ABSTRACT
Objective:To investigate the skin positioning error in total breast radiotherapy after breast cancer surgery through image analysis.Methods:The study period was from January 2019 to June 2019. A total of 80 patients who received breast-conserving breast cancer surgery and adjuvant radiotherapy during this period in Zhejiang Cancer Hospital were selected. The CT positioning image for each patient in the treatment plan was created and the relevant cone beam computed tomography verification film after the patient positioning setting was obtained during radiotherapy, and the positioning map and the verification film to each patient through image processing software skin surface location were overlapped. The isocenter deviation of the nipple-lung ( X) and cranial tail ( Y) directions and the deviation of the X and Y axis rotation angle of the superimposed image were measured. Results:In the 80 patients, the system error ( μ, Σ) and random error ( σ) were calculated based on the X-axis and Y-axis deviation and the rotation angle deviation. The μ value of X-axis, Y-axis and rotation angle were (0.01 ± 0.01) mm, (-1.35 ± 0.14) mm and (0.06 ± 0.01)°. The Σ value of X-axis, Y-axis and rotation angle were (1.76 ± 0.72) mm, (1.49 ± 0.58)mm and (0.90 ± 0.12)°. The σ value of X-axis, Y-axis and rotation angle were (1.34 ± 0.96) mm, (1.93 ± 1.02) mm and (1.0 ± 0.2)°. The average value of the total vector error in the left and right patients were (3.02 ± 1.26), (2.88 ± 1.03) and (3.25 ± 1.38) mm, which had no clinical significance. Conclusions:In the routine breast radiotherapy after breast-conserving surgery, the smallest position error of the skin can be obtained by using the skin surface position combined with image processing software.
ABSTRACT
Objective To learn the current situation and influencing factors of outpatients′perceptions of doctor-patient relationship,and to generate evidence for effective improvement of outpatients′perceptions of doctor-patient relationship.Methods Based on the results of the third party evaluation of the National Healthcare Improvement Initiative(2016-2017)in 136 hospitals, we analyzed the outpatients′perceptions of doctor-patient relationship and its influencing factors.Univariate analysis of the outpatients′perceptions of doctor-patient relationship(Chi-square test and Wilcoxon rank sum test),and binary logistic regression were conducted to analyze the influencing factors of the outpatients′perceptions of doctor-patient relationship.Results A total of 29 105 out-patients were included in this study.The average outpatient perception score of doctor-patient relationship was 3.88 ±0.99, and the median was 4.00.The perception score of outpatients pertaining to doctor-patient relationship was the highest in the eastern regions and lowest in the western regions.That of outpatients from general hospitals was highest than that of those in maternal and child hospitals and traditional Chinese medicine hospitals.Patients′waiting time for consultation,having a fixed physician or general practitioner before visiting, contracting with a community doctor or not, the overall satisfaction,and the household income and insurance coverage were all the influencing factors of the outpatients′perceptions of doctor-patient relationship(P<0.05).Conclusions There is still a long way to go before the patients can agree with the perception of a better doctor-patient relationship.The critical points for improvement include reducing waiting time for consultation, allocation of more medical resources to the western regions,improving humane care to patients and raising outpatients′overall satisfactions, especially in the departments of obstetrics and gynecology,and pediatrics.