A method and auxiliary device for improving the radiation dose distribution after surgery for maxillary sinus cancer

Abstract

The present invention relates to a method and an auxiliary device for improving the radiotherapy dose distribution after surgery for maxillary sinus cancer, comprising: step 1, setting a filling bag for storing equivalent fillers in the residual cavity of the patient's maxillary sinus, the filling bag being constructed with an opening for injecting and discharging the equivalent fillers, and the filling bag being able to expand under the action of internal pressure; step 2, injecting a set volume of equivalent fillers into the filling bag through the opening according to the volume of the residual cavity, so that the equivalent fillers fill the residual cavity under the wrapping of the filling bag, and the opening is closed; the equivalent fillers are water or a mixed liquid with the same density as water; the method is suitable for radiotherapy of patients after surgery for maxillary sinus cancer, so that during the radiotherapy process, the radiotherapy dose can be evenly distributed, especially the influence of the air in the residual cavity on the mucosal area close to the residual cavity can be eliminated, and hot spots and cold spots can be prevented from appearing in the mucosal area close to the residual cavity, so that the radiotherapy dose is accurate and controllable, which is conducive to obtaining better treatment effects.

Description

Technical Field

[0001] The invention relates to the field of medical technology, and in particular to a method and an auxiliary device for improving the postoperative radiotherapy dose distribution of maxillary sinus cancer. Background Art

[0002] Maxillary sinus cancer is one of the common malignant tumors of the head and neck. It is usually treated by maxillary sinus tumor resection combined with postoperative radiotherapy (abbreviated as radiotherapy). Because simple surgery is prone to recurrence, radiotherapy is often required before and after surgery. In the process of maxillary sinus resection, it is usually necessary to completely remove the inner wall and bottom wall of the entire maxillary sinus (including tumor tissue) to completely remove the primary tumor, thereby forming a residual cavity (or cavity, usually the maxillary sinus cavity) in the patient's maxillary sinus. Figure 1 As shown, the residual cavity is often connected to the patient's oral cavity.

[0003] In the prior art, during the subsequent adjuvant radiotherapy for patients after surgery for maxillary sinus cancer, due to the existence of the residual cavity, the residual cavity is filled with air, resulting in a very uneven distribution of radiotherapy dose, thereby affecting the effect of radiotherapy; in particular, the mucosal area close to the residual cavity is affected by the gas in the residual cavity, and the dose distribution is very uneven, and usually uneven hot spots (radiotherapy doses greater than the set dose are called hot spots) and cold spots (radiotherapy doses lower than the set dose are called cold spots) will appear during the radiotherapy process. However, no effective solution to this problem has been disclosed in the prior art, resulting in that the dose distribution of patients after surgery for maxillary sinus cancer in the subsequent radiotherapy process often fails to achieve the expected effect. This technical problem needs to be urgently solved in clinical work. Summary of the invention

[0004] The purpose of the present invention is to improve the deficiencies in the prior art and to provide a method for improving the distribution of radiotherapy dose after surgery for maxillary sinus cancer, so that during the radiotherapy process, the radiotherapy dose can be evenly distributed, especially the influence of the air in the residual cavity on the mucosal area close to the residual cavity can be eliminated, and the appearance of hot spots and cold spots in the mucosal area close to the residual cavity can be prevented, so that the radiotherapy dose is accurate and controllable, which is conducive to obtaining better treatment effects.

[0005] The technical solution adopted by the present invention is:

[0006] The first aspect of the present invention aims to solve the problem of uneven radiotherapy dose distribution in patients after maxillary sinus cancer surgery due to the presence of residual cavity during radiotherapy, and provides a method for improving radiotherapy dose distribution after maxillary sinus cancer surgery, comprising the following steps:

[0007] Step 1, a filling bag for storing an equivalent filler is arranged in the residual cavity of the patient's maxillary sinus, wherein the filling bag is configured with an opening for injecting and discharging the equivalent filler, and the filling bag can expand under the action of internal pressure;

[0008] Step 2, according to the volume of the residual cavity, injecting a set volume of equivalent filler into the filling capsule through the opening, so that the equivalent filler fills the residual cavity under the wrapping of the filling capsule, and closes the opening;

