Preoperative Radiotherapy for Rectal Cancer&Is 5 × 5 Gy a Good or a Bad Schedule?
Preoperative Radiotherapy for Rectal Cancer&Is 5 × 5 Gy a Good or a Bad Schedule?
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直肠癌术前放疗&5 × 5 Gy 是好还是坏？
作者：
B. Isacsson
术前放疗大大降低了直肠癌手术后局部失败率，无论手术是否优化，全肠系膜切除（TME），都可以看到这种效果。术前放疗也能略微提高生存率。术后放疗也降低局部复发率，但即使使用较高剂量，相对降低也不明显。术前，在一些随机试验中使用了高剂量、短期计划，即一周5 - 25戈瑞。这是一个方便的时间表，如果正确执行，毒性很低。在简化了辐射技术的试验中，由于辐照量大，出现了不可接受的急性和晚期毒性。目前还不可能在试验中发现任何晚期毒性，这些试验使用的治疗技术避免了靶体积以外不必要的大组织体积的照射。讨论了使用这种短期方案相对于传统辐照约5周的相对优势。
Preoperative radiotherapy substantially lowers local failure rates after rectal cancer surgery, an effect that is seen whether surgery is optimized, total mesorectal excision (TME), or not. Preoperative radiotherapy also slightly improves survival. Postoperative radiotherapy also decreases local recurrence rates, but the relative reduction is less pronounced even when higher doses are used. Preoperatively, a high-dose, short-term schedule, 5 2 5 Gy in one week, has been used in several randomised trials. This is a convenient schedule and has low toxicity if properly conducted. In trials where the radiation technique has been simplified, resulting in large irradiated volumes, unacceptable acute and late toxicities have been seen. It has not yet been possible to detect any late toxicity in trials where the treatment was given using techniques avoiding the irradiation of unnecessarily large tissue volumes outside the target volume. The relative advantages of using this short-term schedule relative to a conventional irradiation for about 5 weeks are discussed.
DOI：
10.2307/2272241
发表时间：
--
期刊：
JOURNAL OF SYMBOLIC LOGIC
影响因子：
0.57
作者：
F. Lowenthal
通讯作者：
F. Lowenthal
影响因子：
10.3
作者：
Wolmark, N;Wieand, HS;Fisher, B
通讯作者：
Fisher, B
DOI：
10.1016/0360-3016(94)00354-n
发表时间：
1995-01-15
影响因子：
7
作者：
WITHERS, HR;PETERS, LJ;TAYLOR, JMG
通讯作者：
TAYLOR, JMG