Conformal Radiotherapy and Intensity-modulated Radiotherapy: Clinical Data
Conformal Radiotherapy and Intensity-modulated Radiotherapy: Clinical Data
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适形放射治疗和调强放射治疗：临床数据
DOI：
10.1080/028418600750013249
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发表时间：
2000
期刊：
影响因子：
3.1
通讯作者：
M. F. Eschwège
中科院分区：
文献类型：
--
作者：
M. F. Eschwège
适形放射治疗(CRT)基于三个假设：(I)较高的局部控制率可以提高生存率；(Ii)剂量递增可以提高肿瘤控制率；(Iii)CRT允许通过减少晚期效应的发生率来提供更高剂量。这些假设现在得到了几个数据的支持。三维适形放射治疗(3D-CRT)自二十年前问世以来，取得了显著的进展。然而，在某些情况下，3D-CRT由于靶区形状复杂或靠近敏感的正常组织而无法产生令人满意的治疗计划。这就是为什么调强放射治疗(IMRT)被引入的原因。它的目的是通过在光束整形中增加光束强度调制器来克服3D-CRT的局限性。调强放射治疗几乎可以实现任何剂量分布；然而，计划者的作用仍然至关重要。CRT主要用于前列腺癌和头颈癌的研究。总的来说，临床数据虽然仍然有限，但似乎证实了这种类型的放射治疗的优势。前列腺癌的剂量递增提高了局部控制率而不增加远期效应，对于这个肿瘤部位来说，调强放射治疗似乎比传统的3D-CRT有了显着的进步。头颈部癌症的临床数据仍然很少，但令人鼓舞。应对乳腺癌患者进行CRT研究，以减少晚期效应的发生率。现有数据突显了3D-CRT和IMRT取得重大进展的巨大潜力。这些技术仍然昂贵且耗时，但它们值得研究，因为它们的成本应该会降低。应集中精力制定健全的优化标准，同时考虑到临床和放射生物学数据。
Conformal radiotherapy (CRT) is based on three hypotheses: (i) a higher rate of local control can improve the survival rate; (ii) dose escalation can increase tumor control; and (iii) CRT allows the delivery of higher doses by decreasing the incidence of late effects. These postulates are now supported by several data. Three-dimensional conformal radiotherapy (3D-CRT) has markedly progressed since its introduction two decades ago. However, there are situations for which 3D-CRT cannot produce a satisfactory treatment plan because of complex target volume shapes or the close proximity of sensitive normal tissues. This is why intensity-modulated radiation therapy (IMRT) was introduced. Its aim is to overcome the limitations of 3D-CRT by adding modulators of beam intensity to beam shaping. IMRT can achieve nearly any dose distribution; however, the role of the planner remains crucial. CRT has been investigated mainly for prostate cancers and head and neck cancers. By and large, the clinical data, although still limited, seem to confirm the advantages of this type of radiotherapy. Dose escalation in prostate cancers improves the local control rate without increasing late effects and for this cancer site IMRT appears to be a significant advance over conventional 3D-CRT. In head and neck cancers the clinical data are still scarce but encouraging. CRT should be investigated in breast cancers with the aim of reducing the incidence of late effects. The available data underline the great potential for major progress in 3D-CRT and IMRT. The techniques are still costly and time consuming, nevertheless they merit investigation since their cost should decrease. Efforts should be concentrated on the specification of robust optimization criteria, taking into account clinical and radiobiological data.
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局部晚期前列腺癌：三维适形放射治疗后的长期毒性结果——剂量递增研究。
DOI：
10.1148/radiology.209.1.9769828
发表时间：
1998
期刊：
Radiology.
影响因子：
--
作者：
Zelefsky,MJ;Fuks,Z;Wolfe,T;Kutcher,GJ;Burman,C;Ling,CC;Venkatraman,ES;Leibel,SA
通讯作者：
Leibel,SA
剂量的适度增加是否可以被检测为肿瘤控制的增强？
DOI：
10.1016/0360-3016(92)90039-k
发表时间：
1992
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Thames,HD;Schultheiss,TE;Hendry,JH;Tucker,SL;Dubray,BM;Brock,WA
通讯作者：
Brock,WA
使用多叶准直器对前列腺癌和鼻咽癌进行适形放射治疗。
DOI：
10.1016/0360-3016(93)90337-u
发表时间：
1993
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
LoSasso,T;Chui,CS;Kutcher,GJ;Leibel,SA;Fuks,Z;Ling,CC
通讯作者：
Ling,CC
DOI：
10.1001/jama.1993.03510160067031
发表时间：
1993-10
期刊：
JAMA
影响因子：
--
作者：
S. Hancock;M. Tucker;R. Hoppe
通讯作者：
S. Hancock;M. Tucker;R. Hoppe
DOI：
10.1016/s0360-3016(97)00343-x
发表时间：
1997-10-01
影响因子：
7
作者：
Marks, LB;Munley, MT;Anscher, M
通讯作者：
Anscher, M