[0009] The equivalent filler is water or a mixed liquid with the same density as water. In this solution, for patients after maxillary sinus cancer surgery, before radiotherapy is implemented, a filling bag with elasticity that can expand under the action of internal pressure is set in the residual cavity of the maxillary sinus, and a set volume of equivalent filler is injected into the filling bag. The filling bag serves the purpose of restraining and storing the equivalent filler, and due to the injection of the equivalent filler, the filling bag can gradually expand until the entire residual cavity is filled, so as to effectively discharge the air in the residual cavity and prevent the difference between the air density and the human tissue density from seriously affecting the uniform distribution of the radiotherapy dose; and further, since the density of water is very close to the density of human tissue, In this scheme, water or a mixed liquid with the same density as water is used as an equivalent filler, so that the filling bag can fill the entire residual cavity, that is, the equivalent filler is used to replace the residual cavity air to fill the entire residual cavity, thereby effectively reducing or eliminating the density difference between the residual cavity and the surrounding tissue, so as to effectively eliminate the influence of the air in the residual cavity on the mucosal area close to the residual cavity (that is, the tissue around the residual cavity), and effectively avoid the occurrence of hot spots and cold spots in the mucosal area close to the residual cavity, so that the radiotherapy dose can be evenly distributed, which not only makes the radiotherapy dose accurate and controllable, but also is conducive to obtaining better treatment effects.

[0010] The second aspect of the present invention is to solve the problem of sealing the residual cavity so that the filling capsule will not automatically fall off from the residual cavity during radiotherapy. Furthermore, it also includes step 3, setting a support body for sealing the residual cavity and supporting the filling capsule below the residual cavity. In this scheme, after the filling capsule is set, a support body can be set below the filling capsule. The support body can not only play a role in constraining the lower edge of the filling capsule so that the filling capsule can better fill the entire residual cavity, but also can use the patient's upper and lower teeth to bite to achieve the purpose of constraining the support body. With such a design, not only does it not need to consider the fixation and constraint of the support body, it is conducive to simplifying the structure and reducing costs, but also during radiotherapy, it can keep the filling capsule and the support body stable, which is conducive to obtaining better radiotherapy effects. In addition, it is also easy to reuse.

[0011] The third aspect of the present invention is to solve the problem that the patient can conveniently bite the support body. Furthermore, the upper surface and / or lower surface of the support body is constructed with a bite portion, and the bite portion is used to match the patient's teeth. When the patient's teeth are bitten together, the bite portion can just bite with the teeth corresponding to the residual cavity, and the bite of the teeth can just support the support body, so that the support body and the filling capsule above the support body can be stably set in the residual cavity, which is more conducive to radiotherapy; and when the radiotherapy is over, the patient only needs to open his mouth to conveniently remove the support body, and can conveniently discharge the equivalent filler and take out the filling capsule for use in the next radiotherapy, which is very simple and convenient.

[0012] The fourth aspect of the present invention aims to solve the problem of uneven radiotherapy dose distribution caused by residual cavity in the prior art by implementing the above method conveniently and efficiently, and provides an auxiliary device, including a support body and a filling capsule, wherein the filling capsule is configured with an internal space for storing an equivalent filling material, and an opening for injecting and discharging the equivalent filling material, wherein the opening is connected to the internal space;

[0013] The support body is configured with a through hole, the filling bag is connected to one side of the support body, and the opening extends through the through hole to the other side of the support body or communicates with the through hole;

[0014] The filling capsule is made of elastic material, and the support body is made of hard material. In this solution, the support body made of hard material has plasticity and certain rigidity, and can close the lower end of the residual cavity, so that the residual cavity is relatively closed, and the filling capsule can be just located in the residual cavity, and the opening of the filling capsule can be left outside the residual cavity. Before radiotherapy, an equivalent filler of a set volume can be injected into the internal space of the filling capsule through the opening, so that the filling capsule expands and fills the entire residual cavity; thereby, the air in the residual cavity can be effectively discharged, and the equivalent filler can be water with a density close to that of human tissue or a mixed liquid with the same density as water, thereby effectively eliminating the influence of the air in the residual cavity on the mucosal area close to the residual cavity, effectively avoiding the occurrence of hot spots and cold spots in the mucosal area close to the residual cavity, so that the radiotherapy dose can be evenly distributed, not only making the radiotherapy dose accurate and controllable, but also conducive to obtaining better treatment effects; in addition, the device also has the characteristics of simple structure, easy use, and reusability, and is particularly suitable for use by patients undergoing radiotherapy after maxillary sinus cancer surgery, and can effectively improve the radiotherapy effect.

