WO2015194514A1

WO2015194514A1 - Subject-holding apparatus

Info

Publication number: WO2015194514A1
Application number: PCT/JP2015/067218
Authority: WO
Inventors: 健有村; 貢松山; 尚荻野; 良夫菱川; 慶一野間; あかり桜木; 喜崇田口
Original assignee: フジデノロ株式会社; 一般財団法人メディポリス医学研究財団
Priority date: 2014-06-16
Filing date: 2015-06-15
Publication date: 2015-12-23
Also published as: JP6653815B2; JP2016002219A

Abstract

Provided is a subject-holding apparatus for securing the body of a subject during particle beam therapy, etc. with ample security. The subject-holding apparatus is equipped with a subject-securing jig (14) for securing a subject (8), who has been placed on a subject placement table (12), to the subject placement table (12). The subject-securing jig (14) is provided with an airtight bag (28) for cylindrically covering a portion or all of the body of the subject (8). The interior (28i) of the bag (28) is filled with multiple particulate materials (38) and changes in shape are limited by making the interior (28i) to have a negative pressure. The subject-securing jig (14) is equipped with hook and loop fasteners (22a, 22b) and bonds (24a, 24b) as securing members for securing the relative position of the bag (28) with respect to the subject placement table (12). As a result, changes in the shape of the bag (28) can be limited and the body of the covered subject (8) can be securely held by making the interior (28i) of the bag (28), which is cylindrically covering the subject (8), to have a negative pressure by extracting air from the interior (28i), etc.

Description

Subject holding device

The present invention relates to a subject holding device for holding a subject during particle beam therapy or the like.

For example, a device for fixing a subject's body on a subject mounting table when performing X-ray imaging or radiotherapy with a medical device is known. For example, the subject fixing device of the medical device described in Patent Document 1 is an example. According to this technique, the bed top plate on which the subject is placed is provided with a bag body surrounding the subject, and the bag body is formed of a hard and durable material and a soft material having elasticity inside. It is said that the subject can be securely fixed to the couch top in a state surrounded by a bag by injecting gas or liquid into the expansion chamber with a compressor.

JP 2007-301217 A

Recently, medical devices for treating cancer and the like using particle beams such as proton beams have been developed and used for actual treatment. In such particle beam therapy, since the relative positional relationship between the apparatus for irradiating the particle beam and the body of the subject is involved in determining the treatment site, it is required to securely fix the body of the subject. For example, when considering particle beam therapy for breast cancer, the target breast is treated so that the main organs such as the heart and lungs located in the vicinity of the breast are not adversely affected by particle beam irradiation. Need to be separated from. In the technique of fixing the subject's body by increasing the internal pressure by injecting gas or liquid into the bag as in the conventional technique, the position of the subject's body is shifted due to the expansion of the bag. There was a fear, and it was difficult to fix the body sufficiently in light of the demand in particle beam therapy. That is, the present condition is that the subject holding device for fixing the subject's body sufficiently reliably in the particle beam therapy or the like has not been developed yet.

The present invention has been made against the background of the above circumstances, and an object of the present invention is to provide a subject holding device that sufficiently and securely fixes a subject's body during particle beam therapy or the like.

In order to achieve such an object, the gist of the first aspect of the present invention is that a subject mounting table on which a subject is placed, and a subject who fixes the subject placed on the subject placing table to the subject placing table. A fixing jig, and the subject fixing jig includes an airtight bag body that covers a part or all of the body of the subject in a cylindrical shape, and the bag body includes a plurality of particulate materials therein. It is filled, and the change of the shape is suppressed by making the inside negative pressure, and the subject fixing jig includes a fixing member that fixes the relative position of the bag body with respect to the subject mounting table. This is a subject holding device.

According to the first aspect of the present invention, a subject mounting table on which a subject is mounted, and a subject fixing jig that fixes the subject mounted on the subject mounting table to the subject mounting table. The device includes an airtight bag body that covers a part or all of the body of the subject in a cylindrical shape, and the bag body is filled with a plurality of particulate materials, and the inside thereof is set to a negative pressure. The subject fixing jig is provided with a fixing member that fixes the relative position of the bag body with respect to the subject mounting table, so that the subject is covered in a cylindrical shape. By changing the inside of the bag body to a negative pressure, such as by removing air from the inside of the bag body, changes in the shape of the bag body can be suppressed, and the covered body of the subject can be reliably held. That is, it is possible to provide a subject holding device that sufficiently sufficiently fixes the subject's body during particle beam therapy or the like.

