Deformable image registration (DIR) has been an important component in adaptive radiotherapy (ART). Our goal was to examine the accuracy of ART using the dice similarity coefficient (DSC) and to determine the optimal ...Deformable image registration (DIR) has been an important component in adaptive radiotherapy (ART). Our goal was to examine the accuracy of ART using the dice similarity coefficient (DSC) and to determine the optimal timing of replanning. A total of 22 patients who underwent volume modulated arc therapy (VMAT) for head and neck (H&N) cancers were prospectively analyzed. The planning target volume (PTV) was to receive a total of 70 Gy in 33 fractions. A second planning CT scan (rescan) was performed at the 15th fraction. The DSC was calculated for each structure on both CT scans. The continuous variables to predict the need for replanning were assessed. The optimal cut-off value was determined using receiver operating characteristic (ROC) curve analysis. In the correlation between body weight loss and DSC of each structure, weight loss correlated negatively with DSC of the whole face (rs = -0.45) and the face surface (rs = -0.51). Patients who required replanning tended to have experienced rapid weight loss. The threshold DSC was 0.98 and 0.60 in the whole face and the face surface, respectively. Patients who showed low DSC in the whole face and the face surface required replanning at a significantly high rate (P < 0.05 and P < 0.01). Weight loss correlated with DSC in both the whole face and the face surface (P < 0.05 and P < 0.05). The DSC values in the face predicted the need for replanning. In addition, weight loss tended to correlate with DSC. DIR during ART was found to be a useful tool for replanning.展开更多
Objective:To determine factors that influence comfort in head and neck neoplasm patients receiving radiotherapy.Methods:In total,200 head and neck neoplasm patients receiving radiotherapy were recruited from three ter...Objective:To determine factors that influence comfort in head and neck neoplasm patients receiving radiotherapy.Methods:In total,200 head and neck neoplasm patients receiving radiotherapy were recruited from three tertiary first class hospitals.They were assessed by Radiotherapy Comfort Questionnaire for patients with head and neck neoplasm,Social Support Scale,and Medical Coping Modes Questionnaire.Results:The total score of comfort was 60.54±8.32.Multiple linear regression analysis indicated that number of radiation treatments,family accompaniment,educational level,resignation coping mode,complications due to diabetes,accompanying chemotherapy,and the utilization of social support significantly influenced comfort level(p<0.05).Among these,number of radiation treatments,complications due to diabetes,accompanying chemotherapy,and resignation coping were negative factors.Conclusion:Encouraging utilization of social support systems and a positive coping mode is important for increasing comfort level in head and neck neoplasm patients during radiotherapy.Nurses should pay particular attention to those patients during later stages of radiotherapy or chemotherapy,with diabetes,without family accompaniment,and with lower education level.展开更多
Radiotherapy (RT) in the head and neck, despite coming from technological evolution, is challenged by the acute and late side effects of local irradiation, including permanent loss of saliva, osteoradionecrosis, denta...Radiotherapy (RT) in the head and neck, despite coming from technological evolution, is challenged by the acute and late side effects of local irradiation, including permanent loss of saliva, osteoradionecrosis, dental caries induced by radiation and necrosis of the oral cavity, mucositis, xerostomia and secondary infections like candidiasis. Since these manifestations are limiting and the integrity of the vital organs contemplates the patient’s general