[0015] Preferably, the filling capsule is made of silica gel, latex or rubber, so that the filling capsule has the required elasticity, so that it can expand freely under the action of the equivalent filler, and can be deformed under the constraints of the residual cavity and the support body, so as to be suitable for residual cavities of different shapes.

[0016] Preferably, the support body is made of plastic, resin or polymer material. The support body can also play a role in filling the gingival gap.

[0017] The fifth aspect of the present invention is to solve the problem of matching the support body with the residual cavity and the oral cavity of the patient so that the patient can bite. Further, the support body includes a bottom support part for closing the residual cavity, and a bite part is configured on one or both sides of the bottom support part, and the bite part is used to match the patient's teeth. During installation, the bottom support part can just close the residual cavity, and the bite part can just match the corresponding teeth, so that when the patient's teeth bite together, they can just bite the bite part, thereby achieving the purpose of restraining and maintaining the position of the support body unchanged.

[0018] In order to better match the teeth in the residual cavity, the bite portion is further configured with a plurality of grooves matching the teeth, so that when the patient bites, the lower teeth can just match the corresponding grooves, achieving better bite and more convenient use.

[0019] In order to better fit the patient's oral cavity, preferably, the bottom support portion is a plate-shaped structure, and / or the occlusal portion is an arc-shaped structure.

[0020] To be suitable for different patients, preferably, the support body is formed by 3D printing, so that the support body can be customized according to different patients.

[0021] The sixth aspect of the present invention is to solve the problem of closing and opening the opening, and further comprises a control component, which is connected to the through hole or the opening and is used to control the opening / closing of the through hole or the opening, and the control component is a valve. In actual use, the user can adjust the control component to open or close the opening.

[0022] The seventh aspect of the present invention is to solve the problem of reflux when injecting equivalent fillers into the filling capsule. In a preferred solution, the control component adopts a water injection soft valve. By setting the water injection soft valve, the user can conveniently use a syringe to inject equivalent fillers into the filling capsule, which can prevent the problem of reflux during the injection of equivalent fillers, which is conducive to simplifying the operation, and can use the syringe to suck out the equivalent fillers in the filling capsule, so as to facilitate the removal of the device from the patient's mouth.

[0023] In another preferred solution, the control component is a one-way valve, which can also achieve one-way injection of equivalent filling material, thereby preventing the problem of backflow of equivalent filling material during injection.

[0024] The eighth aspect of the present invention is to solve the problem of discharging the equivalent filler in the filling capsule. In the first solution, it also includes a connecting tube, one end of which is connected to the opening or through hole, and the other end is matched with the nipple of the syringe. The control component is arranged on the connecting tube, and the side wall of the connecting tube is configured with a discharge port, and the discharge port is located between the control component and the through hole. The discharge port is provided with an adjustment component for controlling on / off, and the adjustment component is a valve, a cover or a plug. In this solution, by constructing the connecting tube, the nipple of the syringe can be conveniently matched so that the equivalent filler can be injected into the filling capsule by the syringe, and by constructing the discharge port, the discharge port can be controlled on / off by the adjustment component according to actual needs so as to discharge the equivalent filler in the filling capsule.

[0025] In the second solution, a connecting tube is also included, and the connecting tube includes an upper section and a lower section, wherein the upper end of the upper section is connected to the opening or the through hole, the control component is arranged on the lower section, and the lower section is connected to the upper section by a thread. That is, the lower section and the upper section are respectively configured with mutually matching threads, and in actual use, the user can inject equivalent fillers into the filling capsule through the control component, and after the radiotherapy is finished, the user can remove the lower section through the threaded connection, so that the equivalent fillers in the filling capsule can be discharged smoothly through the upper section, which is very convenient and can be reused.

[0026] Compared with the prior art, the method and auxiliary device for improving the radiotherapy dose distribution after maxillary sinus cancer surgery provided by the present invention are suitable for radiotherapy of patients after maxillary sinus cancer surgery, so that during the radiotherapy process, the radiotherapy dose can be evenly distributed, especially the influence of the air in the residual cavity on the mucosal area close to the residual cavity can be eliminated, and the appearance of hot spots and cold spots in the mucosal area close to the residual cavity can be prevented, so that the radiotherapy dose is accurate and controllable, which is conducive to obtaining better treatment effects. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings required for use in the embodiments are briefly introduced below. It should be understood that the following drawings only show certain embodiments of the present invention and therefore should not be regarded as limiting the scope. For ordinary technicians in this field, other related drawings can be obtained based on these drawings without creative work.