The gist of the second invention subordinate to the first invention is that the bag body exposes the treatment affected area from the bag body at a position corresponding to the treatment affected area of the subject covered by the bag body. It has a hole. In this way, the subject's body can be fixed sufficiently reliably during the particle beam treatment in a predetermined treatment affected area.

The gist of the third invention subordinate to the second invention is that the treatment affected part is at least one breast of the subject. In this way, the subject's body can be fixed sufficiently reliably during particle beam therapy for breasts including breast cancer.

The gist of the fourth invention according to any one of the first to third inventions is that the cup is formed in accordance with the shape of the body surface including at least one breast of the subject, and the subject is on the inner surface side. A breast holder provided with an adhesive layer having adhesiveness with respect to the skin surface of the subject, provided between the subject mounting table and the breast holder, and placed on the subject mounting table in a supine position An arm member capable of adjusting at least one of a position and an angle in a three-dimensional direction of the breast holder relative to the subject mounting table with a head-and-foot direction as a reference direction. In this way, when performing particle beam therapy on breasts such as breast cancer, the breasts can be separated from major organs such as the heart and lungs, and the shape of the breasts can be maintained.

The gist of the fifth invention according to any one of the first to fourth inventions is that the bag body has a cylindrical shape in one direction or a cylindrical shape branched in a plurality of directions. If it does in this way, a subject's body can be fixed enough certainly at the time of particle beam therapy etc. with a subject fixing jig of a practical mode.

The gist of the sixth invention, which is dependent on any one of the first to fifth inventions, is that the bag body is provided with one or more pairs of fixing parts that are fixed to each other, and the fixing parts are It is formed into a cylindrical shape by being fixed to each other. If it does in this way, a subject's body can be fixed enough certainly at the time of particle beam therapy etc. with a subject fixing jig of a practical mode.

According to the seventh aspect of the present invention, which is dependent on the sixth aspect of the invention, the bag body is formed as a jacket without sleeves by fixing the fixing portions to each other. If it does in this way, a subject's body can be fixed enough certainly at the time of particle beam therapy etc. with a subject fixing jig of a practical mode.

It is a figure explaining an example of composition of a subject holding device which is a suitable example of the present invention. It is the top view which looked at the test subject mounting stand with which the test subject holding apparatus of FIG. 1 was equipped from the direction perpendicular | vertical to the upper surface where a test subject is mounted. FIG. 3 is a side view of the subject mounting table of FIG. 2 viewed in a direction indicated by an arrow III. It is a figure explaining an example of composition of a subject fixing jig with which a subject holding device of Drawing 1 was equipped in detail, and is a front view which looked at a mode that it unfolded from the front side. It is a figure explaining in detail an example of composition of a subject fixing jig with which a subject holding device of Drawing 1 was equipped, and is a rear view which looked at a mode that it developed. It is a figure explaining in detail an example of composition of a subject fixing jig with which a subject holding device of Drawing 1 was equipped, and is a front view which looked at a mode that a surface fastener was pasted together from the front side. It is a figure which shows typically a mode that the test subject was coat | covered with the test subject fixing jig with which the test subject holding apparatus of FIG. 1 was equipped, and it is the figure seen from the test subject's back side. It is a figure which shows typically a mode that the test subject was coat | covered with the test subject fixing jig with which the test subject holding apparatus of FIG. 1 was equipped, and it is the figure seen from the test subject's front side. FIG. 7 is a diagram schematically showing a configuration of a bag body provided in the subject fixing jig of FIGS. 4 to 6. FIG. 2 is a diagram illustrating the configuration of a breast holder provided in the subject holding device of FIG. 1, and is a plan view of the breast holder viewed from the upper side. FIG. 11 is a sectional view taken along line XI-XI in FIG. 10. It is a perspective view which shows an example of a structure of the arm-shaped member with which the test subject holding apparatus of FIG. 1 was equipped. It is a figure which illustrates the structure by which the breast holder in which an aspect differs from the breast holder shown in FIG. 12 was attached to the arm-shaped member. It is a flowchart explaining the principal part of an example of the treatment process which performs a particle beam therapy to a test subject using the test subject holding | maintenance apparatus of FIG. It is a figure explaining an example of composition of a subject holding device which is other examples of the present invention. It is a figure which shows another example of the test subject fixing jig with which the test subject holding apparatus of FIG. 1 was equipped. It is a perspective view which shows an example of another structure of the arm-shaped member with which the test subject holding apparatus of FIG. 1 was equipped. It is a perspective view which shows an example of another structure of the arm-shaped member with which the test subject holding apparatus of FIG. 1 was equipped.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the drawings. In the drawings used for the following description, the dimensional ratios and the like of each part are not necessarily drawn accurately.

