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Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding01:15

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Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
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Enteral nutrition delivers nutrients directly to the stomach or small intestine through a tube. This method is appropriate for patients who cannot eat but still have a functioning digestive system. It is also beneficial for individuals with swallowing difficulties, anorexia, malabsorption, or those who have undergone gastrointestinal (GI) surgery.
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Gustation, or the sense of taste, is intrinsically linked to the anatomical structures located on the tongue. This organ's surface, along with the entirety of the oral cavity, is adorned with stratified squamous epithelium. Evident on the tongue are elevated structures known as papillae (singular = papilla), which house the mechanisms for the transduction of gustatory stimuli. Four distinct types of papillae exist, each identified by their unique morphological attributes: the circumvallate,...
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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
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嚥下障害に最適化された知識ベース計画:頭頸部がん

Tu Thi1,2, Kirk Luca1, Justin Roper1

  • 1Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA.

Journal of applied clinical medical physics
|February 24, 2026
PubMed
まとめ

新しい嚥下障害最適化知識ベース計画(DO-KBP)モデルは、放射線療法後の嚥下構造への放射線量を大幅に削減します。この標的化されたアプローチは、全体的な治療品質を損なうことなく、患者のアウトカムを改善します。

キーワード:
constrictor musclesdysphagiahead and neck cancerknowledge‐based planningtreatment planningvolumetric modulation radiation therapy

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科学分野:

  • 放射線腫瘍学
  • 医用物理学
  • 頭頸部がん治療

背景:

  • 頭頸部がんの放射線療法は、咽頭粘膜の損傷により嚥下機能障害を引き起こす可能性があります。
  • 従来の治療計画では、咽頭を単一の構造として扱うことが多く、最適とは言えない線量分布につながる可能性があります。

研究 の 目的:

  • 嚥下障害に最適化された知識ベース計画(DO-KBP)モデルを開発すること。
  • 個々の咽頭収縮筋を治療計画に組み込むことにより、嚥下構造の保護を改善すること。

主な方法:

  • 175件の頭頸部症例で従来の咽頭知識ベース計画(P-KBP)モデルを訓練しました。
  • 収縮筋が描画された36件の口腔咽頭症例でP-KBPモデルを拡張し、DO-KBPモデルを作成しました。
  • 線量測定パラメータと医師の好みを比較して、25件のテスト患者で両方のモデルを評価しました。

主要な成果:

  • DO-KBPモデルは、下咽頭収縮筋(36.52 Gyから19.52 Gy)および中咽頭収縮筋(51.89 Gyから47.46 Gy)の平均線量を大幅に減少させました。
  • リスク臓器(脊髄PRV、蝸牛、下顎骨、腕神経叢)への線量の軽微で臨床的に許容可能な増加が観察されました。
  • 計画の均一性は同等であり、盲検化された医師によるレビューではDO-KBP計画が好まれました。

結論:

  • 個別に輪郭形成された収縮筋による標的化されたデータ拡張は、嚥下構造の保護を大幅に強化します。
  • DO-KBPモデルは、全体的な計画品質を損なうことなく、またはOAR線量閾値を超えることなく、臨床的に意味のある改善を達成します。
  • 標的化されたデータ拡張は、頭頸部がん患者の放射線療法計画を最適化するための効果的な戦略です。