[0028] Figure 1 This is a schematic structural diagram of a filling capsule in an auxiliary device provided in Example 2 of the present invention.

[0029] Figure 2 This is a schematic structural diagram of a support body in an auxiliary device provided in Example 2 of the present invention.

[0030] Figure 3This is one of the structural schematic diagrams of an auxiliary device provided in Example 2 of the present invention.

[0031] Figure 4 This is a second structural schematic diagram of an auxiliary device provided in Example 2 of the present invention.

[0032] Figure 5 This is a front view of another auxiliary device provided in Example 2 of the present invention.

[0033] Figure 6 This is a partial schematic diagram of another auxiliary device provided in Example 2 of the present invention.

[0034] Figure 7 This is a schematic diagram of the structure of an auxiliary device provided in Example 3 of the present invention.

[0035] Figure 8 This is a CT image of the maxillary sinus of a healthy person.

[0036] Fig. 9 CT image of the residual cavity of the maxillary sinus after maxillary sinus cancer surgery after the filling capsule was filled. At this time, the filling capsule has not completely filled the entire residual cavity.

[0037] Fig.10 Comparison of isodose curves of the two plans, where (A) and (B) are for the P2 plan, and (C) and (D) are for the P1 plan.

[0038] Fig.11 Comparison of the DVHs curves of the two plans.

[0039] Description of symbols in the figure

[0040] Support body 100, bottom support portion 101, through hole 102, bite portion 103, groove 104,

[0041] Filling bag 200, opening 201, connecting pipe 203, upper section 204, lower section 205, flow channel 206, control component 207, discharge port 208, regulating component 209, water injection soft valve 210

[0042] Maxillary sinus 301 and residual cavity 302 . DETAILED DESCRIPTION

[0043] The technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are only a part of the embodiments of the present invention, rather than all the embodiments. The components of the embodiments of the present invention generally described and shown in the drawings here can be arranged and designed in various different configurations. Therefore, the following detailed description of the embodiments of the present invention provided in the drawings is not intended to limit the scope of the claimed invention, but merely represents the selected embodiments of the present invention. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without making creative work belong to the scope of protection of the present invention.

[0044] Example 1

[0045] See also Figure 8 and Fig. 9 In this embodiment, a method for improving the radiation dose distribution after surgery for maxillary sinus cancer is provided, comprising the following steps:

[0046] Step (1), in the residual cavity 302 of the patient's maxillary sinus (such as Fig. 9 A filling bag 200 for storing equivalent filling material is provided in the inner portion of the residual cavity 302, wherein the filling bag 200 is provided with an opening 201 for injecting and discharging the equivalent filling material, and the filling bag 200 can expand under the action of the internal pressure so as to fill the entire residual cavity 302;

[0047] Step (2), according to the volume of the residual cavity 302, injecting a set volume of equivalent filler into the filling capsule 200 through the opening 201, so that the equivalent filler fills the residual cavity 302 under the wrapping of the filling capsule 200, such as Fig. 9 As shown, the opening 201 is closed; wherein the equivalent filler can preferably be water or a mixed liquid with the same density as water;

[0048] In a more complete solution, step (3) is further included, wherein a support body 100 is provided below the residual cavity 302 for sealing the residual cavity and for supporting the filling capsule 200; the support body 100 can be used to constrain the lower edge of the filling capsule 200 so that the filling capsule 200 can better fill the entire residual cavity, and the purpose of constraining the support body 100 can be achieved by utilizing the occlusion of the patient's upper and lower teeth.