FIG. 1 is a diagram illustrating an example of a configuration of a subject holding device 10 which is a preferred embodiment of the present invention. The subject holding device 10 is a device that fixes (holds) the body of a subject (patient) when performing particle beam therapy including proton beam therapy and heavy particle beam therapy using a medical device (not shown), for example. . As shown in FIG. 1, the subject holding device 10 includes a subject placing table 12 on which a subject 8 is placed and a subject fixing the subject 8 placed on the subject placing table 12 to the subject placing table 12. A fixing jig 14, a breast holder 16 that holds at least one breast 8 b of the subject 8, and an arm-like member 18 that holds the breast holder 16 with respect to the subject mounting table 12 are provided. .

2 and 3 are views showing an example of the configuration of the subject mounting table 12. FIG. 2 is a plan view seen from a direction perpendicular to the upper surface 20 on which the subject 8 is placed. FIG. It is the side view which looked at the test subject mounting base 12 in the direction shown by arrow III. As shown in FIGS. 2 and 3, the subject mounting table 12 is configured in a flat plate shape, for example, and the subject 8 is placed on the upper surface 20 which is one flat surface portion. As the fixing member for fixing the relative position of the subject fixing jig 14 (the bag body 28 provided in the subject fixing jig 14) with respect to the subject mounting table 12, for example, the subject fixing treatment is applied to the subject mounting table 12. A longitudinal hook-and-loop fastener 22a bonded to the hook-and-loop fastener 22b provided on the tool 14 side, and a plurality of connecting portions 24a respectively connected to the plurality of connecting portions 24b provided on the subject fixing jig 14 side. , Provided.

The subject mounting table 12 includes an attachment portion 26 to which the arm-shaped member 18 is attached. Preferably, one or more pairs of the mounting portions 26 are provided in the left-right direction of the subject 8 placed on the subject placing table 12 in a supine position. Each attachment portion 26 is provided with a plurality of attachment positions to which the arm-like member 18 is selectively attached in the direction of the head and feet of the subject 8 placed on the subject placement table 12 in a supine position. . When the arm-shaped member 18 is attached to any one of the mounting positions, the head-foot direction of the base portion 18b (see FIG. 12 and the like) of the arm-shaped member 18 with respect to the subject mounting table 12, that is, FIG. The position in the direction indicated by the x-axis is determined.

4 to 6 are diagrams for explaining in detail an example of the configuration of the subject fixing jig 14, and FIG. 4 is a front view of the unfolded

surface fasteners

30a, 30b and the like when viewed from the front side. FIG. 5 is a rear view of the state in which the hook-and-

loop fasteners

30a and 30b and the like are unfolded and viewed from the back side, and FIG. 6 is a front view of the state in which the hook-and-

loop fasteners

30a and 30b and the like are bonded together. The subject fixing jig 14 includes an airtight bag 28 that covers a part or all of the body of the subject 8 in a cylindrical shape. The bag body 28 has a cylindrical shape in one direction or a cylindrical shape branched in a plurality of directions. 4 to 6 exemplify a bag body 28 formed in a cylindrical shape in one direction. The bag body 28 preferably includes a pair or a plurality of fixing portions that are fixed to each other, and each fixing portion is fixed to each other to form a cylinder. More preferably, as the fixing portions are fixed to each other, as shown in FIG. 6, the fixing portion has a sleeve-like shape (that is, a so-called sleeveless shape) excluding the neck portion and the arm portion. In FIG. 1, the subject holding tool 14 exemplifies a form that covers not only the upper body of the subject 8 but also the lower body, but the subject holding tool 14 is at least the upper body of the subject 8 (preferably, Any material may be used as long as it covers the portion excluding the head and arms. This is the same in the description of FIG.

As shown in FIGS. 4 to 6, the bag body 28 is a pair of surfaces that are bonded to each other, for example, in a portion corresponding to a pocket (overlay) when the bag body 28 is viewed as a jacket.

