摘要目的:探讨乳腺癌患者心理状态对放疗摆位误差的影响。方法:前瞻性队列研究。选取中国医学科学院北京协和医学院肿瘤医院2022年10月至2023年5月收治的193例乳腺癌患者，均采用头胸腹一体多功能装置固定后进行放疗。患者首次放疗前、第10次放疗和末次放疗时采用9条目患者健康问卷（PHQ-9）和广泛性焦虑自评量表（GAD-7）对患者心理状态进行评估。根据评估结果将患者分为有心理问题[焦虑和（或）抑郁]组和无心理问题组，比较两组患者的一般资料和放疗摆位误差。结果:193例患者均为女性，中位年龄47岁。有心理问题组53例，共行507次图像引导，在左右（X）、头脚（Y）、腹背（Z）方向上的摆位误差分别为[ M（ Q1， Q3）]0.18（0.07，0.33）、0.20（0.10，0.33）和0.19（0.09，0.30）；无心理问题组140例，共行1 240次图像引导，在X、Y和Z方向上的摆位误差分别为0.17（0.08，0.30）、0.20（0.10，0.30）和0.18（0.09，0.28）；两组在Y和Z方向上的摆位误差比较，差异均有统计学意义（ Z值分别为-3.78、-2.00， P值分别为<0.001、0.046）。 结论:焦虑和抑郁对乳腺癌患者放疗摆位误差有影响，在乳腺癌放疗过程中需要关注患者心理状态。

abstractsObjective:To investigate the effects of psychological state on the setup errors of radiotherapy for breast cancer patients.Methods:A prospective cohort study was conducted. A total of 193 breast cancer patients in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from October 2022 to May 2023 were selected. Radiotherapy was performed after fixation with an integrated multi-functional device for the head, chest and abdomen. Psychological status of patients was assessed by using 9-item health questionnaire (PHQ-9) and generalized anxiety disorder 7 self-rating scale (GAD-7) before first radiotherapy, the 10th radiotherapy and the last radiotherapy. Based on the results of the questionnaires, patients were divided into psychological problem (anxiety or depression) group and non-psychological problem group. The general data and setup errors of radiotherapy in both groups were compared.Results:All the 193 patients were female, with a median age of 47 years. There were 53 patients in psychological problem group and they underwent a total of 507 image-guided procedures, with setup errors [ M ( Q1, Q3)] of 0.18 (0.07, 0.33), 0.20 (0.10, 0.33) and 0.19 (0.09, 0.30) in the left-right (X), superior-inferior (Y), and anterior-posterior (Z) directions, respectively; the remaining 140 patients in non-psychological problem group underwent 1 240 image-guided procedures, with setup errors [ M ( Q1, Q3)]of 0.17 (0.08, 0.30), 0.20 (0.10, 0.30) and 0.18 (0.09, 0.28) in the X, Y, and Z directions, respectively, and the differences were statistically significant ( Z values were -3.78, -2.00; P < 0.001, P = 0.046). Conclusions:Anxiety and depression have an influence on the setup errors of radiotherapy in patients with breast cancer. In the processs of radiotherapy for breast cancer, it is important to pay attention to the psychological status of patients.