目的利用Compass三维验证系统对乳腺癌保乳术后调强放射治疗计划进行剂量验证,研究其影响因素并进行分类分析。方法选择乳腺癌保乳放射治疗女性患者20例,年龄45~74岁,中位年龄59岁;侧别,左侧10例,右侧10例。用Compass系统进行计划剂量验...目的利用Compass三维验证系统对乳腺癌保乳术后调强放射治疗计划进行剂量验证,研究其影响因素并进行分类分析。方法选择乳腺癌保乳放射治疗女性患者20例,年龄45~74岁,中位年龄59岁;侧别,左侧10例,右侧10例。用Compass系统进行计划剂量验证,包括独立核算验证和实测重建剂量验证;将Monaco计划系统蒙卡算法计算的剂量(MCD)、Compass卷积/超分割算法独立核算剂量(CCD)和Compass实测重建剂量(CRD)三者之间两两剂量验证结果进行两两比较(CCD-MCD、CRD-CCD、CRD-MCD),比较参数包括靶区剂量最大限值10%生成区域的γ结果及剂量体积直方图(DVH)结果。结果CRD-MCD与CRD-CCD的γ通过率和平均γ值差异均有统计学意义[(95.23±2.38)%vs(96.33±2.72)%、(94.78±2.56)%vs(95.97±2.95)%、0.41±0.04 vs 0.37±0.04、0.42±0.04 vs 0.38±0.04。P<0.05],CRD-MCD与CCD-MCD的γ通过率和平均γ值差异也均有统计学意义[(95.23±2.38)%vs(99.29±0.46)%、(94.78±2.56)%vs(99.26±0.46)%、0.41±0.04 vs 0.26±0.03、0.42±0.04 vs 0.27±0.03。P<0.05],CRD-CCD与CCD-MCD的γ通过率和平均γ值差异也均有统计学意义[(96.33±2.72)%vs(99.29±0.46)%、(95.97±2.95)%vs(99.26±0.46)%、0.37±0.04 vs 0.26±0.03、0.38±0.04 vs 0.27±0.03。P<0.05]。计划肿瘤靶区(PGTV)的D_(98%)和计划靶区(PTV)的D_(mean)、健侧乳腺的D_(mean)、V5和患侧肺的V20、V30的剂量体积相对偏差在CRD-MCD与CRD-CCD比较,差异有统计学意义[(2.01±1.27)%vs(2.60±1.05)%、(2.84±0.55)%vs(2.55±0.71)%、(-11.15±7.87)%vs(-18.29±7.91)%、(-1.45±5.45)%vs(-2.76±3.83)%、(-0.85±0.36)%vs(-0.65±0.23)%、(-0.56±0.37)%vs(-0.38±0.27)%。P<0.05]。PGTV的D98%、D_(2%)、D_(mean),PTV的D_(98%)、D_(2%)、D_(mean),心脏的D_(mean)、健侧乳腺的D_(mean)、V_(5),健侧肺的V_(5)和患侧肺的V_(5)、V_(20)、V_(30)的剂量体积相对偏差在CRD-MCD与CCD-MCD比较,差异均有统计学意义[(2.01±1.27)%vs(-0.51±0.54)%、(2.86±1.22)%vs(-0.002±0.92)%、(2.63±0.75)%vs(-0.19±0.40)%、(2.17±0.82)%vs(0.38±1.01)%、(2.81±0.95)%vs(-0.17±0.70)%、(2.84±0.55)%vs(0.29±0.43)%、(-17.39±7.79)%vs(0.87±3.30)%、(-11.15±7.87)%vs(9.27±4.87)%、(-1.45±5.45)%vs(2.01±1.30)%、(-0.24±0.80)%vs(0.01±0.04)%、(-4.60±0.87)%vs(0.27±0.59)%、(-0.85±0.36)%vs(-0.21±0.21)%、(-0.56±0.37)%vs(-0.22±1.34)%。P<0.05]。PGTV的D_(98%)、D_(2%)、D_(mean),PTV的D_(98%)、D_(2%)、D_(mean),心脏的D_(mean)、健侧乳腺的D_(mean)、V_(5),健侧肺的V_(5)和患侧肺的V5、V20、V30的剂量体积相对偏差在CRD-CCD与CCD-MCD比较,差异均有统计学意义[(2.60±1.05)%vs(-0.51±0.54)%、(2.88±1.12)%vs(-0.002±0.92)%、(2.83±0.68)%vs(-0.19±0.40)%、(1.81±0.90)%vs(0.38±1.01)%、(2.87±0.82)%vs(-0.17±0.70)%、(2.55±0.71)%vs(0.29±0.43)%、(-18.10±7.40)%vs(0.87±3.30)%、(-18.29±7.91)%vs(9.27±4.81)%、(-2.76±3.83)%vs(2.01±1.30)%、(-0.25±0.81)%vs(0.01±0.04)%、(-4.90±1.03)%vs(0.27±0.59)%、(-0.65±0.23)%vs(-0.21±0.21)%、(0.38±0.27)%vs(-0.22±1.34)%。P<0.05]。结论不同算法在高剂量区、低剂量区和肺等组织密度比较大或者含空腔的组织中计算精度偏差更加显著;机器的稳定性状态对剂量差异亦有影响。展开更多
