宫颈癌患者调强适形放疗摆位重复性及误差情况
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摘要
目的探究降低宫颈癌患者调强适形放疗摆位误差与重复性的有效措施。方法选择2016年4月至2017年4月中国人民解放军南京总医院收治的宫颈癌患者70例,按照入院顺序分为对照组和观察组两组实施对比研究,每组35例。两组患者均接受调强适形放疗,对照组给予常规摆位,观察组在对照组基础上,联合给予真空垫固定摆位。观察两组患者的放疗不同轴向(x、y、z轴)误差情况、总不良反应发生率等实验数据。结果对两组患者不同放疗不同轴向(x、y、z轴)误差情况进行统计比较,可得观察组在各轴向上的误差均显著小于对照组,差异具有统计学意义(all P <0. 05)。观察组不良反应发生率为5. 71%,显著低于对照组的25. 71%,,差异具有统计学意义(P <0. 05)。结论对接受调强适形放疗的宫颈癌患者,在对其进行摆位的时候,联合应用真空垫固定摆位效果确切,可以更好地减少放疗不同轴向上的误差,提高放疗的精确度。
Objective To explore the effective measures to reduce the setup error and repeatability of intensity modulated conformal radiotherapy for patients with cervical cancer. Methods 70 patients with cervical cancer in our hospital from April 2016 to April 2017 were selected and divided into control group and observation group,with 35 cases in each group. Both the two groups received intensity-modulated radiotherapy. The control group was given routine positioning,and the observation group was given vacuum pad to fix the position on the basic positioning of the control group. Different axial radiotherapy( x,y,z axis) error,total adverse reaction rate and other experimental data of the two groups were observed. Results The error of two groups with different radiotherapy and different axis( x,y,z axis) were statistically compared. And the error of each axis in observation group was significantly smaller than that of the control group,with statistically significant difference( all P < 0. 05). In terms of radiotherapy related adverse reactions,the total incidence of adverse reactions in observation group( 5. 71%) was significantly lower than that in control group( 25. 71%),with statistically significant difference( all P < 0. 05).Conclusions For cervical cancer patients undergoing intensity-modulated radiotherapy,the combination of vacuum pad fixation has a definite effect,which can reduce the error of radiotherapy in different axial directions and improve the accuracy of radiotherapy.
Objective To explore the effective measures to reduce the setup error and repeatability of intensity modulated conformal radiotherapy for patients with cervical cancer. Methods 70 patients with cervical cancer in our hospital from April 2016 to April 2017 were selected and divided into control group and observation group,with 35 cases in each group. Both the two groups received intensity-modulated radiotherapy. The control group was given routine positioning,and the observation group was given vacuum pad to fix the position on the basic positioning of the control group. Different axial radiotherapy( x,y,z axis) error,total adverse reaction rate and other experimental data of the two groups were observed. Results The error of two groups with different radiotherapy and different axis( x,y,z axis) were statistically compared. And the error of each axis in observation group was significantly smaller than that of the control group,with statistically significant difference( all P < 0. 05). In terms of radiotherapy related adverse reactions,the total incidence of adverse reactions in observation group( 5. 71%) was significantly lower than that in control group( 25. 71%),with statistically significant difference( all P < 0. 05).Conclusions For cervical cancer patients undergoing intensity-modulated radiotherapy,the combination of vacuum pad fixation has a definite effect,which can reduce the error of radiotherapy in different axial directions and improve the accuracy of radiotherapy.
引文
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[10]杨晓梅,邱云芳,储开岳,等.宫颈癌调强放疗中应用专用腹板治疗的摆位及护理体会[J].护士进修杂志,2014(14):1298-1299,1300.
[11] Sharma DN,Gandhi AK,Sharma S,et al. Interstitial brachytherapy vs. intensity-modulated radiation therapy for patients with cervical carcinoma not suitable for intracavitary radiation therapy[J]. Brachytherapy,2013,12(4):311-316.
[12]林赛云,王根桃.宫颈癌调强适形放疗36例摆位误差分析[J].福建医药杂志,2012,34(1):123-124.
[13]陈鑑,郭和锋,林浩,等.利用锥形束CT分析宫颈癌调强适形放疗摆位误差[J].医学信息,2013(21):78-79.
[14] Gandhi AK,Sharma DN,Rath GK,et al. Early clinical outcomes and toxicity of intensity modulated versus conventional pelvic radiation therapy for locally advanced cervix carcinoma:A prospective randomized study[J]. International Journal of Radiation Oncology Biology Physics,2013,87(3):542-548.
