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目的 探讨影响直肠癌容积旋转调强放疗（volumetric modulated arc therapy, VMAT）期间膀胱充盈程度的相关因素，并建立膀胱体积预测模型，为临床膀胱准备和放疗管理提供参考。方法 选取2021年4月至8月在中山大学肿瘤防治中心接受VMAT放疗的10例初治直肠癌患者。每日放疗前行锥形束计算机断层扫描（cone-beam computed tomography, CBCT）扫描，勾画CBCT图像上的膀胱轮廓并获取膀胱体积。记录成功执行膀胱准备方案分次的饮水量、饮水至CBCT扫描间隔时间、放疗分次、性别、当日是否同步化疗、体质量变化率和肿瘤TNM分期等资料。以膀胱体积为因变量，采用Pearson相关性分析探讨各变量与膀胱体积的相关性，并采用多元线性回归分析建立膀胱体积预测模型。结果 共纳入成功执行膀胱准备方案的192次放疗分次数据。Pearson相关性分析显示，膀胱体积与饮水至CBCT扫描间隔时间呈强相关（r=0.602,P<0.01），与饮水量呈中度相关（r=0.511,P<0.01），与性别（r=0.340,P<0.01）、体质量变化率（r=0.314,P<0.01）和肿瘤N分期（r=-0.367,P<0.01）呈弱相关。多元线性回归分析显示，性别、饮水量、饮水至CBCT扫描间隔时间和体质量变化率为膀胱体积的预测因素，建立回归方程为：膀胱体积（mL）=-85.097+44.344×性别+0.344×饮水量（mL）+3.079×饮水至CBCT扫描间隔时间（min）+10.080×体质量变化率（%），其中性别男性=1，女性=0。该模型拟合度较好（R2=0.650），数据满足独立性要求（DW=1.509），模型差异具有统计学意义（F=85.424,P<0.01）。结论 饮水量、饮水至CBCT扫描间隔时间、性别、体质量变化率和肿瘤N分期与直肠癌VMAT放疗期间膀胱体积相关。基于性别、饮水量、饮水至CBCT扫描间隔时间和体质量变化率构建的多元线性回归模型可用于预测膀胱体积，对指导直肠癌放疗期间膀胱准备具有一定参考价值。
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基本信息:
DOI：10.3785/syzlzz.2026.044
引用信息:
[1]林志悦,李宗泰,罗嘉秀,等.直肠癌放疗膀胱充盈情况的影响因素分析及预测模型构建[J],2026,41(4):314-318.DOI:10.3785/syzlzz.2026.044.