Fasteners

30a and 30b are provided. A pair of hook-and-

loop fasteners

32a and 32b are attached to a portion corresponding to the left side when the bag body 28 is viewed as a jacket. A pair of hook-and-

loop fasteners

34a and 34b are attached to a portion corresponding to the right side when the bag body 28 is viewed as a jacket. That is, the bag body 28 includes a plurality of pairs of hook-and-

loop fasteners

30a, 30b, 32a, 32b, 34a, and 34b (hereinafter simply referred to as hook-and-

loop fasteners

30a and 30b) as the fixing portion, for example, A part of the bag body 28 is wound or folded, and the hook-and-

loop fasteners

30a and 30b and the like are fixed to each other, thereby forming a jacket shape without sleeves as shown in FIG. The

surface fasteners

30a, 30b and the like are known tape-shaped fixing members, one of which is hook-shaped and the other of which is pile-shaped (the same applies to the description of the surface fastener below). The bag body 28 may be provided with a member such as a known binding belt (band) or string as the fixing portion in addition to or as an alternative to the hook-and-

loop fasteners

30a and 30b.

FIGS. 7 and 8 are views schematically showing a state in which the subject 8 is covered with the subject fixing jig 14 (bag body 28), and FIG. 7 is a view seen from the back side of the subject 8. 8 is a view seen from the front side of the subject 8. The subject fixing jig 14 includes a fixing member that fixes the relative position of the bag body 28 with respect to the subject mounting table 12. For example, as shown in FIGS. 5 and 7, the surface fastener 22 b bonded to the surface fastener 22 a provided on the subject mounting table 12 side is a back surface portion of the bag body 28 (see the bag body 28 as a jacket). (Position corresponding to the back in the case), for example, is provided along the spinal column of the subject 8 in a longitudinal shape. A plurality of coupling portions 24 b coupled to the plurality of coupling portions 24 a provided on the subject fixing base 12 side are provided on the back surface portion of the bag body 28. The

coupling portions

24a and 24b are known fitting members (engaging members) that are fixed by being fitted (engaged) with each other, and are formed of, for example, a synthetic resin material or the like. . The subject mounting table 12 and the subject fixing jig 14 are fixed to a member such as a known binding belt (band) or string in addition to or instead of the

surface fasteners

22a and 22b and the

coupling portions

24a and 24b. It may be provided as a part.

As shown in FIG. 8, the bag body 28 is preferably at a position corresponding to a treatment affected area of a subject 8 covered by the bag body 28 (a site to be treated by a medical device (not shown)). A hole portion 36 is provided for exposing the treatment affected area from the bag body 28 (bare). Preferably, a hole 36 for exposing (bare) the breast 8b from the bag 28 is provided at a position corresponding to at least one breast 8b of the subject 8 covered by the bag 28. In other words, the

surface fasteners

30a, 30b and the like are attached to each other in a state where a part or all of the body of the subject 8 is wrapped or covered by the bag body 28, or is sandwiched and covered. When at least one hole 36 is formed so that the breast 8b of the subject 8 is exposed from the bag body 28 when the bag body 28 has a cylindrical shape (cylindrical shape) covering the subject 8 as shown in FIG. It is provided by being cut through. The hole 36 is provided at a portion where at least a part or the whole of the breast 8 b including the nipple (nipple) in the subject 8 is exposed from the bag body 28. Preferably, a part or all of a region including the breast 8b, the sternum, the clavicle, and the rib in the subject 8 is provided at a site where the bag 28 is exposed.

FIG. 9 is a diagram schematically showing the configuration of the bag body 28. As shown in FIG. 9, the bag body 28 is preferably filled with a large number of particulate materials 38 in the inside 28 i of the bag body 28, and the inside 28 i is set to a negative pressure (pressure lower than the outside). Therefore, the change in shape is suppressed. The particulate material 38 is preferably made of a synthetic resin material such as expanded polystyrene and has a substantially spherical shape with a diameter of about 1 mmφ, for example. In the bag body 28, an inside 28i of a bag-like member having airtightness is filled with the numerous particulate materials 38, and the bag body 28 has a valve capable of adjusting the amount of air in the inside 28i. 28v is provided. For example, by sucking air in the interior 28i of the bag body 28 through the valve 28v, the interior 28i can be set to a negative pressure. In the bag body 28, when a sufficient amount of air is sealed in the interior 28 i, the numerous particulate materials 38 are freely moved (flowed) through the interior 28 i, and the body surface of the subject 8 is uneven and curved. The bag body 28 is deformed along the shape. When the air inside the bag body 28i is sucked through the valve 28v in the state where the bag body 28 is deformed along the unevenness and curved surface shape of the body of the subject 8, The large number of particulate materials 38 filled in the interior 28i are aggregated, and the bag body 28 is solidified (cured) as a whole, and its deformation is suppressed. Accordingly, the body of the subject 8 can be reliably held and fixed by the subject fixing jig 14. In other words, the bag body 28 is a suction-type fixed cushion whose shape change is suppressed by sucking the air inside the interior 28i.

