锥形束CT引导下研究宫颈癌放射治疗中文化差异对治疗精度的影响  

Cone-beam CT-guided Study of the Effect of Cultural Differences on Treatment Accuracy in Cervical Cancer Radiation Therapy

作　　者：呼婷婷 白飞 HU Ting-ting;BAI Fei(Xijing Hospital,Air Force Medical University,Xi'an 710032,Shaanxi Province,China)

机构地区：[1]空军军医大学第一附属医院,陕西西安710032

出　　处：《中国CT和MRI杂志》2024年第7期134-136,共3页Chinese Journal of CT and MRI

基　　金：西京医院学科助推项目(XJZT19ML24)。

摘　　要：目的利用锥形束CT研究文化差异对宫颈癌患者放射治疗的差异性,为临床个体化治疗提供依据。方法选取宫颈癌患者208例,研究组88例为高中以上学历,对照组120例为高中以下学历,都采用热塑体模和自制的辅助装置加以固定。放疗前行CBCT扫描并在线匹配,得出x、y、z方向上的摆位误差,经有资历的两名临床医师审核,确认无误后,做相应的记录;同时测量膀胱的大小,直肠的直径,并做记录。两组间比较采用t检验。结果1.误差比较:研究组患者左右﹑上下﹑前后方向的摆位误差分别为x(1.56±1.21)﹑y(1.65±1.24)﹑z(1.46±1.01)mm;对照组的分别为x(1.96±1.39)﹑y(2.20±1.91)﹑z(2.10±1.02)mm;两组间比较在Y轴、Z轴有统计学意义。2.膀胱尿量变化范围:研究组较为稳定。3.肠道准备:研究组每次肠道准备优于对照组。结论高学历患者的治疗精度﹑膀胱充盈一致性和肠道准备一致性均优于低学历患者。建议临床医生和治疗师要对待农村或低学历患者应该要有耐心,给予细致的多次的宣教,直至患者及家属完全理解并积极配合治疗。Objective Cone beam CT was used to study the differences of cultural differences on radiation therapy for cervical cancer patients to provide a basis for individualized clinical treatment.Methods Two hundred and eight cervical cancer patients,88 with high school education or above in the study group and 120 with less than high school education in the control group,were selected and all were fixed using thermoplastic body molds and homemade assistive devices.CBCT scans were performed and matched online before radiotherapy to derive positional errors in x,y,and z directions,which were reviewed by two qualified clinicians to confirm that they were correct and recorded accordingly;the size of the bladder and the diameter of the rectum were also measured and recorded.The t-test was used for comparison between the two groups.Results 1.Comparison of errors:The positional errors of the study group were x(1.56±1.21),y(1.65±1.24),and z(1.46±1.01)mm in the left and right,up and down,and anterior and posterior directions,respectively;those of the control group were x(1.96±1.39),y(2.20±1.91),and z(2.10±1.02)mm,respectively;the comparison between the two groups was statistically significant in the y-axis,and z-axis were statistically significant.2.Range of bladder urine volume variation:the study group was more stable.3.Bowel preparation:the study group was better than the control group in each bowel preparation.Conclusion Treatment accuracy,consistency of bladder filling and consistency of bowel preparation were better in patients with high education than in patients with low education.It is recommended that clinicians and therapists should be patient with rural or low-education patients and give meticulous and repeated preaching until patients and families fully understand and actively cooperate with treatment.

关 键 词：锥形束CT 文化差异 宫颈癌 膀胱容量 摆位误差 

分 类 号：R711.74[医药卫生—妇产科学]