[0049] According to the concept of this embodiment, for patients who have undergone maxillary sinus 301 resection, before radiotherapy is performed, a filling capsule 200 with elasticity and capable of expanding under the action of internal pressure can be set in advance in the residual cavity 302 of the patient's maxillary sinus, and a set volume of equivalent filler can be injected into the filling capsule 200. The filling capsule 200 serves the purpose of restraining and storing the equivalent filler, and due to the injection of the equivalent filler, the filling capsule 200 can gradually expand until the entire residual cavity 302 is filled. Fig. 9 As shown, in order to effectively discharge the air in the residual cavity and prevent the difference between the air density and the human tissue density from seriously affecting the uniform distribution of the radiotherapy dose; and further, since the density of water is very close to the density of human tissue, in this scheme, water or a mixed liquid with the same density as water is used as an equivalent filler, so that the filling capsule 200 can fill the entire residual cavity, that is, the equivalent filler is used to replace the residual cavity air to fill the entire residual cavity, thereby effectively reducing or eliminating the density difference between the residual cavity and the surrounding tissues, so as to effectively eliminate the influence of the air in the residual cavity on the mucosal area close to the residual cavity (that is, the tissue around the residual cavity), and effectively avoid the occurrence of hot spots and cold spots in the mucosal area close to the residual cavity, so that the radiotherapy dose can be evenly distributed, which not only makes the radiotherapy dose accurate and controllable, but also is conducive to obtaining better treatment effects.

[0050] In order to allow the filling capsule 200 to be fully deformed under the action of internal pressure and fill the entire residual cavity, the filling capsule 200 can preferably be made of silicone, latex or rubber, and the wall thickness of the filling capsule 200 should be as thin as possible, so that the filling capsule 200 can be deformed under the action of internal pressure and match residual cavities of different shapes; in an embodiment, when the filling capsule 200 is made of silicone, latex or rubber, the filling capsule 200 has the required elasticity so that it can expand freely under the action of an equivalent filler, and can be deformed under the constraints of the residual cavity and the support body 100, so as to be suitable for residual cavities of different shapes.

[0051] In this embodiment, the support body 100 can be preferably made of plastic, resin or polymer material, so as to support and restrain the filling capsule 200; preferably, the support body 100 can be formed by 3D printing, so that the support body 100 can be customized according to different patients, which can be quickly formed and meet the needs of different patients.

[0052] In a more complete solution, in order to facilitate the occlusion of the support body 100, the upper surface and / or lower surface of the support body 100 can also be respectively constructed with an occlusal portion 103, so that the occlusal portion 103 can be adapted to the patient's teeth, so that in actual use, after the patient's teeth are occluded together, the occlusal portion 103 can just occlude with the teeth corresponding to the residual cavity, and the occlusion of the teeth can just support the support body 100, so that the support body 100 and the filling capsule 200 above the support body 100 can be stably arranged in the residual cavity, which is more conducive to radiotherapy; and when the radiotherapy is over, the patient only needs to open his mouth to conveniently remove the support body 100, and can conveniently discharge the equivalent filler and remove the filling capsule 200 for use during the next radiotherapy, which is very simple and convenient.

[0053] Example 2

[0054] According to the method provided in Example 1, an auxiliary device is provided in Example 2, including a support body 100 and a filling capsule 200, wherein the filling capsule 200 is configured with an internal space for storing an equivalent filling material and an opening 201 for injecting the equivalent filling material. Figure 1 As shown, the opening 201 is connected to the internal space;

[0055] like Figure 2 As shown, the support body 100 is configured with a through hole 102, the filling capsule 200 is connected to one side of the support body 100, and the opening 201 extends through the through hole 102 to the other side of the support body 100 or communicates with the through hole 102, as shown in FIG. Figure 3 and Figure 4 As shown;

[0056] In this embodiment, the filling capsule 200 can be made of an elastic material, for example, it can be preferably made of silicone, latex or rubber; the support body 100 can be preferably made of a hard material, for example, it can be preferably made of plastic, resin or polymer material, so as to have a certain rigidity and can seal the lower end of the residual cavity, so that the residual cavity is relatively closed, and the filling capsule 200 can be located exactly in the residual cavity 302, and the opening 201 of the filling capsule 200 can be left outside the residual cavity. Before radiotherapy, a set volume of equivalent filler can be injected into the internal space of the filling capsule 200 through the opening 201, so that the filling capsule 200 expands and fills the entire residual cavity, such as Figure 8 and Fig. 9As shown; the air in the residual cavity can be effectively discharged, and the equivalent filler can be water with a density close to that of human tissue or a mixed liquid with the same density as water, so as to effectively eliminate the influence of the air in the residual cavity on the mucosal area close to the residual cavity, and effectively avoid the appearance of hot spots and cold spots in the mucosal area close to the residual cavity, so that the radiotherapy dose can be evenly distributed, which not only makes the radiotherapy dose accurate and controllable, but also is conducive to obtaining better treatment effects.

