POJAVNOST STRANSKIH UČINKOV PRI OBSEVANJU RAKA DANKE IN ANALNEGA KANALA Z UPORABO BOLUSA...Radiological Societies Engineers of Slovenia Proceedings and lectures posters IV. Congress, 25-26 May, 2018, Zreče, Slovenia.
Introduction and purpose: Rectal and anal canal cancers are among the leading causes of death nowadays. One of the treatment methods is also radiotherapy. On account of surface tumors and due to the characteristics of the photonic beam at depth, a bolus is used in order to enable the dose to increas...
| Publicado en: | Bulletin: Newsletter of the Society of Radiographers of Slovenia & the Chamber of Radiographers of Slovenia Vol. 35; pp. 10 - 12 |
|---|---|
| Autores principales: | , , , |
| Formato: | abstract proceedings research Journal Article |
| Publicado: |
Slovenian Society of Radiographers
2018 Supplement
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| Sumario: | Introduction and purpose: Rectal and anal canal cancers are among the leading causes of death nowadays. One of the treatment methods is also radiotherapy. On account of surface tumors and due to the characteristics of the photonic beam at depth, a bolus is used in order to enable the dose to increase toward the surface; however, this also increases the prominence of side effects on the skin and mucous membrane. The purpose of the research is to determine which side effects are caused by the use of a bolus in irradiation of the above-mentioned cancers, how they present themselves, and when they appear. Methods: The descriptive method with a systematic literature review was used. The data were obtained retrospectively by means of the Webdoctor program and Mosaiq system of the Varian radiation system (Clinac 2100 C/D) at the Department of Radiotherapy, Institute of Oncology Ljubljana from 1 November 2014 to 31 January 2017. 30 patients with rectal and anal canal cancer, irradiated by intensity-modulated radiotherapy were included in the study. 15 patients were irradiated with a bolus, while the other 15 patients were irradiated without it. The analysis was made using Microsoft Office Excel 2016 and IBM SPSS 24 computer programs. Results and discussion: The results indicated multiple side effects in patients irradiated using a bolus (radiodermatitis - RD, burning pain in perianal and inguinal area, burning or obstructed urination). To determine the differences between the patients treated with and without a bolus, we used the chi-square test. The most pronounced was RD, which most often presents itself in patients treated with a bolus; namely first-degree (53.3 %; p = 0.003), second-degree (86.7 %; p < 0.001 ), and third-degree (46.7 %; p = 0.010). Statistically significant differences were present in the onset of RD, in all degrees, depending on whether the patients were irradiated with or without a bolus. The most pronounced side effects in patients treated without a bolus were diarrhea and dysuria. Conclusion: In the irradiation of surface tumors, a bolus is used so that the target volume receives the optimum dose. It is crucial that the resulting side effects are recognized and treated as soon as they occur. Uvod in namen: Rak danke in analnega kanala predstavljata enega izmed vodilnih vzrokov smrti v današnjem času. Metoda zdravljenja je tudi radioterapija. Zaradi površinsko ležečih tumorjev in značilnosti fotonskega snopa v globini bolnika, se uporabi bolus, ki omogoči dvig doze proti površju, vendar so stranski učinki na koži in sluznici izrazitejši. Namen raziskave je ugotoviti, katere stranske učinke povzroča uporaba bolusa pri obsevanju omenjenih rakov, kako so izraženi in kdaj se pojavijo. Metode dela: V raziskavi smo uporabili deskriptivno metodo dela s sistematičnim pregledom literature. Retrospektivno smo pridobili podatke v programu Webdoctor in sistemu Mosaiq obsevalnega aparata (Clinac 2100 C/D) Varian na radioterapevtskem oddelku Onkološkega inštituta Ljubljana od 1. 11. 2014 do 31. 1. 2017. Vključenih je bilo 30 bolnikov z rakom danke in analnega kanala, obsevanih s tehniko intenzitetno modulirane radioterapije. Z uporabo bolusa je bilo obsevanih 15 bolnikov, ostalih 15 bolusa niso imeli. Analiza je bila narejena s pomočjo računalniškega programa Microsoft Offi ce Excel 2016 in IBM SPSS 24. Rezultati in razprava: Rezultati so pokazali več stranskih učinkov pri obsevanih bolnikih z bolusom (radiodermatitis – RD, pekoče bolečine perianalno in v ingvinalnem predelu, pekoče ali ovirano uriniranje). Za ugotavljanje razlik med bolniki z in brez bolusa smo uporabili Hi-kvadrat test. Najpogosteje izražen RD se v večji meri pojavlja pri bolnikih z bolusom – 1. stopnja (53,3 %; p = 0,003), 2. stopnja (86,7 %; p < 0,001 ) in 3. stopnja (46,7; p = 0,010). Statistično značilne razlike so v pojavnosti RD pri vseh stopnjah glede na to, ali bolnike obsevajo z bolusom ali brez. Najpogosteje izražena stranska učinka pri bolnikih brez bolusa sta diareja in disurija. Zaključek: Bolus pri obsevanju površinsko ležečih tumorjev uporabimo z namenom, da tarčni volumen prejme optimalno dozo. Pomembno je, da se nastali stranski učinki spoznajo in zdravijo takoj, ko se pojavijo. |
|---|