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膀胱充盈状态对子宫切除术后宫颈癌放疗中定位误差的影响。

Effect of bladder filling status on positioning errors in post-hysterectomy cervical cancer radiotherapy.

机构信息

Department of Radiotherapy, Nantong Tumor Hospital, The Affiliated Tumor Hospital of Nantong University, Nantong, China.

出版信息

Ann Med. 2023;55(2):2249936. doi: 10.1080/07853890.2023.2249936.

Abstract

To investigate the effect of different bladder filling states on positioning errors in radiotherapy for cervical cancer and obtain the reference range of bladder filling consistency during radiotherapy. Patients who underwent postoperative radiotherapy for cervical cancer in Nantong Tumor Hospital from October 2018 to December 2019 were selected. According to the bladder filling deviation, they were divided into group A1 (deviation < 20%) and group B1 (deviation ≥ 20%). The bladder filling variations of the two groups were compared with different positioning errors. Group A2 has a positioning error of <0.4 cm, and group B2 has a positioning error of ≥0.4 cm. The reference range of bladder filling consistency during radiotherapy is obtained by analyzing the composition ratio of different positioning errors of bladder filling deviation. This study included 195 patients with cervical cancer. The error of longitudinal and vertical position in group B1 was significantly higher than that in group A1 (0.50 ± 0.34 vs. 0.26 ± 0.22 cm,  < 0.001, and 0.22 ± 0.17 vs. 0.16 ± 0.12 cm,  < 0.001). Compared with group B2, the absolute deviation of bladder filling in group A2 (54.1% ± 54.4% vs. 25.6% ± 22.7%,  < 0.001) was slight. The chi-square test showed significant differences in the proportion of the positioning state of different bladder filling forms ( = 31.006,  < 0.001). In addition, there was a significant difference in the proportion of stability errors in patients with poor stability in different directions ( = 118.551,  < 0.001). In patients with cervical cancer fixed in the supine position, a bladder capacity deviation <20% is easier to achieve excellent positioning with, and it can better control the positioning error of radiotherapy and ensure the positioning accuracy of dose distribution to the target area. It can also achieve good tumor treatment effects. This range can be used as a reference for bladder filling consistency in patients with cervical cancer undergoing radiotherapy.

摘要

为了研究不同膀胱充盈状态对宫颈癌放疗定位误差的影响,并获得放疗过程中膀胱充盈一致性的参考范围。选取 2018 年 10 月至 2019 年 12 月南通肿瘤医院行术后放疗的宫颈癌患者。根据膀胱充盈偏差,将其分为 A1 组(偏差<20%)和 B1 组(偏差≥20%)。比较两组不同定位误差的膀胱充盈变化。A2 组定位误差<0.4cm,B2 组定位误差≥0.4cm。通过分析不同膀胱充盈偏差的定位误差构成比,获得放疗过程中膀胱充盈一致性的参考范围。本研究共纳入 195 例宫颈癌患者。B1 组纵向和垂直位置误差明显高于 A1 组(0.50±0.34cm 比 0.26±0.22cm,<0.001;0.22±0.17cm 比 0.16±0.12cm,<0.001)。与 B2 组相比,A2 组膀胱充盈的绝对偏差较小(54.1%±54.4%比 25.6%±22.7%,<0.001)。卡方检验显示不同膀胱充盈形式的定位状态比例差异有统计学意义(=31.006,<0.001)。此外,不同方向稳定性差的患者稳定性误差的比例差异有统计学意义(=118.551,<0.001)。在仰卧位固定的宫颈癌患者中,膀胱容量偏差<20%更容易达到理想的定位效果,可更好地控制放疗定位误差,保证靶区剂量分布的定位精度,达到良好的肿瘤治疗效果。此范围可作为宫颈癌放疗患者膀胱充盈一致性的参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cd5/10494734/3718c977139f/IANN_A_2249936_F0001_B.jpg

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