Introduction: Nurses’ constant exposure to severe human suffering within constrained health care environments places them at risk for developing Secondary Traumatic Stress and Burnout. The current study therefore sou...Introduction: Nurses’ constant exposure to severe human suffering within constrained health care environments places them at risk for developing Secondary Traumatic Stress and Burnout. The current study therefore sought to establish the prevalence and social demographic factors associated with Secondary Traumatic Stress, Burnout and Compassion Satisfaction among Nurses working at selected Teaching Hospitals in Lusaka, Zambia. Methods: A correlational design employing a self-administered questionnaire adapted from version five of the Professional Quality of Life scale was used to collect data from 250 nurses drawn using proportional stratified sampling method. The resulting data were analyzed using version 23 of the Statistical Package for Social Sciences (SPSS). Hierarchical multiple linear regression analysis was used to identify predictors of Secondary Traumatic Stress and Burnout. Findings: Whilst the majority of respondents reported average levels of Secondary Traumatic Stress and Burnout, about a quarter reported high Secondary Traumatic Stress and Burnout scores at 23% and 26% respectively. Only 81 (32.4%) scored high on Compassion Satisfaction. Social demographic factors including;working in the main Intensive Care Unit, and being married accounted for the greatest variance in Secondary Traumatic Stress (R<sup>2</sup> = 0.237, p Conclusion: Findings of the current study signify a need to institute measures to help nurses cope with the deleterious psychological effects of constant engagement with those in distress and to foster Compassion Satisfaction.展开更多
文摘目的利用Compass三维验证系统对乳腺癌保乳术后调强放射治疗计划进行剂量验证,研究其影响因素并进行分类分析。方法选择乳腺癌保乳放射治疗女性患者20例,年龄45~74岁,中位年龄59岁;侧别,左侧10例,右侧10例。用Compass系统进行计划剂量验证,包括独立核算验证和实测重建剂量验证;将Monaco计划系统蒙卡算法计算的剂量(MCD)、Compass卷积/超分割算法独立核算剂量(CCD)和Compass实测重建剂量(CRD)三者之间两两剂量验证结果进行两两比较(CCD-MCD、CRD-CCD、CRD-MCD),比较参数包括靶区剂量最大限值10%生成区域的γ结果及剂量体积直方图(DVH)结果。结果CRD-MCD与CRD-CCD的γ通过率和平均γ值差异均有统计学意义[(95.23±2.38)%vs(96.33±2.72)%、(94.78±2.56)%vs(95.97±2.95)%、0.41±0.04 vs 0.37±0.04、0.42±0.04 vs 0.38±0.04。P<0.05],CRD-MCD与CCD-MCD的γ通过率和平均γ值差异也均有统计学意义[(95.23±2.38)%vs(99.29±0.46)%、(94.78±2.56)%vs(99.26±0.46)%、0.41±0.04 vs 0.26±0.03、0.42±0.04 vs 0.27±0.03。P<0.05],CRD-CCD与CCD-MCD的γ通过率和平均γ值差异也均有统计学意义[(96.33±2.72)%vs(99.29±0.46)%、(95.97±2.95)%vs(99.26±0.46)%、0.37±0.04 vs 0.26±0.03、0.38±0.04 vs 0.27±0.03。P<0.05]。计划肿瘤靶区(PGTV)的D_(98%)和计划靶区(PTV)的D_(mean)、健侧乳腺的D_(mean)、V5和患侧肺的V20、V30的剂量体积相对偏差在CRD-MCD与CRD-CCD比较,差异有统计学意义[(2.01±1.27)%vs(2.60±1.05)%、(2.84±0.55)%vs(2.55±0.71)%、(-11.15±7.87)%vs(-18.29±7.91)%、(-1.45±5.45)%vs(-2.76±3.83)%、(-0.85±0.36)%vs(-0.65±0.23)%、(-0.56±0.37)%vs(-0.38±0.27)%。P<0.05]。