北京大学学报(医学版) ›› 2020, Vol. 52 ›› Issue (4): 688-691. doi: 10.19723/j.issn.1671-167X.2020.04.017
王皓1,姜树坤1,彭冉1,黄毅2,△(),王明清1,王俊杰1,刘承2,张帆2,马潞林2
Hao WANG1,Shu-kun JIANG1,Ran PENG1,Yi HUANG2,△(),Ming-qing WANG1,Jun-jie WANG1,Cheng LIU2,Fan ZHANG2,Lu-lin MA2
摘要:
目的: 探索个体化尿量控制训练模式,以个体化预期尿量为患者膀胱管控的目标,指导泌尿系统肿瘤患者主动感知膀胱容受性,提高放疗期间膀胱管控的精准度。方法: 选择2019年5月—9月北京大学第三医院收治的25例泌尿系统肿瘤患者。放疗定位前进行憋尿训练,要求患者以个体化膀胱适度充盈为训练目的,建议最佳的膀胱容量范围200~400 mL。训练2~4周后根据患者个体化的膀胱容受性确定放疗定位条件和放疗实施时的膀胱处方体积。患者CT模拟定位时采集平扫CT图像和静脉注射造影剂后8 min图像,分别测量膀胱体积。患者治疗前自评膀胱体积接近膀胱处方体积时使用膀胱容量测量仪测量体积,治疗前行锥形束计算机断层扫描(cone beam computed tomography,CBCT)并测量膀胱体积,治疗结束后再次使用膀胱仪测量膀胱体积。结果: 放疗前自评膀胱体积(VEVA01)与放疗前膀胱仪测量体积(VBVI01)、定位CT测量膀胱体积(VCT01)与放疗前膀胱仪测量体积(VBVI01)、定位CT测量膀胱体积(VCT01)与CBCT测量膀胱体积(VCBCT)存在相关性,配对样本t检验差异无统计学意义。定位CT体积(VCT01)与放疗前自评膀胱体积(VEVA01)、放疗前自评膀胱体积(VEVA01)与CBCT体积(VCBCT)存在相关性,配对t检验差异无统计学意义。结论: 前列腺癌和膀胱癌等泌尿系统肿瘤放疗期间,在膀胱容量测量仪的辅助下尝试让患者根据自身情况适度憋尿,个体化膀胱处方可能有利于实现放疗期间稳定的膀胱体积。
中图分类号:
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