Objective:To evaluate the acute toxicities and related influencing factors of vertebral-body-sparing proton craniospinal irradiation (VBSpCSI) using pencil beam scanning (PBS) technology in pediatric patients, and to assess spinal growth and survival outcomes.Methods:A retrospective analysis was conducted on 70 pediatric patients treated with PBS-based VBSpCSI at Hebei Yizhou Cancer Hospital between January 2020 and December 2022, and continued to follow up until November 2023. Acute toxicities were assessed, and linear regression analysis combined with receiver operating characteristic curve were employed to investigate the dose-effect relationship between vertebral dose and toxicities. Spinal growth after radiotherapy was evaluated by measuring the Cobb angle on follow-up MRI. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method.Results:The median age of patients at the time of irradiation was 6 years (range, 2-16 years). Two patients (3%) developed grade ≥3 gastrointestinal toxicities, while 7 patients (10%) experienced grade 1 radiation-induced esophagitis. The nadirs of white blood cell count (WBC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) during treatment were significantly negatively correlated with vertebral V 5 Gy ( P=0.009, 0.006, 0.001) and vertebral V 20 Gy ( P=0.007, 0.011, <0.001). When vertebral V 5 Gy<86.5% and vertebral V 20 Gy<73.2%, the incidence of grade ≥3 myelosuppression was significantly reduced ( P<0.001, =0.001). Additionally, younger patient age (in months) and concurrent chemotherapy were also significantly associated with increased acute hematologic toxicity. Among 43 patients with MRI follow-up, no scoliosis, kyphosis, or chronic lumbosacral pain was observed. The 3-year OS and PFS rates were 95.7% and 86.4%, respectively. Conclusions:PBS-based VBSpCSI in pediatric patients demonstrates manageable acute toxicities, with a clear dose-effect relationship between vertebral V 5 Gy , V 20 Gy and hematologic toxicities, and the incidence of non-hematological toxicities remains low. No adverse effects on spinal growth or survival outcomes were observed in the short term.

Objective:To evaluate the acute toxicities and related influencing factors of vertebral-body-sparing proton craniospinal irradiation (VBSpCSI) using pencil beam scanning (PBS) technology in pediatric patients, and to assess spinal growth and survival outcomes.Methods:A retrospective analysis was conducted on 70 pediatric patients treated with PBS-based VBSpCSI at Hebei Yizhou Cancer Hospital between January 2020 and December 2022, and continued to follow up until November 2023. Acute toxicities were assessed, and linear regression analysis combined with receiver operating characteristic curve were employed to investigate the dose-effect relationship between vertebral dose and toxicities. Spinal growth after radiotherapy was evaluated by measuring the Cobb angle on follow-up MRI. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method.Results:The median age of patients at the time of irradiation was 6 years (range, 2-16 years). Two patients (3%) developed grade ≥3 gastrointestinal toxicities, while 7 patients (10%) experienced grade 1 radiation-induced esophagitis. The nadirs of white blood cell count (WBC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) during treatment were significantly negatively correlated with vertebral V 5 Gy ( P=0.009, 0.006, 0.001) and vertebral V 20 Gy ( P=0.007, 0.011, <0.001). When vertebral V 5 Gy<86.5% and vertebral V 20 Gy<73.2%, the incidence of grade ≥3 myelosuppression was significantly reduced ( P<0.001, =0.001). Additionally, younger patient age (in months) and concurrent chemotherapy were also significantly associated with increased acute hematologic toxicity. Among 43 patients with MRI follow-up, no scoliosis, kyphosis, or chronic lumbosacral pain was observed. The 3-year OS and PFS rates were 95.7% and 86.4%, respectively. Conclusions:PBS-based VBSpCSI in pediatric patients demonstrates manageable acute toxicities, with a clear dose-effect relationship between vertebral V 5 Gy , V 20 Gy and hematologic toxicities, and the incidence of non-hematological toxicities remains low. No adverse effects on spinal growth or survival outcomes were observed in the short term.

Objective: To analyze the status quo and influencing factors of psychological collectivism of nurses in hematology department of tertiary care hospital, so as to provide guidance for improving the cohesion of nurses in hematology department. Methods: A total of 249 hematological nurses from 6 tertiary care hospitals in Wuhan and Jingzhou were selected by convenience sampling. The basic information and psychological collectivism scale (PCS) were used to investigate psychological collectivism. Results: The score of psychological collectivism of nurses in hematology department was 53.21±6.84. Univariate analysis showed that the scores of psychological collectivism of nurses in hematology department had significant differences in age, educational background, professional title, hospital grade, children or not, working hours, advanced studies, monthly income and employment methods (F=5.125-76.674, P<0.05). The occupational expectation score was 75.06±6.25 and the occupational values score was 92.32±5.84 in the nurses from Hematology Department of tertiary hospitals, the Pearson correlation analysis showed that career expectation, career values and psychological collectivism were significantly positively correlated (r=0.510, 0.624, P<0.01). Multivariate linear regression equation showed that educational background, professional title, children, working hours, advanced education, hospital level, monthly income, career expectations and professional values were significant influencing factors of psychological collectivism of hematological nurses (P<0.01). Conclusions The level of psychological collectivism of nurses in hematology department is relatively high. We should fully realize the importance of psychological collectivism of nurses and improve the psychological tendency of nurses in hematology department towards collective.