Objective Risk perception and disease cognition may influence the efficiency of lung cancer screening by affecting the participation rate. There is still some uncertainty regarding the association between risk perception and disease cognition and how they affect participation in lung cancer screening. Therefore, we explored the influence of risk perception and disease cognition on the willingness to participate in screening among people at high risk of lung cancer. Methods Subjects with high-risk factors for lung cancer were recruited in Lu’an City, Anhui Province, China. Questionnaires were used to determine their demographic characteristics, risk perception, disease cognition, and willingness to engage in screening. Results Of the 1955 subjects with high risk factors for lung cancer, 1136 (58.12%) were willing to participate in lung cancer screening. Univariable and multivariable analyses showed that disease cognition ( adj OR = 2.012, 95% CI: 1.528–2.649, P = 0.000), cognitive risk ( adj OR = 7.661, 95% CI: 6.049–9.704, P = 0.000), and affective risk ( adj OR = 5.964, 95% CI: 4.552–7.815, P = 0.000) were significant factors in promoting screening participation. For those with moderate risk perception, improving disease cognition was a key approach to increase screening participation. Conclusion This study elucidated the relationship between various factors and lung cancer screening participation and proposed a feasible route for the screening implementation, providing a theoretical basis to further improve the participation rate and efficiency of lung cancer screening.

目的:探索分析肺癌高风险人群参与筛查意愿的影响因素.方法:招募具有肺癌高风险因素的受试者1955例,开展问卷调查人口学特征、疾病认知情况和参与筛查意愿,采用Logistic回归分析筛查意愿的影响因素.结果:在1955例具有肺癌高风险因素的受试者中,1136例(58.12％)愿意参与肺癌筛查.疾病认知中预防相关知识(OR=1.519,95％CI=1.401～1.648,P<0.001)、筛查相关知识(OR=1.246,95％CI=1.094～1.418,P=0.001)与筛查意愿正相关;治疗相关知识(OR=0.785,95％CI=0.704～0.875,P<0.001)、当前吸烟状态(OR=0.609,95％CI=0.450～0.825,P=0.001)与筛查意愿负相关.结论:本研究发现疾病认知是高风险人群参与肺癌筛查实践的重要影响因素,为进一步寻找特定人群开展针对性健康宣教,提高筛查参与度提供相关信息.

目的 研究家庭赋权方案在食管癌放疗患者及主要照顾者中的应用效果.方法 选择2020年6月—2021年10月入住安徽某三甲医院肿瘤放疗科的首次接受食管癌放疗患者64例及主要照顾者为研究对象,将患者随机分为实验组和对照组两组,每组各32例.实验组接受家庭赋权方案及常规护理,对照组接受常规护理.比较两组患者心理韧性量表评分和两组主要照顾者照顾能力评分、Zarit护理者负担量表评分.结果 干预前两组患者及主要照顾者一般资料比较,差异无统计学意义(P>0.05);干预后实验组患者心理韧性总分及各维度评分均高于对照组,差异有统计学意义(P>0.05);干预后实验组主要家庭照顾者照顾能力总分及各维度评分、Zarit护理者负担评分均低于对照组,差异均有统计学意义(P<0.05).结论 家庭赋权方案可改善食管癌放疗患者心理韧性,提高主要照顾者的照顾能力,减轻照顾负担.

Objective:To discuss the clinical value and safety of individualized helical tomotherapy radical radiotherapy united with chemotherapy in patients with stage IV non-small cell lung cancer (NSCLC). Methods:40 patients with NSCLC in stage IV were enrolled in this retrospective study, and all of them were admitted to Air Force General Hospital from October 2011 to December 2013. They were treated by helical tomotherapy radical radiotherapy united with chemotherapy. Results:The CR and PR rates of the treated tumor were 5%and 65%. The effective rate (CR+PR) was 70.0%. The 1 and 2 years local control rates were 67.5%and 42.5%. The progression-free survivals were 32.5%and 7.5%. The overall survival time rates were 50.0%and 7.5%, respectively. Of the 40 patients, the median progression-free time was 8 months and the median survival time was 12 months. There were no significant differences among age, sex, smoking history or numbers of metastatic organs. The toxicities in most of the patients were grade 1 and grade 2, minority of them was grade 3, and none was grade 4. Conclusion:We showed that united individualized helical tomotherapy radical radiotherapy and chemotherapy can be effective, improve the quality of life and be safe.

目的：分析靶中靶放射治疗食管癌的近期疗效、局控率、生存期及不良反应。方法回顾性分析32例食管癌患者接受螺旋断层放射治疗，给予靶中靶剂量层层递增的治疗模式，治疗计划：计划靶区（PTV）剂量/大体肿瘤区（GTV）剂量/次数：60 Gy/（66～70）Gy/30次，5次/周，6周完成。生存分析采用Kaplan-Meier法。结果总有效率为93.8%，1、2年局部控制率分别为94.70%、88.90%，局部复发率为18.75%；1、2年生存率分别为53.1%、30.0%，中位生存期为13个月，其中Ⅱ期的1、2年生存率分别为62.5%、46.9%，中位生存期为24个月；Ⅲ期的1、2年生存率分别为45.5%、34.1%，中位生存期为13个月；Ⅳ期的1、2年生存率分别为38.5%、7.7%，中位生存期为7个月。发生急性放射性食管炎1级的11例（34.4%），2级的5例（15.6%）；发生急性放射性肺炎1级的2例（6.3%），2级的3例（9.4%），而且均经对症治疗后缓解。结论靶中靶放射治疗为在满足PTV 60 Gy同时，给予GTV更高剂量，形成洋葱皮样剂量梯度，提高了局部剂量，局部控制有效，而且急性放射性肺炎与急性放射性食管炎的发生率低，多为1、2级，显示了靶中靶治疗的优势，是食管癌患者有效的治疗选择。