改良电场贴片操作方法对胶质母细胞瘤肿瘤电场治疗患者头皮不良反应的影响

目的探讨改良电场贴片操作方法对胶质母细胞瘤(GBM)肿瘤电场治疗（TTFields）头皮不良反应的影响。方法选取于空军军医大学唐都医院2019年5月—2022年7月接受TTFields的73例GBM患者为研究对象，其中2021年4月前的36例采用常规电场贴片操作方法的患者为对照组，2021年5月后的37例在电场贴片粘贴、移除、高温环境维护等环节进行改进的患者为改良组。比较两组患者TTFields头皮不良反应的发生率、佩戴电场治疗的依从性等指标。结果改良组患者发生头皮瘙痒（P=0.024 6）、接触性皮炎（P=0.025 3）、皮肤溃疡（P=0.029 9）的发生率显著低于对照组，佩戴电场治疗依从性≥90%的几率较对照组显著提高（分别为81.1%和52.8%，P=0.010 1）。针对两组患者头皮不良反应的研究发现，夏季患者头皮不良反应的发生率最高（56.16%），冬季则最低（8.22%），采用改良电场贴片操作方法后，可以显著降低在夏季（P=0.000 2）、秋季（P=0.041 1）和春季（P=0.034 2）的头皮不良反应的发生。结论胶质母细胞瘤TTFields患者采用改良电场贴片的操作方法可有效预防头皮不良反应的发生，减少电场治疗的中断，提高治疗依从性。

Objective To investigate the impact of modified electric field patch operation method on scalp adverse reactions in glioblastoma(GBM) patients undergoing tumor treating fields(TTFields). Methods A total of 73 GBM patients who received TTFields from May 2019 to July 2022 in Tangdu Hospital were selected as the study subjects. Among them, 36 patients treated with the conventional electric field patch operation method before April 2021 served as the control group, and 37 treated after May 2021 were served as the modified group, using the improved technique involved adhesion and removal in electric field patch, and management in high-temperature environments. The incidence of adverse scalp reactions and compliance of TTFields were compared between the two groups. Results The incidence of scalp pruritus(P=0.024 6), contact dermatitis(P=0.025 3), and skin ulceration(P=0.029 9) in the modified group were significantly lower than those in the control group. Compliance of TTFields was significantly higher in the modified group than in the control group(81.1% vs 52.8%,P=0.010 1). The incidence of adverse scalp reactions varied with seasons, being highest in summer(56.16%) and lowest in winter(8.22%). After adopting the modified electric field patch operation method, the occurrence of adverse scalp reactions in summer(P=0.000 2), autumn(P=0.041 1), and spring(P=0.034 2) was significantly reduced. Conclusion The modified electric field patch operation method can effectively prevent scalp adverse reactions, reduce treatment interruptions, and improve treatment compliance in patients with TTFields.