A randomized controlled study on improving the repeatability of setup in postoperative radiotherapy for head and neck cancers through neck muscle group exercise
10.3760/cma.j.cn112271-20240918-00357
- VernacularTitle:颈部肌群锻炼提高头颈癌术后放疗摆位可重复性的随机对照研究
- Author:
Jie LI
1
;
Xiaowei YAO
;
Bo LI
;
Linlin XU
;
Zhaodi XU
;
Lihua ZHANG
;
Fei BAI
Author Information
1. 空军军医大学第一附属医院放疗科，西安 710032
- Publication Type:Journal Article
- Keywords:
Neck muscle group exercise;
Head and neck cancer;
Radiotherapy;
Setup error
- From:
Chinese Journal of Radiological Medicine and Protection
2025;45(10):979-985
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of neck muscle group exercise on setup errors in postoperative radiotherapy for head and neck cancers.Methods:A total of 126 head and neck cancer patients scheduled for radiotherapy at the First Affiliated Hospital, Air Force Medical University from February 2021 to October 2022 were prospectively enrolled. Among these patients, four patients discontinued treatment due to personal reasons, and the remaining 126 patients were randomly divided into an experimental group and a control group, with 61 patients in each group. The experimental group received neck muscle group exercise, while the control group received routine treatment without intervention. Cone-beam CT (CBCT) scans were performed weekly to measure setup errors at the levels of the clivus and the 4 th and 7 th cervical vertebrae (C4 and C7, respectively). Three-dimensional displacement, systematic errors, and random errors were calculated for each level. The appropriate margins of planning target volumes (PTVs) were determined using the Van Herk formula. Results:Baseline characteristics were well-balanced between the two groups, with no statistically significant differences ( P > 0.05). Compared to the control group, the experimental group showed significantly smaller setup errors in the left-right ( x) and anterior-posterior ( z) directions at the clivus level, as well as in the z direction at the C4 and C7 vertebral levels ( t = 2.30, 5.29, 4.07, 2.40, P < 0.05). The required PTV margin in the z direction increased to 4.0 mm at C7 from 2.4 mm and 2.8 mm at the clivus in the experimental and control groups, respectively. Correlation analysis revealed a strong negative correlation between the x-direction at the clivus and C4 vertebral levels and the couch angle (RTN) among all patients ( r = -0.548, -0.452, P < 0.001). A moderate negative correlation was observed between the inferior-superior ( y) direction and the z-direction at the C4 and C7 vertebral levels ( r = -0.160, -0.222, P < 0.001). Conclusions:Neck muscle group exercise can reduce setup errors and PTV margins in the anterior-posterior direction in postoperative radiotherapy for head and neck cancer patients.