health status, the oral health-related quality of life (OHRQoL) can be significantly aff<span style="font-family:Verdana;">ected by the treatment of head and neck cancer (HNC), since cancer ca</span><span style="font-family:Verdana;">n cause important changes in vital functions related to communication, food and social contact, causing disturbances in the patient’s life. An observational and longitudinal study was carried out with 16 cancer patients submitted to RT in the head and neck, between the years 2019-2020 with the objectives of collecting clinical and epidemiological data on the main oral changes caused by RT in the head and neck and correlating them with the impact on OHRQoL. To analyze the OHRQoL, the University of Washington’s Quality of Life Assessment questionnaire (UW-QOL) was applied once a week for 4 weeks and </span><span style="font-family:Verdana;">to observe oral manifestations, a dental clinic file standardized by the re</span><span style="font-family:Verdana;">searchers was applied. The main oral manifestations clinically observed were hyposalivation, trismus and oral mucositis. The UW-QOL presented pain, chewing and taste as the main complaints reported by patients, however, appearance, salivation and chewing showed statistically significant differences over t</span><span style="font-family:Verdana;">he weeks. The main manifestations observed were hyposalivation, trismus</span><span style="font-family:Verdana;"> and oral mucositis, the physical limitations resulting from these manifestations impact the OHRQoL of cancer patients in terms of appearance, salivation and chewing.</span>展开更多
目的使用网状meta分析评价不同吞咽训练方案对头颈部肿瘤放疗患者吞咽功能的影响。方法计算机检索建库至2023年3月31日知网、万方、维普、Sinomed、Pubmed、Embase、EBSCO、Web of Science及Cochrane Library数据库中有关吞咽功能训练...目的使用网状meta分析评价不同吞咽训练方案对头颈部肿瘤放疗患者吞咽功能的影响。方法计算机检索建库至2023年3月31日知网、万方、维普、Sinomed、Pubmed、Embase、EBSCO、Web of Science及Cochrane Library数据库中有关吞咽功能训练对头颈部肿瘤放疗患者吞咽功能影响的随机对照试验,并追溯已发表系统评价及meta分析中的纳入文献。由2名研究人员独立筛选文献、提取资料及质量评价,并采用Stata 16.0软件进行网状meta分析。结果纳入19篇文献,共1160例研究对象,干预措施采用包括由舌、唇、下颌、咽喉部动作范围练习、发音训练、Masako训练、门德尔松吞咽法、用力吞咽法、舌抗阻训练、声门上/超声门上吞咽训练、Shaker训练和CTAR训练9种吞咽功能训练方式组合成的不同吞咽训练方案。网状meta分析结果显示,与常规护理相比,采用不同吞咽训练方案可改善患者的吞咽功能,其中以舌、唇、下颌、咽喉部动作范围练习+Shaker训练和舌、唇、下颌、咽喉部动作范围练习+Mendelsohn吞咽法+用力吞咽+声门上/超声门上训练效果最佳。结论推荐临床优先将舌、唇、下颌、咽喉部动作范围练习+Shaker训练和舌、唇、下颌、咽喉部动作范围练习+Mendelsohn吞咽法+用力吞咽+声门上/超声门上训练作为改善患者吞咽障碍的最优吞咽训练方案。展开更多
文摘Deformable image registration (DIR) has been an important component in adaptive radiotherapy (ART). Our goal was to examine the accuracy of ART using the dice similarity coefficient (DSC) and to determine the optimal timing of replanning. A total of 22 patients who underwent volume modulated arc therapy (VMAT) for head and neck (H&N) cancers were prospectively analyzed. The planning target volume (PTV) was to receive a total of 70 Gy in 33 fractions. A second planning CT scan (rescan) was performed at the 15th fraction. The DSC was calculated for each structure on both CT scans. The continuous variables to predict the need for replanning were assessed. The optimal cut-off value was determined using receiver operating characteristic (ROC) curve analysis. In the correlation between body weight loss and DSC of each structure, weight loss correlated negatively with DSC of the whole face (rs = -0.45) and the face surface (rs = -0.51). Patients who required replanning tended to have experienced rapid weight loss. The threshold DSC was 0.98 and 0.60 in the whole face and the face surface, respectively. Patients who showed low DSC in the whole face and the face surface required replanning at a significantly high rate (P < 0.05 and P < 0.01). Weight loss correlated with DSC in both the whole face and the face surface (P < 0.05 and P < 0.05). The DSC values in the face predicted the need for replanning. In addition, weight loss tended to correlate with DSC. DIR during ART was found to be a useful tool for replanning.