[0057] The support body 100 has multiple implementations. Preferably, in the present embodiment, the support body 100 may include a bottom support portion 101 for closing the residual cavity, and a bite portion 103 is constructed on one side or both sides of the bottom support portion 101, and the bite portion 103 is used to match the patient's teeth; that is, when the teeth at the patient's maxillary sinus have not been extracted, the upper and lower sides of the bottom support portion 101 may respectively construct the bite portion 103, so as to respectively match the teeth at the maxillary sinus and the teeth below, and when the teeth at the patient's maxillary sinus have been extracted, the lower side of the bottom support portion 101 may construct the bite portion 103, such as Figure 2 and Figure 3 As shown, so as to cooperate with the teeth below the maxillary sinus; when installed, the bottom support portion 101 can just close the residual cavity, and the bite portion 103 can just cooperate with the corresponding teeth, so that when the patient's teeth are bitten together, they can just bite the bite portion 103, thereby achieving the purpose of restraining and maintaining the position of the support body 100 unchanged.

[0058] In order to better match with the teeth, in a further solution, the occlusal portion 103 is constructed with a plurality of grooves 104 that match with the teeth, such as Figure 2 As shown, when the patient bites, the lower teeth can fit exactly into the corresponding grooves 104, achieving better bite and more convenient use.

[0059] Preferably, the bottom support portion 101 may be a plate-shaped structure or a plate-like structure, and the engaging portion 103 may preferably be an arc-shaped structure or an arc-like structure, such as Figure 2 and Figure 3 As shown, in order to adapt to the curved structure of the gums.

[0060] In order to facilitate closing the opening 201 after the injection is completed, in a preferred embodiment, the opening 201 can extend to the other side of the support body 100 through the through hole 102 and have a set extension distance, such as Figure 4 As shown, since the filling capsule 200 is elastic, after completing the injection, the user can tighten the opening 201 by tying a knot or a rope, thereby achieving the purpose of closing the opening 201 .

[0061] In another preferred embodiment, it also includes a control component 207, which is connected to the through hole 102 or the opening 201 and is used to control the opening / closing of the through hole 102 or the opening 201. Preferably, the control component 207 can preferably adopt a valve, so that in actual use, the user can adjust the control component 207 to achieve the purpose of opening or closing the opening 201; because the more equivalent filler is injected into the filling capsule 200, the greater the pressure in the filling capsule 200, which is easy to cause the backflow of the equivalent filler. In order to overcome this problem, preferably, the control component 207 can preferably adopt a one-way valve. The use of a one-way valve can achieve one-way injection of the equivalent filler, thereby preventing the equivalent filler from flowing back during the injection process; as an example, Figure 5 As shown, it also includes a connecting tube 203, one end of which is connected to the opening 201 or the through hole 102, and the other end is adapted to the nipple of a syringe (usually, an equivalent filler can be injected into the filling capsule 200 using a syringe, and the syringe has a scale for easy measurement). For example, the connecting tube 203 can be configured with a conical flow channel 206 at this end to facilitate insertion of the nipple of the syringe; Figure 5 As shown, at this time, the control component 207 can be set on the connecting pipe 203.

[0062] When radiotherapy is finished, the device can be taken out without discharging the equivalent filler in the filling capsule 200. In order to make it more convenient to use, in a more complete solution, further details can be given on how to discharge the equivalent filler in the filling capsule 200. As a preferred embodiment, Figure 5 As shown, the side wall of the connecting tube 203 is constructed with a discharge port 208, and the discharge port 208 is located between the control component 207 and the through hole 102. An adjusting component 209 for controlling on / off is provided at the discharge port 208. The adjusting component 209 is a valve, a cover or a plug, so that in actual use, the user can use the adjusting component 209 to control the on / off of the discharge port 208 according to actual needs, so as to discharge the equivalent filling in the filling bag 200.

