A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists.
A Comprehensive Primer on Radiation Oncology for Non-Radiation Oncologists.
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DOI：
10.3390/cancers15204906
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发表时间：
2023-10-10
期刊：
影响因子：
5.2
通讯作者：
El Fakhri, Georges
中科院分区：
文献类型：
--
作者：
Beddok, Arnaud;Lim, Ruth;Thariat, Juliette;Shih, Helen A.;El Fakhri, Georges
非放射肿瘤学家对放射治疗（RT）程序的理解差距对最佳癌症治疗构成了重大障碍。本文旨在为非肿瘤学家、医学生和非临床研究人员提供关于RT的重要见解，作为一份全面的指南，揭示了从治疗计划到患者随访的复杂、多步骤的过程。强调放射肿瘤学家（ROs）在这一过程中不可或缺的作用，本文深入研究了CT模拟，治疗靶点和危险器官（OAR）划定以及急性毒性管理等关键阶段。最终，该手稿旨在通过弥合非肿瘤医疗保健界关于rt的知识差距，显著提高患者护理标准。其意义在于其促进跨学科合作的潜力，从而提高癌症治疗方案的有效性和安全性。背景：多学科管理在肿瘤诊断和治疗中至关重要。多学科团队包括外科、医学治疗和放射治疗（RT）方面的专家，每个人在肿瘤护理中都发挥着独特的作用。一个重要的方面是放疗，由放射肿瘤学家（ROs）指导。本文为非肿瘤学家，医学生或非临床研究人员提供了详细的入门，教育他们当代RT实践。方法：本报告遵循RT计划和执行的过程。从多学科团队的决策，到完成RT和后续患者随访，旨在让非肿瘤学家全面了解RO的工作。结果：RT的第一步是计划阶段，包括获得待治疗区域的CT扫描，称为CT模拟。病人在他们将要接受治疗的确切位置被成像。第二步是不确定性的主要来源，涉及对治疗靶点和危险器官（OAR）的描述。目的是确保靶体积的精确照射，同时尽可能地保留桨。利用各种放射方式，如电子、光子或粒子（包括质子和碳离子）的外束治疗以及近距离治疗。在这些治疗方式中，采用了几种技术，如三维适形放疗、调强放疗、体积调制电弧治疗、散射束质子治疗和调强质子治疗，以达到最佳治疗效果。RT计划的制定是一个涉及医学物理学家、剂量测定师和ro的迭代过程。复杂程度和所需时间各不相同，从一小时到一周不等。一旦获得批准，就开始进行放射治疗，图像引导放射治疗是患者对齐的标准做法。RO在治疗期间管理急性毒性，并在完成后准备总结。实践中存在相当大的差异，一些ROs提供终身随访并管理治疗的潜在晚期效应。结论：非肿瘤学提供者对放疗临床效果的理解显著提高了患者的长期护理质量。因此，教育非肿瘤学家提高对放疗患者的护理，强调了本报告的重要性。
The gap in understanding of radiation therapy (RT) procedures among non-radiation oncologists poses a significant barrier to optimal cancer care. Aimed at equipping non-oncologists, medical students, and non-clinical researchers with crucial insights into RT, this paper serves as a comprehensive guide that demystifies the intricate, multi-step journey from treatment planning to patient follow-up. Highlighting the indispensable role of radiation oncologists (ROs) in this process, the paper delves into pivotal phases such as CT simulation, treatment target and organs at risk (OAR) delineation, and acute toxicity management. Ultimately, the manuscript aims to significantly elevate patient care standards by bridging the knowledge gap in non-oncology healthcare circles about RT. Its significance lies in its potential to foster improved interdisciplinary collaboration, thereby enhancing the effectiveness and safety of cancer treatment regimens. Background: Multidisciplinary management is crucial in cancer diagnosis and treatment. Multidisciplinary teams include specialists in surgery, medical therapies, and radiation therapy (RT), each playing unique roles in oncology care. One significant aspect is RT, guided by radiation oncologists (ROs). This paper serves as a detailed primer for non-oncologists, medical students, or non-clinical investigators, educating them on contemporary RT practices. Methods: This report follows the process of RT planning and execution. Starting from the decision-making in multidisciplinary teams to the completion of RT and subsequent patient follow-up, it aims to offer non-oncologists an understanding of the RO’s work in a comprehensive manner. Results: The first step in RT is a planning session that includes obtaining a CT scan of the area to be treated, known as the CT simulation. The patients are imaged in the exact position in which they will receive treatment. The second step, which is the primary source of uncertainty, involves the delineation of treatment targets and organs at risk (OAR). The objective is to ensure precise irradiation of the target volume while sparing the OARs as much as possible. Various radiation modalities, such as external beam therapy with electrons, photons, or particles (including protons and carbon ions), as well as brachytherapy, are utilized. Within these modalities, several techniques, such as three-dimensional conformal RT, intensity-modulated RT, volumetric modulated arc therapy, scattering beam proton therapy, and intensity-modulated proton therapy, are employed to achieve optimal treatment outcomes. The RT plan development is an iterative process involving medical physicists, dosimetrists, and ROs. The complexity and time required vary, ranging from an hour to a week. Once approved, RT begins, with image-guided RT being standard practice for patient alignment. The RO manages acute toxicities during treatment and prepares a summary upon completion. There is a considerable variance in practices, with some ROs offering lifelong follow-up and managing potential late effects of treatment. Conclusions: Comprehension of RT clinical effects by non-oncologists providers significantly elevates long-term patient care quality. Hence, educating non-oncologists enhances care for RT patients, underlining this report’s importance.
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影响因子：
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