10 and 11 are views illustrating the configuration of the breast holder 16 provided in the subject holding apparatus 10, FIG. 10 is a plan view of the breast holder 16 as viewed from above, and FIG. FIG. 11 is a sectional view taken along line XI-XI in FIG. 10. As shown in FIG. 11, the breast holder 16 is formed in a cup shape according to the shape of the body surface including at least one breast 8b of the subject 8. At least a part or the whole of the breast 8b including the nipple (nipple) in the subject 8 is covered. That is, the breast holder 16 preferably has a space 16n in which the nipple in the subject 8 is accommodated and a space 16b in which part or all of the breast 8b in the subject 8 is accommodated, as shown in FIGS. Is provided. More preferably, the subject 8 has a shape that covers part or all of the region including the breast 8b, the sternum, the clavicle, and the ribs. The breast holder 16 preferably obtains information on the shape of the breast 8b of the subject 8 by a known three-dimensional scanner (3D scanner) as shown in FIG. It may be created individually for each subject 8. The breast holder 16 is attached to the arm-shaped member 18 by, for example, being fitted to a part of the distal end portion 18p of the arm-shaped member 18 at the mounting portion 16s.

As shown in FIG. 11, the breast holder 16 includes an adhesive layer 40 having adhesiveness to the skin surface of the subject 8 on the inner surface side thereof. That is, when the breast holder 16 is attached to the breast 8b of the subject 8, the adhesive layer having adhesiveness to the skin surface of the breast 8b on the entire surface or a part of the surface in contact with the breast 8b. 40. The adhesive layer 40 is preferably a synthetic resin material having adhesiveness such as urethane gel or silicone gel. An acrylic, silicone, urethane, or rubber-based adhesive may be used for the adhesive layer 40. The adhesive layer 40 may be made of a synthetic resin material having adhesiveness such as acrylic, silicone, urethane, or styrene elastomer. As shown in FIG. 11, preferably, in the breast holder 16, the inner peripheral surface of a space 16 n in which the nipple in the subject 8 is accommodated and the space 16 b in which part or all of the breast 8 b in the subject 8 is accommodated. The adhesive layer 40 is provided so as to cover the peripheral surface.

FIG. 12 is a perspective view showing an example of the configuration of the arm-shaped member 18, and shows a state in which the breast holder 16 is attached to the distal end portion 18p. As shown in FIG. 12, the arm-shaped member 18 is provided between the subject mounting table 12 and the breast holder 16. Preferably, a base portion 18b provided on the side opposite to the distal end portion 18p is directly or indirectly fixed to the mounting portion 26 of the subject mounting table 12. The breast holder 16 is attached to the distal end portion 18p by fitting the attachment portion 16s of the breast holder 16 to a part of the distal end portion 18p.

The arm-shaped member 18 has, for example, an articulated structure as shown in FIG. 12, so that the breast holder 16 attached to the distal end portion 18p is positioned in a three-dimensional direction with respect to the base portion 18b. And at least one of the angles can be adjusted. Preferably, the position in at least the three-dimensional direction can be adjusted. The arm-shaped member 18 is fixed to the subject mounting table 12 in the base part 18b, and the head-foot direction of the subject 8 placed in the supine position on the subject mounting table 12 is a reference direction. It is possible to adjust at least one of the position and angle of the breast holder 16 with respect to the subject mounting table 12 in the three-dimensional direction. That is, as shown in FIG. 1, the head-foot direction of the subject 8 placed on the subject placing table 12 in the supine position is the x-axis direction, and the y-axis is perpendicular to the x-axis and orthogonal to each other When the z axis is determined, adjustment of at least one of the position and angle of the breast holder 16 in the x, y, and z axis directions with respect to the subject mounting table 12 is made possible.

