Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Mối liên hệ giữa liều thể tích bức xạ ruột và sự mất khối cơ xương trong quá trình xạ trị điều biến cường độ ở bệnh nhân ung thư cổ tử cung
Tóm tắt
Tổn thương ruột do bức xạ có thể ảnh hưởng đến quá trình hấp thụ và tiêu hóa dinh dưỡng, đồng thời tác động đến thành phần cơ thể trong quá trình xạ trị vùng chậu ở bệnh nhân ung thư cổ tử cung giai đoạn địa phương (LACC). Nghiên cứu này nhằm đánh giá mối quan hệ giữa liều thể tích bức xạ ruột và các thay đổi về thành phần cơ thể trong quá trình xạ trị. Dữ liệu của 301 bệnh nhân LACC được điều trị bằng hóa xạ trị đã được phân tích. Các thay đổi về chỉ số cơ xương (SMI) và mật độ (SMD), cũng như chỉ số mô mỡ toàn thân (TATI) đã được đo từ hình ảnh chụp cắt lớp vi tính tại mức đốt sống L3. Sự giảm SMI, SMD, hoặc TATI ≥10% được phân loại là “mất mát.” Thể tích ruột V45 chỉ lượng ruột (mL) nhận liều bức xạ ≥45 Gy. Mối quan hệ giữa thành phần cơ thể và V45 của ruột được phân tích bằng cách sử dụng các mô hình hồi quy logistic. Sau điều trị, 61 (20,3%), 81 (26,9%), và 97 (32,2%) bệnh nhân có sự mất SMI, SMD và TATI tương ứng. Tăng V45 ruột có liên quan độc lập đến tăng xác suất mất SMI (tỷ lệ odds [OR]: 1,012; khoảng tin cậy [CI]: 1,007–1,018; p<0,001) và mất TATI (OR: 1,006; 95% CI: 1,001–1,010; p=0,01), nhưng không liên quan đến mất SMD (OR: 1,005; 95% CI: 1,000–1,009; p=0,054). Giá trị cắt ngang với độ chính xác cao nhất để dự đoán mất SMI là V45 ≥222 mL; tỷ lệ mất SMI cao hơn đáng kể ở 40,0% bệnh nhân với V45 ≥222 mL so với 13,7% bệnh nhân với V45 <222 mL (p<0,001). Liều thể tích bức xạ ruột cao hơn có sự liên quan đáng kể đến sự mất khối cơ trong quá trình xạ trị vùng chậu. Cần chú ý đến liều thể tích ruột trong việc tư vấn dinh dưỡng cá nhân hóa và chăm sóc hỗ trợ trong thực hành lâm sàng.
Từ khóa
#bức xạ ruột #ung thư cổ tử cung #khối cơ xương #xạ trị điều biến cường độ #thay đổi thành phần cơ thểTài liệu tham khảo
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