运用PDCA循环降低直肠癌调强放疗摆位误差的效果  

Effect of PDCA circulation to reduce set-up errors in intensity-modulated radiotherapy of rectal cancer

作　　者：杨建芬[1] 曾自力[1] 张若蓉 林锋[1] 谭勇 唐海榕 YANG Jianfen;ZENG Zili;ZHANG Ruorong;LIN Feng;TAN Yong;TANG Hairong(Department of Oncology,Liuzhou Municipal Liutie Central Hospital,Liuzhou 545007,China)

机构地区：[1]柳州市柳铁中心医院肿瘤科,广西柳州545007

出　　处：《中国医学物理学杂志》2021年第6期682-687,共6页Chinese Journal of Medical Physics

基　　金：广西医疗卫生科学研究项目(Z20210643)。

摘　　要：目的:探讨运用PDCA(Plan,Do,Check,Action)循环降低直肠癌调强放疗摆位误差的效果。方法:对2016年10月~2020年10月于柳州市柳铁中心医院行直肠癌调强放疗的60例患者进行分析研究,针对摆位误差高的问题进行分析,将PDCA循环管理实施前、实施后摆位误差的情况进行对比。结果:实施前、后直肠癌调强放疗摆位误差,在X方向分别为(-1.3894±0.4267)mm、(-0.8205±0.2653)mm,Y方向为(0.9712±0.2961)mm、(0.4213±0.1114)mm,Z方向为(0.7125±0.2356)mm、(0.4697±0.1413)mm,差异有统计学意义(P<0.05)。结论:PDCA循环运用于降低直肠癌调强放疗摆位误差中的效果明显,可有效降低直肠癌调强放疗摆位的误差,从而最大限度地将剂量集中在肿瘤靶区内,减少肿瘤周围正常组织不必要的照射。Objective To investigate the effect of reducing set-up errors in intensity-modulated radiotherapy of rectal cancer by PDCA(Plan,Do,Check,Action)circulation.Methods Sixty rectal cancer patients who received intensity-modulated radiotherapy in Liuzhou Municipal Liutie Central Hospital from October 2016 to December 2020 were enrolled in the study.The reasons for large set-up errors are analyzed,and the set-up errors before and after the implementation of PDCA circulation were compared.Results There were statistical differences in set-up errors before and after the implementation of PDCA circulation which were(-1.3894±0.4267)mm and(-0.8205±0.2653)mm in X direction,(0.9712±0.2961)mm and(0.4213±0.1114)mm in Y direction,(0.7125±0.2356)mm and(0.4697±0.1413)mm in Z direction,respectively(P<0.05).Conclusion The application of PDCA circulation can effectively reduce the set-up errors in intensity-modulated radiotherapy of rectal cancer,thereby maximizing the dose concentration in the tumor target area and decreasing unnecessary irradiation of normal tissues around the tumor area.

关 键 词：直肠癌 PDCA循环 调强放射治疗 摆位误差 

分 类 号：R312[医药卫生—基础医学] R811.1