[0063] As another implementation method, Figure 6 As shown, the connecting pipe 203 includes an upper section 204 and a lower section 205, wherein the upper end of the upper section 204 is connected to the opening 201 or the through hole 102, and the control component 207 is disposed in the lower section 205. Figure 6As shown, the lower section 205 can be connected to the upper section 204 by a thread, that is, the upper end of the lower section 205 and the lower end of the upper section 204 are respectively constructed with mutually matching threads. In actual use, the user can inject equivalent fillers into the filling capsule 200 through the control component 207. After the radiotherapy is over, the user can remove the lower section 205 through the threaded connection, so that the equivalent fillers in the filling capsule 200 can be smoothly discharged through the upper section 204. It is very convenient and can be reused.

[0064] It can be understood that in this embodiment, the connecting pipe 203 can preferably be a hose.

[0065] Example 3

[0066] The main difference between this embodiment and the above-mentioned embodiment 2 is that, in order to solve the problem of easy backflow when injecting equivalent filling material into the filling bag 200, the auxiliary device provided in this embodiment has a different structure of the control component 207. In this embodiment, the control component 207 adopts a water injection soft valve 210, which is a commonly used valve, such as Figure 7 As shown, in actual use, the nipple of the syringe can be inserted into the water injection soft valve 210, and then the syringe is pushed. Due to the effect of pressure, the water injection soft valve 210 opens, so that the equivalent filler in the syringe can be smoothly injected into the filling bag 200. After the radiotherapy is over, the user can insert the nipple of the empty syringe into the water injection soft valve 210, and then draw the syringe to generate negative pressure. Due to the effect of negative pressure, the water injection soft valve 210 opens, so that the equivalent filler in the filling bag 200 can be smoothly injected into the syringe, and when the syringe is separated from the water injection soft valve 210, the water injection soft valve 210 will not leak, thereby achieving the purpose of smoothly discharging the equivalent filler in the filling bag 200. Compared with Example 2, the structure of this embodiment is simpler, more practical and more convenient.

[0067] Example 4

[0068] Using the method for improving the radiation dose distribution after surgery for maxillary sinus cancer provided in Example 1, and in combination with the auxiliary device described in any one of Examples 2-3, a comparison of the advantages and disadvantages of the plans for a patient undergoing radiation therapy after surgery for maxillary sinus cancer was performed. Specifically, the filling capsule 200 was set in the right maxillary sinus of the patient. Fig.10As shown (the right side is the left side shown in the figure), an equivalent filler (water is used in this embodiment) is injected into the filling capsule 200, so that the equivalent filler fills the residual cavity under the wrapping of the filling capsule 200. The filling capsule 200 is set in the left maxillary sinus of the patient (the left side is the right side shown in the figure). For the convenience of distinction, the 5mm submucosal area of ​​the right maxillary sinus and the water capsule with technical improvement are set as CTV1, and the left maxillary sinus and the 5mm submucosal area without the water capsule are set as CTV2. The same prescription dose of 6000cGy / 30F is given to both. Under the same physical planning parameters and radiotherapy field setting, multi-leaf grating and intensity modulated radiotherapy planning system, the target area uniformity, feasibility, hot spots, cold spots and related parameters of plan P1 with equivalent filler added and plan P2 without equivalent filler added are compared, as shown in FIG. Fig.10 and Fig.11 As shown in Figure 2, it was found that the target dose of the radiotherapy plan with equivalent fillers was more uniform, and the dose values ​​and corresponding volumes of hot spots and cold spots were better than those of the radiotherapy plan without equivalent fillers. The comparison of the isodose curves of the two plans is shown in Figure 2. Fig.10 As shown, it can be clearly seen that the hot spot dose (yellow and red areas) and cold zone dose (blank area below 6000 cGy in the target area) of the P2 plan (without adding equivalent fillers) are significantly greater than those of the P1 plan (adding equivalent fillers). It can be seen that the method provided in Example 1 and the auxiliary device provided in Example 2 or 3 are conducive to uniform distribution of radiotherapy dose, especially can eliminate the influence of air in the residual cavity on the mucosal area close to the residual cavity, prevent the occurrence of hot spots and cold spots in the mucosal area close to the residual cavity, make the radiotherapy dose accurate and controllable, and help to obtain better treatment effects.

[0069] The comparison of the DVHs of the two plans is as follows Fig.11 As shown, the target dose of the P1 plan (purple dotted line, i.e., curve A) drops faster and can meet the prescription dose requirements of the radiotherapy plan, while in the P2 plan (blue solid line, i.e., curve B), only 88% of the volume meets the prescription dose requirements, and the hot spot dose is higher, and the uneven distribution of radiotherapy dose is more obvious.