FIG. 13 is a diagram illustrating a configuration in which a breast holder 42 having a different form from the breast holder 14 is attached to the distal end portion 18p of the arm-shaped member 18, and (a) is a diagram illustrating the breast holder 42. Is a perspective view for explaining a state in which is attached to the tip end portion 18p of the arm-shaped member 18, and (b) is a front view for explaining in detail the structure of the tip end portion 18p. The breast holder 42 shown in FIG. 13 acquires information related to the shape of the breast 8b of the subject 8 by a known three-dimensional scanner, and is created individually for each subject 8 based on the information. . The breast holder 42 is configured to cover a part or all of the region including the breast 8b, the sternum, the collarbone, and the ribs in the subject 8. An adhesive layer 40 having adhesiveness to the skin surface of the subject 8 is provided on the inner surface side of the breast holder 42. In the configuration shown in FIG. 13, as shown in FIG. 13B, a sphere 18g is fitted inside the distal end portion 18p, and the attachment portion 16s of the breast holder 42 is attached to the sphere 18g. ing. With this configuration, the breast holder 42 (attachment portion 16s) can be adjusted to an arbitrary angle with respect to the distal end portion 18p of the arm-shaped member 18. Further, as shown by an arrow at the tip 18p of the arm-shaped member 18 in (a), the breast holder 42 can be rotated relative to the tip 18p. That is, the angle of the rotation direction of the breast holder 42 around the attachment portion 16s can be changed with respect to the arm-shaped member 18.

FIG. 14 is a flowchart for explaining a main part of an example of a treatment process for performing particle beam therapy on the subject 8 using the subject holding device 10. First, in the process P 1, the subject 8 to be treated is placed on the subject placing table 12 and fixed to the subject placing table 12 by the subject fixing jig 14. In this process P1, the posture of the subject 8 is set to the supine position. Next, in the process P2, the subject mounting table 12 is tilted with respect to the direction of gravity while the subject 8 is fixed to the subject mounting table 12, so that the posture of the subject 8 is changed from the supine position to the prone position. It is changed to the place. Next, in the process P3, the

breast holders

16, 42 and the like are attached to a part including the breast 8b of the subject 8. Next, in the process P4, the

breast holders

16, 42, etc. are attached to the distal end portion 18p of the arm-shaped member 18. Next, in step P5, the base portion 18b of the arm-shaped member 18 is attached to the attachment portion 26 of the subject mounting table 12. Next, in the process P6, the posture of the subject 8 is changed from the prone position to the supine position by, for example, returning the subject placing table 12 to a horizontal position while the subject 8 is fixed to the subject placing table 12. The Next, in a process P7, at least one of a known CT examination and MRI examination for photographing an image inside the subject 8 is performed. Next, in a process P8, particle beam therapy including proton beam therapy and heavy particle beam therapy is performed on the breast 8b of the subject 8.

As described above with reference to FIG. 14, in the particle beam therapy including proton beam therapy and heavy particle beam therapy, it is necessary to appropriately change the posture of the subject 8 between the supine position, the lateral position, the prone position, and the like. In addition, since the relative positional relationship between the apparatus for irradiating the particle beam and the body of the subject 8 is related to the determination of the treatment site, it is required to securely fix the body of the subject 8. In particular, in the particle beam therapy for the breast 8b of the subject 8, the breast 8b is removed from the main organs so that the main organs such as the heart and lungs located in the vicinity of the breast 8b are not adversely affected by the irradiation of the particle beam. Need to be separated. Further, since the breast 8b is easily affected by gravity and easily deforms, it is necessary to maintain the breast shape in a necessary posture so that the shape of the breast 8b does not change during the treatment. The subject holding device 10 of the present embodiment has the configuration described above with reference to FIGS. 1 to 13, so that, for example, when the subject 8 is fixed on the subject mounting table 12 in the supine position as shown in FIG. Even when the subject mounting table 12 is tilted at an arbitrary angle with respect to the direction of gravity, the supine position of the subject 8 with respect to the subject mounting table 12 can be held. In particular, by providing the breast holder 16 and the arm-shaped member 18, it is possible to suitably suppress changes in the shape of the breast 8 b in the subject 8 and changes in the relative position with respect to the subject mounting table 12. That is, the body including the breast 8b of the subject 8 can be reliably held during particle beam therapy including proton beam therapy and heavy particle beam therapy.

Thus, according to the present embodiment, the subject placing table 12 on which the subject 8 is placed and the subject fixing jig 14 for fixing the subject 8 placed on the subject placing table 12 to the subject placing table 12. The subject fixing jig 14 includes an airtight bag body 28 that covers a part or all of the body of the subject 8 in a cylindrical shape, and the bag body 28 has a plurality of particles in an interior 28i. The shape change is suppressed by filling the shape material 38 and the inside 28i is set to a negative pressure, and the subject fixing jig 14 has a relative position of the bag body 28 with respect to the subject mounting table 12. Are provided with hook and

loop fasteners

22a and 22b and connecting

portions

24a and 24b as fixing members, so that air is extracted from the inside 28i of the bag body 28 covering the subject 8 in a cylindrical shape. 28i negative pressure Doing, to suppress a change in shape of the bag 28, it is possible to reliably hold the coated body of the subject 8. That is, it is possible to provide the subject holding device 10 that sufficiently and reliably fixes the body of the subject 8 during particle beam therapy or the like.

