca of casing can be in axial adjusted separately, hydraulic control unit is communicated with water pocket by box body wall, the port of air extractor is positioned at the water pocket inboard, and casing is provided with sub-controller, and master controller connects with air extractor, hydraulic control unit and sub-controller respectively.
2. a kind of radiocurable respiratory control positioner of breast tumor that is used for according to claim 1 is characterized in that described water pocket is the latex water pocket.
3. a kind of radiocurable respiratory control positioner of breast tumor that is used for according to claim 1 is characterized in that described casing is the carbon fiber casing.
4. a kind of radiocurable respiratory control positioner of breast tumor that is used for according to claim 1, it is characterized in that described water pocket be connected in casing by several junction points before, the chamber interior wall that constitutes of left and right, upper and lower wall.
5. a kind of radiocurable respiratory control positioner of breast tumor that is used for according to claim 1 is characterized in that described air extractor is made up of air pump and the air shooter that is connected with gas valve.
6. a kind of radiocurable respiratory control positioner of breast tumor that is used for according to claim 1, it is characterized in that described hydraulic control unit by liquor pump, be connected with the liquid delivery tube of liquor pump and the water container that is communicated with liquid delivery tube is formed.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201010548461 CN102058936A (en) | 2010-11-17 | 2010-11-17 | Respiratory control locating device for breast tumor radiotherapy |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201010548461 CN102058936A (en) | 2010-11-17 | 2010-11-17 | Respiratory control locating device for breast tumor radiotherapy |
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| CN102058936A true CN102058936A (en) | 2011-05-18 |
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| CN 201010548461 Pending CN102058936A (en) | 2010-11-17 | 2010-11-17 | Respiratory control locating device for breast tumor radiotherapy |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2015081589A1 (en) * | 2013-12-06 | 2015-06-11 | 刘苗生 | Inflatable vest capable of monitoring and controlling amplitude and phase of respiratory motion |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2794540Y (en) * | 2005-01-28 | 2006-07-12 | 无锡市第四人民医院 | Fixing radiation therapy device for head and hand |
| CN201253214Y (en) * | 2007-12-29 | 2009-06-10 | 上海市第一人民医院 | Device for stereo positioning tumor in radiotherapy |
-
2010
- 2010-11-17 CN CN 201010548461 patent/CN102058936A/en active Pending
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2794540Y (en) * | 2005-01-28 | 2006-07-12 | 无锡市第四人民医院 | Fixing radiation therapy device for head and hand |
| CN201253214Y (en) * | 2007-12-29 | 2009-06-10 | 上海市第一人民医院 | Device for stereo positioning tumor in radiotherapy |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2015081589A1 (en) * | 2013-12-06 | 2015-06-11 | 刘苗生 | Inflatable vest capable of monitoring and controlling amplitude and phase of respiratory motion |
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Application publication date: 20110518 |