文摘Objective:To determine factors that influence comfort in head and neck neoplasm patients receiving radiotherapy.Methods:In total,200 head and neck neoplasm patients receiving radiotherapy were recruited from three tertiary first class hospitals.They were assessed by Radiotherapy Comfort Questionnaire for patients with head and neck neoplasm,Social Support Scale,and Medical Coping Modes Questionnaire.Results:The total score of comfort was 60.54±8.32.Multiple linear regression analysis indicated that number of radiation treatments,family accompaniment,educational level,resignation coping mode,complications due to diabetes,accompanying chemotherapy,and the utilization of social support significantly influenced comfort level(p<0.05).Among these,number of radiation treatments,complications due to diabetes,accompanying chemotherapy,and resignation coping were negative factors.Conclusion:Encouraging utilization of social support systems and a positive coping mode is important for increasing comfort level in head and neck neoplasm patients during radiotherapy.Nurses should pay particular attention to those patients during later stages of radiotherapy or chemotherapy,with diabetes,without family accompaniment,and with lower education level.
文摘Radiotherapy (RT) in the head and neck, despite coming from technological evolution, is challenged by the acute and late side effects of local irradiation, including permanent loss of saliva, osteoradionecrosis, dental caries induced by radiation and necrosis of the oral cavity, mucositis, xerostomia and secondary infections like candidiasis. Since these manifestations are limiting and the integrity of the vital organs contemplates the patient’s general health status, the oral health-related quality of life (OHRQoL) can be significantly aff<span style="font-family:Verdana;">ected by the treatment of head and neck cancer (HNC), since cancer ca</span><span style="font-family:Verdana;">n cause important changes in vital functions related to communication, food and social contact, causing disturbances in the patient’s life. An observational and longitudinal study was carried out with 16 cancer patients submitted to RT in the head and neck, between the years 2019-2020 with the objectives of collecting clinical and epidemiological data on the main oral changes caused by RT in the head and neck and correlating them with the impact on OHRQoL. To analyze the OHRQoL, the University of Washington’s Quality of Life Assessment questionnaire (UW-QOL) was applied once a week for 4 weeks and </span><span style="font-family:Verdana;">to observe oral manifestations, a dental clinic file standardized by the re</span><span style="font-family:Verdana;">searchers was applied. The main oral manifestations clinically observed were hyposalivation, trismus and oral mucositis. The UW-QOL presented pain, chewing and taste as the main complaints reported by patients, however, appearance, salivation and chewing showed statistically significant differences over t</span><span style="font-family:Verdana;">he weeks. The main manifestations observed were hyposalivation, trismus</span><span style="font-family:Verdana;"> and oral mucositis, the physical limitations resulting from these manifestations impact the OHRQoL of cancer patients in terms of appearance, salivation and chewing.</span>
文摘目的使用网状meta分析评价不同吞咽训练方案对头颈部肿瘤放疗患者吞咽功能的影响。方法计算机检索建库至2023年3月31日知网、万方、维普、Sinomed、Pubmed、Embase、EBSCO、Web of Science及Cochrane Library数据库中有关吞咽功能训练对头颈部肿瘤放疗患者吞咽功能影响的随机对照试验,并追溯已发表系统评价及meta分析中的纳入文献。由2名研究人员独立筛选文献、提取资料及质量评价,并采用Stata 16.0软件进行网状meta分析。结果纳入19篇文献,共1160例研究对象,干预措施采用包括由舌、唇、下颌、咽喉部动作范围练习、发音训练、Masako训练、门德尔松吞咽法、用力吞咽法、舌抗阻训练、声门上/超声门上吞咽训练、Shaker训练和CTAR训练9种吞咽功能训练方式组合成的不同吞咽训练方案。网状meta分析结果显示,与常规护理相比,采用不同吞咽训练方案可改善患者的吞咽功能,其中以舌、唇、下颌、咽喉部动作范围练习+Shaker训练和舌、唇、下颌、咽喉部动作范围练习+Mendelsohn吞咽法+用力吞咽+声门上/超声门上训练效果最佳。结论推荐临床优先将舌、唇、下颌、咽喉部动作范围练习+Shaker训练和舌、唇、下颌、咽喉部动作范围练习+Mendelsohn吞咽法+用力吞咽+声门上/超声门上训练作为改善患者吞咽障碍的最优吞咽训练方案。