[0070] The comparison of relevant plan parameters is shown in Table 1, where HI is an indicator of the uniformity of the radiotherapy plan. The lower the value, the more uniform the plan. It can be seen from the data that by adopting the method provided in Example 1, HI can be reduced by an order of magnitude, which is more conducive to uniform distribution of radiotherapy dose.

[0071] Table 1 Comparison of physical parameters of the two plans

[0072] Comparative Data P1 (Plan to add equivalent filler) P2 (Plan without equivalent filling) Prescription dose 6000cGy / 30F 6000cGy / 30F Maximum target dose Dmax (cGy) 6451 6731 Minimum target dose Dmin (cGy) 5604 5209 95% volume dose of target area (cGy) 6040 5793 Target volume 98% dose (cGy) 5983 5664 2% volume dose of target area (cGy) 6285 6520 50% volume dose of target area (cGy) 6154 6275 1% volume dose of target area (cGy) 6310 6547 Dose per cubic centimeter target area (cGy) 6306 6462 Target volume 99% dose (cGy) 5934 5576 60Gy target volume as a percentage of the total volume V60 (%) 97.48 88.85 57Gy target volume as a percentage of the total volume V57 (%) 99.97 97.24 64.2Gy target volume as a percentage of the total volume V64.2 (%) 0.02 12.53 Plan homogeneity index HI (ICRU83) 0.0491 0.1364

[0073] The above description is only a specific implementation mode of the present invention, but the protection scope of the present invention is not limited thereto. Any technician familiar with the technical field can easily think of changes or substitutions within the technical scope disclosed by the present invention, which should be covered by the protection scope of the present invention.

Claims

1. A method for improving the radiation dose distribution after surgery for maxillary sinus cancer, characterized in that: The auxiliary device comprises an auxiliary device, which comprises a support body and a filling capsule, wherein the filling capsule is configured with an internal space for storing an equivalent filling material and an opening for injecting and discharging the equivalent filling material, and the opening is communicated with the internal space; the support body is configured with a through hole, the filling capsule is connected to one side of the support body, and the opening extends to the other side of the support body through the through hole or is communicated with the through hole; the filling capsule is made of an elastic material, and the support body is made of a hard material; the support body comprises a bottom supporting portion for closing the residual cavity of the maxillary sinus, and the upper surface and / or the lower surface of the support body are configured with an occlusal portion, and the occlusal portion is used to match the patient's teeth; the following steps are included: Step 1, a filling bag for storing an equivalent filler is arranged in the residual cavity of the patient's maxillary sinus, wherein the filling bag is configured with an opening for injecting and discharging the equivalent filler, and the filling bag can expand under the action of internal pressure; Step 2, according to the volume of the residual cavity of the maxillary sinus, injecting a set volume of equivalent filler into the filling bag through the opening, so that the equivalent filler fills the residual cavity of the maxillary sinus under the wrapping of the filling bag, and closes the opening; the equivalent filler is water or a mixed liquid with the same density as water; Step 3, a support body is provided below the maxillary sinus residual cavity to close the maxillary sinus residual cavity and to support the filling capsule, the support body serves to constrain the lower edge of the filling capsule so that the filling capsule fills the entire maxillary sinus residual cavity.

2. The method for improving the postoperative radiotherapy dose distribution of maxillary sinus cancer according to claim 1, characterized in that: The support body is formed by 3D printing.

3. The method for improving the postoperative radiotherapy dose distribution of maxillary sinus cancer according to claim 1, characterized in that: The filling bag is made of silicone, latex or rubber; And / or, the support body is made of plastic.

4. The method for improving the postoperative radiotherapy dose distribution of maxillary sinus cancer according to claim 1, characterized in that: The bite portion is configured with a plurality of grooves adapted to the teeth.

5. The method for improving the postoperative radiotherapy dose distribution of maxillary sinus cancer according to claim 1, characterized in that: It also includes a control component, which is connected to the through hole or the opening and is used to control the opening / closing of the through hole or the opening. The control component is a valve.

6. The method for improving the postoperative radiotherapy dose distribution of maxillary sinus cancer according to claim 5, characterized in that: The control component adopts a water injection soft valve; Alternatively, the control component is a one-way valve.

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