The bag body 28 is provided with a hole 36 for exposing the breast 8b from the bag body 28 at a position corresponding to at least one breast 8b of the subject 8 covered by the bag body 28. In the particle beam therapy related to the breast 8b including breast cancer, the body of the subject 8 can be fixed sufficiently reliably.

A breast holder 16 which is formed in a cup shape according to the shape of the body surface including at least one breast 8b of the subject 8 and has an adhesive layer 40 having adhesiveness to the skin surface of the subject 8 on the inner surface side. , 42, and the subject mounting table 12 and the

breast holder

16, 42, and the subject 8 with the head-foot direction of the subject 8 placed on the subject mounting table 12 in a supine position as a reference direction. Since the arm member 18 capable of adjusting at least one of the position and angle of the

breast holders

16 and 42 relative to the mounting table 12 in the three-dimensional direction is provided, the particle beam related to the breast 8b including breast cancer In the treatment, the breast 8b can be separated from main organs such as the heart and lungs, and the shape of the breast 8b can be maintained.

The bag body 28 includes one or a plurality of pairs of

surface fasteners

30a and 30b that are fixed to each other, and the

surface fasteners

30a and 30b are fixed to each other to form a cylindrical shape. Therefore, the body of the subject 8 can be fixed with sufficient certainty during particle beam therapy or the like by the subject fixing jig 14 of a practical aspect.

The bag body 28 is shaped like a vest without sleeves by fixing the hook and

loop fasteners

30a, 30b and the like. At this time, the body of the subject 8 can be fixed sufficiently reliably.

The preferred embodiments of the present invention have been described above in detail with reference to the drawings. However, the present invention is not limited to these embodiments, and may be implemented in other modes.

For example, in the above-described embodiment, the arm-shaped member 18 has its base portion 18b directly attached to the attachment portion 26 provided on the subject mounting table 12, but the present invention is not limited thereto. For example, as illustrated in FIG. 15, a bridging portion 44 may be attached to the subject mounting table 12, and the arm-shaped member 18 may be attached to the bridging portion 44. The bridging portion 44 is a pair of elongated members that are spanned between a pair of the attachment portions 26 provided in the left-right direction of the subject 8 placed on the subject placing table 12 in a supine position. is there. The bridging portion 44 is attached to any one of a plurality of attachment positions in the attachment portion 26, so that the bridging portion 44 is in the head-foot direction with respect to the subject mounting table 12, that is, in the direction indicated by the x axis in FIG. Is determined. The base portion 18 b of the arm-shaped member 18 is attached to an arbitrary position in the longitudinal direction of the bridging portion 44. When the base portion 18b of the arm-shaped member 18 is attached to a predetermined position in the longitudinal direction of the bridging portion 44, the direction of the arm-shaped member 18 perpendicular to the head-and-foot direction with respect to the subject mounting table 12, that is, FIG. 1 determines the position in the direction indicated by the y-axis. That is, in the configuration shown in FIG. 15, the arm-shaped member 18 is indirectly fixed to the subject mounting table 12 via the bridging portion 44, so that the base portion 18 b of the arm-shaped member 18 is The positions in the x-axis direction and the y-axis direction (that is, the plane direction of the upper surface 20) with respect to the subject mounting table 12 can be determined. Thereby, the breast 8b of the subject 8 placed on the subject holding device 10 can be more reliably held.

In the above-described embodiment, the subject holding device 10 fixes the subject 8 when performing particle beam therapy on the breast 8b of the subject 8, but the present invention is not limited to this. The present invention is also preferably applied to a mode in which the subject 8 is fixed in the particle beam therapy for other sites. In this case, the subject fixing jig 14 does not necessarily need to include the hole 36. The subject fixing jig 14 may cover and fix the head of the subject 8 and the like. The subject fixing jig 14 may not be provided with fixing portions such as the hook-and-

loop fasteners

30a and 30b, and may be configured in a cylindrical shape or a jacket shape. For example, a jacket-like (shirt-like) subject fixing jig 50 as shown in FIG. 16 may be provided. The subject fixing jig 50 is also an airtight bag that covers part or all of the body of the subject 8 in a cylindrical shape. That is, FIG. 16 illustrates the subject fixing jig 50 including a cylindrical bag body branched in three directions.

