直肠癌辅助放疗中患者腹围在不同体位下与肠道剂量体积的相关性分析  

Analysis of correlation between abdominal circumference and intestinal dose volume in patients with rectal cancer treated with adjuvant radiotherapy under different positions

作　　者：黄婷婷 王文玲[2] 董洪敏[2] 胡银祥[2] 陈唯唯 陈望花 李国栋 白赛曦 陈娟[1,2] 金海洁[2] 张毅 王刚[2] HUANG Tingting;WANG Wenling;DONG Hongmin;HU Yinxiang;CHEN Weiwei;CHEN Wanghua;LI Guodong;BAI Saixi;CHEN Juan;JIN Haijie;ZHANG Yi;WANG Gang(Guizhou Medical University,Guizhou Guiyang 550001,China;Department of Abdominal Oncology,Guizhou Provincial Cancer Hospital,Guizhou Guiyang 550001,China)

机构地区：[1]贵州医科大学,贵州贵阳550001 [2]贵州省肿瘤医院腹部肿瘤科,贵州贵阳550001

出　　处：《现代肿瘤医学》2022年第8期1463-1467,共5页Journal of Modern Oncology

基　　金：贵州省教育厅创新群体重大研究项目(编号:黔教合KY字[2018]020)。

摘　　要：目的:通过对比分析直肠癌辅助放疗患者的不同腹围在俯卧位联合Belly-board和仰卧位两种治疗体位下与肠道剂量体积的相关性,为不同腹围大小患者选择合适的治疗模式提供临床证据。方法:通过单因素线性回归分析初步评估与各剂量水平的肠道剂量体积(肠道V_(10)、V_(20)、V_(30)、V_(40)、V_(50))相关的临床因素和体型指标(身高、体重、脐部腹围、BMI);多因素线性回归分析评估各个体型指标对肠道剂量体积的独立作用,筛选可以预测肠道剂量体积的体型指标。应用配对t检验在中大和小腹围两组患者间进行仰卧位和俯卧位的肠道剂量体积均数比较。结果:多因素线性回归分析显示,无论何种体位,脐部腹围与各肠道剂量体积均有显著的负的线性关系;配对t检验显示,在中大腹围患者中,V_(30)、V_(40)、V_(50)在俯卧位时显著低于仰卧位,V_(10)在俯卧位时显著高于仰卧位,而在小腹围患者中,V_(20)、V_(30)、V_(40)、V_(50)在俯卧位和仰卧位间均无显著差异,V_(10)在俯卧位时仍显著高于仰卧位,而且均值差显著大于中大腹围患者。结论:对于中大腹围的患者,俯卧位垫Belly-board较仰卧位有中高剂量的肠道剂量学优势;在小腹围患者中,仰卧位在肠道低剂量体积(V;)更有优势,而其他肠道剂量体积与俯卧位并无差异。Objective:To provide clinical evidence for the selection of appropriate treatment mode for patients with different abdominal circumference in prone position combined with Belly-board and supine position by comparing and analyzing the correlation between different abdominal circumference and intestinal dose volume in patients with rectal cancer assisted radiotherapy.Methods:Univariate linear regression analysis was used to preliminarily evaluate the clinical factors and body size indexes(height,weight,umbilical abdominal circumferenceand BMI)associated with intestinal dose volume(Intestinal V10,V20,V30,V40,V50)at each dose level.Multivariate linear regression analysis was used to evaluate the independent effects of various body size indicators on intestinal dose volume,and to screen body size indicators that could predict intestinal dose volume.Pairedt test was used to compare the mean intestinal dose volume of patients in supine and prone positions between the mid-large and small abdominal circumference groups.Results:Multivariate linear regression analysis showed that there was a significant negative linear relationship between umbilical abdominal circumference and the dose volume of each intestinal tract,regardless of the position.Paired t test showed that in the mid-large abdominal circumference patients,V30,V40,V50 in prone position was significantly lower than the supine position,use the V10 in prone position is significantly higher than the supine position,and in small abdominal circumference patients,intestinal V20,V30,V40,V50 in prone and supine,had no significant differences between V10 was significantly higher than the supine position,while in the prone position and the mean difference was greater than the mid-large abdominal circumference patients significantly.Conclusion:For patients with large abdominal circumference,prone position with Belly-board has medium and high dose intestinal dosimetry advantage compare with supine position.In patients with small abdominal circumference,supine position is mor

关 键 词：直肠癌 Belly-board 放疗 肠道剂量体积 腹围 

分 类 号：R735.3[医药卫生—肿瘤]