[15] Liang J,Chen S. Hung Y,et al. Low-dose,prophylactic,extendedfield,intensity-modulated radiotherapy plus concurrent weekly cisplatin for patients with stage IB2-IIIB cervical cancer,positive pelvic lymph nodes,and negative para-aortic lymph nodes[J]. International Journal of Gynecological Cancer,2014,24(5):901-907.
[16]张润华,罗明香,王贤和,等.使用真空垫在宫颈癌普通放疗摆位减小误差的作用[J].大家健康(中旬版),2014,(2):75-75.
[17]米热古丽·阿克木江,苏莱娅·胡赛音.放疗同步化疗对宫颈癌患者临床疗效的初步观察[J].中国性科学,2015,24(11):39-42.
[18]王兰荣,曹旸,王刚,等.宫颈癌调强适形放疗中有孔泡沫板两种摆放位置对小肠受照射体积的影响研究[J].中国继续医学教育,2015(24):133-134.
[2]赖勇,罗志刚,陈炀,等.不同放射治疗技术对人乳头瘤病毒感染宫颈癌患者的临床效果对比研究[J].中国性科学,2017,26(4):62-64.
[3]鲍慧,孙晓东,王明,等.术后调强放疗对宫颈癌患者卵巢功能的影响[J].中国性科学,2017,26(9):80-83.
[4]西永忠,祁英,孟万斌,等.宫颈癌调强放疗模拟定位机和彩色多普勒位置验证对比探讨[J].甘肃医药,2012,31(9):692-694.
[5]李鑫,陈云.不同体位方式在宫颈癌调强适形放疗中采用热塑膜固定的效果比较[J].临床医药文献电子杂志,2017,4(27):5213-5214.
[6]林原,周莉均,徐志勇,等.宫颈癌术后盆腔三维适形与调强放疗剂量学与技术的研究[J].中华放射肿瘤学杂志,2008,17(5):372-376.
[7]宋慧胜,陈龙华,冯正富等.宫颈癌三维适形放射治疗与常规放射治疗临床观察[J].西部医学,2011,23(5):838-841.
[8]苏善宁,曾自力.宫颈癌三维适形放疗摆位的质量保证与质量控制[J].中国辐射卫生,2015,24(1):93-96.
[9] Yin Y,Li H,Sheng X,et al. The Treatment of pelvic locoregional recurrence of cervical cancer after radical surgery with intensity-modulated radiation therapy compared with conventional radiotherapy a retrospective study[J]. Int J Gynecol Cancer,2015,25(6):1058-1065.
[10]杨晓梅,邱云芳,储开岳,等.宫颈癌调强放疗中应用专用腹板治疗的摆位及护理体会[J].护士进修杂志,2014(14):1298-1299,1300.
[11] Sharma DN,Gandhi AK,Sharma S,et al. Interstitial brachytherapy vs. intensity-modulated radiation therapy for patients with cervical carcinoma not suitable for intracavitary radiation therapy[J]. Brachytherapy,2013,12(4):311-316.
[12]林赛云,王根桃.宫颈癌调强适形放疗36例摆位误差分析[J].福建医药杂志,2012,34(1):123-124.
[13]陈鑑,郭和锋,林浩,等.利用锥形束CT分析宫颈癌调强适形放疗摆位误差[J].医学信息,2013(21):78-79.
[14] Gandhi AK,Sharma DN,Rath GK,et al. Early clinical outcomes and toxicity of intensity modulated versus conventional pelvic radiation therapy for locally advanced cervix carcinoma:A prospective randomized study[J]. International Journal of Radiation Oncology Biology Physics,2013,87(3):542-548.
[15] Liang J,Chen S. Hung Y,et al. Low-dose,prophylactic,extendedfield,intensity-modulated radiotherapy plus concurrent weekly cisplatin for patients with stage IB2-IIIB cervical cancer,positive pelvic lymph nodes,and negative para-aortic lymph nodes[J]. International Journal of Gynecological Cancer,2014,24(5):901-907.
[16]张润华,罗明香,王贤和,等.使用真空垫在宫颈癌普通放疗摆位减小误差的作用[J].大家健康(中旬版),2014,(2):75-75.
[17]米热古丽·阿克木江,苏莱娅·胡赛音.放疗同步化疗对宫颈癌患者临床疗效的初步观察[J].中国性科学,2015,24(11):39-42.
[18]王兰荣,曹旸,王刚,等.宫颈癌调强适形放疗中有孔泡沫板两种摆放位置对小肠受照射体积的影响研究[J].中国继续医学教育,2015(24):133-134.