基于工程医学理论显现医学摆位伦理之专家共识  

Expert consensus on the revealing of the medical ethics on patient setup based on the theory of engineering medicine

作　　者：葛云[1] 殷芳芳 吴昊[3] 万遂人[4] 孔德兴[5] 颜子夜 杨瑞杰[7] 于大海[8] 梁军 孙向东 戴相昆 李谭谭 金献测[13] 黄晓延[14] 吴建峰[15] GE Yun;YIN Fangfang;WU Hao;WAN Suiren;KONG Dexing;YAN Ziye;YANG Ruijie;YU Dahai;LIANG Jun;SUNXiangdong;DAI Xiangkun;LI Tantan;JIN Xiance;HUANG Xiaoyan;WU Jianfeng(School of Electronic Science and Engineering,Nanjing University,Nanjing 210023,China;Medical Physics Graduate Program,Duke Kunshan University,Kunshan 215316,China;Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education,Beijing)/Department of Radiotherapy,Peking University Cancer Hospital&Institute,Beijing 100142,China;School of Biological Science and Medical Engineering,Southeast University,Nanjing 210000,China;School of Mathematical Sciences,Zhejiang University,Hangzhou 310058,China;Guangzhou Perception Vision Medical Technologies Co.,Ltd.,Guangzhou 510799,China;Department of Radiation Oncology,Peking University Third Hospital,Beijing 100191,China;Department of Radiation Oncology,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China;Shaanxi Provincial Cancer Hospital,Xi'an 710061,China;Department of Radiotherapy,General Hospital of Eastern Theater Command of Chinese People's Liberation Army/Jinling Hospital,the Affiliated Hospital of Medical School of Nanjing University,Nanjing 210002,China;Department of Radiation Oncology,the First Medical Center of the PLA General Hospital,Beijing 100143,China;Department of Radiotherapy,Cancer Hospital,Chinese Academy of Medical Sciences,Beijing 100021,China;Radiotherapy Center,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Radiotherapy,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Department of Radiotherapy,Jiangsu Cancer Hospital,Nanjing 210000,China)

机构地区：[1]南京大学电子科学与工程学院,江苏南京210023 [2]昆山杜克大学医学物理研究生项目,江苏昆山215316 [3]北京大学肿瘤医院暨北京市肿瘤防治研究所放疗科/恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [4]东南大学生物科学与医学工程学院,江苏南京210000 [5]浙江大学数学科学学院,浙江杭州310058 [6]广州柏视医疗科技有限公司,广东广州510799 [7]北京大学第三医院肿瘤放疗科,北京100191 [8]江苏省中医院放疗科,江苏南京210029 [9]陕西省肿瘤医院放疗医院,陕西西安710061 [10]中国人民解放军东部战区总医院/南京大学医学院附属金陵医院放射治疗科,江苏南京210002 [11]中国人民解放军总医院第一医学中心放射治疗科,北京100143 [12]中国医学科学院肿瘤医院放疗科,北京100021 [13]温州医科大学附属第一医院放疗中心,浙江温州325015 [14]中山大学肿瘤防治中心放射治疗科,广东广州510060 [15]江苏省肿瘤医院放射治疗科,江苏南京210000

出　　处：《中国医学物理学杂志》2024年第12期1453-1459,共7页Chinese Journal of Medical Physics

摘　　要：基于工程医学理论,针对目前摆位设备和方式种类繁多、原理差异大、摆位不精准的临床问题,以减少伤害的基本医学伦理准则为出发点,形成两方面共识:(1)提倡协调多种摆位方法进行联合摆位,对摆位方法进行数据收集、比较、分析和甄别,基于规范统一的临床一致性原则,确定联合摆位的操作准则和方法,以期达到不依靠金标准即可极大地保证放疗摆位精度和放疗安全的临床目的;(2)规范摆位偏差溯源操作方法,实现对摆位差异导致临床一致性差时,可溯源偏差原因、甄别不同摆位有效性。本共识预期基于工程医学理念,规范放疗摆位方法,实现精准的放疗,提升治疗效果和显现医学伦理关怀。Based on the theory of engineering medicine,a consensus which takes the basic medical ethics of harm reduction as the starting point is proposed to addresses the current clinical problems of a wide variety of radiotherapy setup equipments and methods,large differences by principles,and inaccurate setup.The consensus is formed in two aspects.(1)Advocate coordination of multiple setup methods for joint setup;collect,compare,analyze and screen data on setup methods;determine the operational guidelines and methods for joint setup based on the principle of standardized and unified clinical consistency,with a view to achieving the clinical purpose of greatly ensuring the precision of radiotherapy setup and radiotherapy safety without relying on the golden standard.(2)Standardize the operational methods for tracing setup deviations,so that when the difference in setup leads to poor clinical consistency,the cause of deviation can be traced and the effectiveness of different setups can be screened.Based on the concept of engineering medicine,the consensus is expected to standardize the method of radiotherapy setup,realize accurate radiotherapy,improve treatment effect and show medical ethical care.

关 键 词：放疗摆位 放疗摆位偏差数据 临床一致性 医学伦理 放疗医学摆位伦理 专家共识 

分 类 号：R318[医药卫生—生物医学工程]