Objective: To examine the trajectory of psychosomatic symptoms and to explore the impact of psychosomatic symptoms on setup error in patients undergoing breast cancer radiotherapy.Methods: A total of 102 patients with...Objective: To examine the trajectory of psychosomatic symptoms and to explore the impact of psychosomatic symptoms on setup error in patients undergoing breast cancer radiotherapy.Methods: A total of 102 patients with early breast cancer who received initial radiotherapy were consecutively recruited. The M.D. Anderson Symptom Inventory(MDASI) and three different anxiety scales, i.e., the Self-Rating Anxiety Scale(SAS), State-Trait Anxiety Inventory(STAI), and Anxiety Sensitivity Index(ASI), were used in this study. The radiotherapy setup errors were measured in millimetres by comparing the real-time isocratic verification film during radiotherapy with the digitally reconstructed radiograph(DRR). Patients completed the assessment at three time points: before the initial radiotherapy(T1), before the middle radiotherapy(T2), and before the last radiotherapy(T3).Results: The SAS and STAI-State scores of breast cancer patients at T1 were significantly higher than those at T2 and T3(F=24.44, P<0.001;F=30.25, P<0.001). The core symptoms of MDASI were positively correlated with anxiety severity. The setup errors of patients with high SAS scores were greater than those of patients with low anxiety levels at T1(Z=-2.01, P=0.044). We also found that higher SAS scores were associated with a higher risk of radiotherapy setup errors at T1(B=0.458, P<0.05).Conclusions: This study seeks to identify treatment-related psychosomatic symptoms and mitigate their impact on patients and treatment. Patients with early breast cancer experienced the highest level of anxiety before the initial radiotherapy, and then, anxiety levels declined. Patients with high somatic symptoms of anxiety may have a higher risk of radiotherapy setup errors.展开更多
This study aims to evaluate inter-fractional set-up errors in patients treated with distinct immobilization equipment (thermoplastic mask, knee-fix and feet-fix, wing board and vac-lok) for four anatomical regions inc...This study aims to evaluate inter-fractional set-up errors in patients treated with distinct immobilization equipment (thermoplastic mask, knee-fix and feet-fix, wing board and vac-lok) for four anatomical regions including brain, head and neck (HN), thorax and pelvis. Data of randomly selected 140 patients who were treated for four anatomical regions were obtained using Hi-Art Helical Tomotherapy (HT) system. Pre-treatment planning was based on automatic registration readings of computed tomography (CT) and mega-voltage computed tomography (MVCT) on a daily basis. Distinct immobilization equipment was used for varying anatomical regions. Individual mean set-up error (M), systematic error (Σ), and random error (σ) values were calculated through daily translational and rotational deviation values. The size of translational, systematic and random error was 1.31 - 4.93 mm for brain, 2.28 - 4.88 mm for HN, 4.04 - 9.90 mm for thorax, and 6.34 - 14.68 mm for pelvis. Rotational values were as follows: 0.06° - 0.73° for brain, 0.42° - 0.6° for HN, 0.48° - 1.14° for thorax and 0.65° - 1.05° for pelvis. The highest translational, systematic and random error value was obtained from the pelvic regional. The highest standard and random error value in pitch and roll was produced in the rotational direction of the pelvis (0.05° and 0.71°), while the highest error value in yaw was (1.14°) produced from thorax. Inter-fractional set-up errors were most commonly produced in the pelvis, followed by thorax. Our study results suggest that the highest systematic and random errors are found for thorax and pelvis. Distinct immobilization equipment was important in these results. Safety margins around the clinical target volume (CTV) are changeable for different anatomical regions. A future work could be developed to new equipment for immobilization because of the reduced margins CTV.展开更多
文摘Objective: To examine the trajectory of psychosomatic symptoms and to explore the impact of psychosomatic symptoms on setup error in patients undergoing breast cancer radiotherapy.Methods: A total of 102 patients with early breast cancer who received initial radiotherapy were consecutively recruited. The M.D. Anderson Symptom Inventory(MDASI) and three different anxiety scales, i.e., the Self-Rating Anxiety Scale(SAS), State-Trait Anxiety Inventory(STAI), and Anxiety Sensitivity Index(ASI), were used in this study. The radiotherapy setup errors were measured in millimetres by comparing the real-time isocratic verification film during radiotherapy with the digitally reconstructed radiograph(DRR). Patients completed the assessment at three time points: before the initial radiotherapy(T1), before the middle radiotherapy(T2), and before the last radiotherapy(T3).Results: The SAS and STAI-State scores of breast cancer patients at T1 were significantly higher than those at T2 and T3(F=24.44, P<0.001;F=30.25, P<0.001). The core symptoms of MDASI were positively correlated with anxiety severity. The setup errors of patients with high SAS scores were greater than those of patients with low anxiety levels at T1(Z=-2.01, P=0.044). We also found that higher SAS scores were associated with a higher risk of radiotherapy setup errors at T1(B=0.458, P<0.05).Conclusions: This study seeks to identify treatment-related psychosomatic symptoms and mitigate their impact on patients and treatment. Patients with early breast cancer experienced the highest level of anxiety before the initial radiotherapy, and then, anxiety levels declined. Patients with high somatic symptoms of anxiety may have a higher risk of radiotherapy setup errors.
文摘This study aims to evaluate inter-fractional set-up errors in patients treated with distinct immobilization equipment (thermoplastic mask, knee-fix and feet-fix, wing board and vac-lok) for four anatomical regions including brain, head and neck (HN), thorax and pelvis. Data of randomly selected 140 patients who were treated for four anatomical regions were obtained using Hi-Art Helical Tomotherapy (HT) system. Pre-treatment planning was based on automatic registration readings of computed tomography (CT) and mega-voltage computed tomography (MVCT) on a daily basis. Distinct immobilization equipment was used for varying anatomical regions. Individual mean set-up error (M), systematic error (Σ), and random error (σ) values were calculated through daily translational and rotational deviation values. The size of translational, systematic and random error was 1.31 - 4.93 mm for brain, 2.28 - 4.88 mm for HN, 4.04 - 9.90 mm for thorax, and 6.34 - 14.68 mm for pelvis. Rotational values were as follows: 0.06° - 0.73° for brain, 0.42° - 0.6° for HN, 0.48° - 1.14° for thorax and 0.65° - 1.05° for pelvis. The highest translational, systematic and random error value was obtained from the pelvic regional. The highest standard and random error value in pitch and roll was produced in the rotational direction of the pelvis (0.05° and 0.71°), while the highest error value in yaw was (1.14°) produced from thorax. Inter-fractional set-up errors were most commonly produced in the pelvis, followed by thorax. Our study results suggest that the highest systematic and random errors are found for thorax and pelvis. Distinct immobilization equipment was important in these results. Safety margins around the clinical target volume (CTV) are changeable for different anatomical regions. A future work could be developed to new equipment for immobilization because of the reduced margins CTV.
