Proton Therapy for Vaginal Reirradiation.
Proton Therapy for Vaginal Reirradiation.
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DOI：
10.14338/ijpt-16-00013.1
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发表时间：
2016-01-01
影响因子：
1.7
通讯作者：
Lin, Lilie
中科院分区：
文献类型：
--
作者：
Li, Yun Rose;Kirk, Maura;Lin, Lilie
有骨盆放射史的可手术患者的原发性或复发性妇科癌症通常基于与再放射史相关的晚期毒性风险进行手术治疗。许多研究表明，与使用光子的传统放射治疗（RT）相比，质子治疗（PT）通过减少对健康组织的辐射剂量，为妇科癌症患者提供了剂量学优势。因此，我们期望，在适当选择的病例中，PT可以在不影响治疗效果的情况下减少长期治疗相关的发病率。在此，我们描述了一位在骨盆放疗后近30年接受PT治疗的原发性阴道癌患者的治疗计划、技术和长期随访。通过这个病例，我们说明了PT在治疗发生在不太有利部位、靠近正常结构、低辐射耐受性或有既往放疗史的患者中的效用和优势。此外，我们提供了一个简短的讨论和回顾文献先前的病例系列盆腔再照射，说明确定治疗方法的价值，可以减少治疗相关的发病率，特别是晚期治疗毒性。
Primary or recurrent gynecologic cancers in operable patients with a history of prior pelvic radiation are typically treated with surgery based on the risk of late toxicities historically associated with reirradiation. A number of studies have demonstrated that, compared with conventional radiation therapy (RT) using photons, proton therapy (PT) offers dosimetric advantages for patients with gynecologic cancers by reducing radiation dose to healthy tissues. Thereby, we expect that, in appropriately selected cases, PT may reduce long-term treatment-related morbidities without compromising treatment efficacy. Herein, we describe the treatment planning, technique, and long-term follow-up of a patient who was treated with PT for a primary vaginal carcinoma nearly 30 years after a prior course of pelvic RT. Using this case, we illustrate the utility and advantages of PT in the treatment of cancers that occur at less favorable sites, adjacent to normal structures with low radiation tolerance, or in paients with a history of prior irradiation. Additionally, we provide a brief discussion and review of literature of prior case series of pelvic reirradiation, illustrating the value of identifying treatment approaches that can reduce treatment-related morbidities, particularly late treatment toxicities.