PGTV的D98%、D_(2%)、D_(mean),PTV的D_(98%)、D_(2%)、D_(mean),心脏的D_(mean)、健侧乳腺的D_(mean)、V_(5),健侧肺的V_(5)和患侧肺的V_(5)、V_(20)、V_(30)的剂量体积相对偏差在CRD-MCD与CCD-MCD比较,差异均有统计学意义[(2.01±1.27)%vs(-0.51±0.54)%、(2.86±1.22)%vs(-0.002±0.92)%、(2.63±0.75)%vs(-0.19±0.40)%、(2.17±0.82)%vs(0.38±1.01)%、(2.81±0.95)%vs(-0.17±0.70)%、(2.84±0.55)%vs(0.29±0.43)%、(-17.39±7.79)%vs(0.87±3.30)%、(-11.15±7.87)%vs(9.27±4.87)%、(-1.45±5.45)%vs(2.01±1.30)%、(-0.24±0.80)%vs(0.01±0.04)%、(-4.60±0.87)%vs(0.27±0.59)%、(-0.85±0.36)%vs(-0.21±0.21)%、(-0.56±0.37)%vs(-0.22±1.34)%。P<0.05]。PGTV的D_(98%)、D_(2%)、D_(mean),PTV的D_(98%)、D_(2%)、D_(mean),心脏的D_(mean)、健侧乳腺的D_(mean)、V_(5),健侧肺的V_(5)和患侧肺的V5、V20、V30的剂量体积相对偏差在CRD-CCD与CCD-MCD比较,差异均有统计学意义[(2.60±1.05)%vs(-0.51±0.54)%、(2.88±1.12)%vs(-0.002±0.92)%、(2.83±0.68)%vs(-0.19±0.40)%、(1.81±0.90)%vs(0.38±1.01)%、(2.87±0.82)%vs(-0.17±0.70)%、(2.55±0.71)%vs(0.29±0.43)%、(-18.10±7.40)%vs(0.87±3.30)%、(-18.29±7.91)%vs(9.27±4.81)%、(-2.76±3.83)%vs(2.01±1.30)%、(-0.25±0.81)%vs(0.01±0.04)%、(-4.90±1.03)%vs(0.27±0.59)%、(-0.65±0.23)%vs(-0.21±0.21)%、(0.38±0.27)%vs(-0.22±1.34)%。P<0.05]。结论不同算法在高剂量区、低剂量区和肺等组织密度比较大或者含空腔的组织中计算精度偏差更加显著;机器的稳定性状态对剂量差异亦有影响。
文摘Introduction: Nurses’ constant exposure to severe human suffering within constrained health care environments places them at risk for developing Secondary Traumatic Stress and Burnout. The current study therefore sought to establish the prevalence and social demographic factors associated with Secondary Traumatic Stress, Burnout and Compassion Satisfaction among Nurses working at selected Teaching Hospitals in Lusaka, Zambia. Methods: A correlational design employing a self-administered questionnaire adapted from version five of the Professional Quality of Life scale was used to collect data from 250 nurses drawn using proportional stratified sampling method. The resulting data were analyzed using version 23 of the Statistical Package for Social Sciences (SPSS). Hierarchical multiple linear regression analysis was used to identify predictors of Secondary Traumatic Stress and Burnout. Findings: Whilst the majority of respondents reported average levels of Secondary Traumatic Stress and Burnout, about a quarter reported high Secondary Traumatic Stress and Burnout scores at 23% and 26% respectively. Only 81 (32.4%) scored high on Compassion Satisfaction. Social demographic factors including;working in the main Intensive Care Unit, and being married accounted for the greatest variance in Secondary Traumatic Stress (R<sup>2</sup> = 0.237, p Conclusion: Findings of the current study signify a need to institute measures to help nurses cope with the deleterious psychological effects of constant engagement with those in distress and to foster Compassion Satisfaction.
