水凝胶在前列腺癌图像引导放疗中的应用

Application of hydrogel in image guided radiotherapy for prostate cancer

目的:评价前列腺癌(PCa)图像引导放疗(IGRT)中水凝胶注入后的不良事件(AE)、患者直肠毒性和生活质量(QOL)。方法:筛选2022年10月至2023年3月在我院放疗科接受IGRT的PCa患者70例。采用简单随机分配法将患者均分为注入水凝胶的试验组(n=35)和未注入的对照组(n=35)。采用疼痛视觉模拟评分(VAS)和常见不良事件评价标准(CTCAE)5.0评价术后AE。比较两组急性和晚期放射性直肠炎(RP)发生率和QOL评分。结果:试验组水凝胶注入术中和术后6 h VAS分别为(2.31±0.59)分和(1.43±0.47)分,首次大小便后分别为(1.52±0.33)分和(1.10±0.28)分。试验组5.71%和2.86%的患者分别存在严重出血和手术区域感染。试验组8.57%的患者发生了急性Ⅰ级RP,2.86%的患者发生了晚期Ⅰ级RP;对照组28.57%的患者发生了急性Ⅰ级RP,11.43%的患者发生了急性Ⅱ级RP;对照组17.14%的患者发生晚期Ⅰ级RP,5.71%的患者发生晚期Ⅱ级RP。试验组RP发生率低于对照组,水凝胶的注入降低了患者直肠毒性。自IGRT开始后第3周起,试验组QOL评分显著高于对照组(均P<0.05),水凝胶的注入在一定程度上提高了患者QOL。结论:水凝胶在PCa IGRT中应用时安全性较为理想,能够降低患者直肠毒性和在一定程度上提高QOL,具有一定临床应用价值。

Objective:To evaluate the adverse event(AE),rectal toxicity and quality of life(QOL)of patients with prostate cancer(PCa)after the injection of hydrogel in image guided radiotherapy(IGRT).Methods:70 PCa patients who received IGRT from October 2022 to March 2023 in department of radiotherapy of our hospital were selected.The patients were equally divided into the test group(n=35)injected with hydrogel and the control group(n=35)without hydrogel by using simple random allocation method.The postoperative AE was evaluated by using pain visual analog scale(VAS)and common adverse event evaluation standard(CTCAE)5.0.The incidence rate of acute/advanced radiation proctitis(RP)and the QOL score between two groups were compared.Results:The VAS in the test group was(2.31±0.59)score and(1.43±0.47)score respectively during operation and 6 hours after hydrogel injection.The VAS was(1.52±0.33)score and(1.10±0.28)score respectively after the first defecation and urination.5.71%(2/35)and 2.86%(1/35)of the patients in the test group had severe bleeding and surgical area infection,respectively.8.57%of the patients in the test group developed acute grade I RP,while 2.86%of the patients developed advanced grade I RP.28.57%of the patients in the control group developed acute grade I RP,while 11.43%of the patients developed acute grade II RP.17.14%of the patients in the control group developed advanced grade I RP,while 5.71%of the patients developed advanced grade II RP.The incidence rate of RP in the test group was lower than that in the control group.Hydrogel injection reduced the rectal toxicity for the patients.The QOL score in the test group was significantly higher than that in the control group from the third week after IGRT(all P<0.05).Hydrogel injection improved the QOL of the patients to a certain extent.Conclusion:The safety of hydrogel is ideal in PCa IGRT.Hydrogel can reduce the rectal toxicity for the patients and improve the QOL to a certain extent.Hydrogel has certain clinical application value.