In the above-described embodiment, the arm-shaped member 18 has a multi-joint structure, so that at least one of the position and angle of the breast holder 16 and the like in the three-dimensional direction with respect to the subject mounting table 12 can be changed. However, a known flexible arm or the like can be used as an alternative to the arm-shaped member 18 as long as the position and angle of the breast holder 16 can be fixed sufficiently reliably with respect to the subject mounting table 12. It may be a thing.

The distal end portion 18p of the arm-like member 18 may be fixed (clamped) with an attachment portion 16s such as the

breast holders

16 and 42 interposed therebetween as shown in FIG. In such a configuration, the

breast holders

16, 42 and the like can be easily attached to the arm-shaped member 18. Further, according to the configuration shown in FIG. 17, the distal end portion 18p is not located above the attachment portion 16s (on the opposite side of the

breast holders

16, 42, etc. in the axial direction), so that it is above the attachment portion 16s. An irradiation gantry or the like of a medical device (not shown) can be arranged. Thereby, compared with the configuration described above with reference to FIG. 13 and the like, the irradiation gantry and the like can be further brought closer to the treatment affected part (for example, the breast 8b) of the subject 8, and treatment accuracy can be improved.

The subject holding device 10 may include an arm-shaped member 52 that does not have a multi-joint structure, for example, as shown in FIG. 18 as an alternative to the arm-shaped member 18. According to such an arm-shaped member 52, in addition to improving the position fixability of the

breast holders

16, 42, etc., the subject mounting table 12 of the

breast holders

16, 42, etc. and the arm-shaped member 18 are provided. The attachment to can be made simple. In the configuration shown in FIG. 18, preferably, the

breast holders

16, 42 are matched to the shape of the treatment affected part (for example, the breast 8 b), the lesion (tumor) position, the treatment plan, and the like in the subject 8 to be treated. And the arm-like member 52 are integrally formed by, for example, a known 3D printer.

In addition, although not illustrated one by one, the present invention is implemented with various modifications within a range not departing from the gist thereof.

8: Subject, 8b: Breast, 10: Subject holding device, 12: Subject mounting table, 14, 50: Subject fixing jig, 16, 42: Breast holder, 18, 52: Arm-shaped member, 22a, 22b: Surface Fastener (fixing member), 24a, 24b: coupling portion (fixing member), 28: bag body, 28i: inside, 30a, 30b, 32a, 32b, 34a, 34b: hook-and-loop fastener (fixing portion), 36: hole portion, 38: particulate material, 40: adhesive layer

Claims

A subject mounting table on which the subject is placed;
A subject fixing jig for fixing the subject placed on the subject placement table to the subject placement table,
The subject fixing jig includes an airtight bag that covers a part or all of the body of the subject in a cylindrical shape,
The bag body is filled with a plurality of particulate materials, and a change in shape is suppressed by the negative pressure inside the bag body,
The subject holding jig includes a fixing member that fixes a relative position of the bag body with respect to the subject mounting table.
The subject holding apparatus according to claim 1, wherein the bag body includes a hole portion that exposes the treatment affected area from the bag body at a position corresponding to the treatment affected area of the subject covered by the bag body.
The subject holding apparatus according to claim 2, wherein the treatment affected part is at least one breast of the subject.
A breast holder that is formed in a cup shape according to the shape of the body surface including at least one breast of the subject, and has an adhesive layer that has adhesiveness to the skin surface of the subject on the inner surface side;
A three-dimensional direction of the breast holder with respect to the subject mounting table that is provided between the subject mounting table and the breast holder and that has a head-foot direction of the subject placed in a supine position on the subject mounting table as a reference direction. The subject holding device according to any one of claims 1 to 3, further comprising: an arm member capable of adjusting at least one of the position and the angle.
The test subject holding apparatus according to any one of claims 1 to 4, wherein the bag body has a cylindrical shape in one direction or a cylindrical shape branched in a plurality of directions.
6. The bag according to claim 1, wherein the bag body includes one or a plurality of fixing portions that are fixed to each other, and is formed into a cylindrical shape by fixing the fixing portions to each other. Subject holding device.
The test subject holding apparatus according to claim 6, wherein the bag body is shaped like a jacket without sleeves by fixing the fixing portions to each other.