对前列腺内病灶进行病灶剂量升级的全腺前列腺近距离放射治疗的综述:临床疗效和技术方面

IF 3.4 Q2 ONCOLOGY
Joel Poder , Peter Hoskin , Hayley Reynolds , Tsz Him Chan , Annette Haworth
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引用次数: 0

摘要

在放射治疗中对前列腺内病变(IPL)进行局部增强可提高治疗效果。近距离放射治疗(BT)可提供高度适形的剂量和尖锐的剂量梯度,是对IPL进行精确剂量升级的最佳方法。本研究旨在整合实施全腺前列腺 BT 和 IPL 局灶剂量升级的临床和规划研究,以综合有关该策略有效性和可变性的证据。在这篇综述中,我们确定了九项临床研究和十项规划/模拟研究,重点关注 IPL 剂量升级的全腺前列腺 BT。从临床研究来看,对 T1b - T2c 前列腺癌男性患者而言,使用全腺体前列腺 BT 配合病灶剂量递增疗法与体外射束放疗 (EBRT) 联合治疗似乎是一种安全有效的治疗方式,平均五年无生化失败22 存活率 (BFFS) 为 94 %(范围为 81.1 %-100%),且报告的三级毒性极低。临床研究和计划研究都表明,使用 BT 可以实现高水平的病灶剂量升级,IPL D90 的平均值分别为 132% 和 146%(以占整个腺体处方剂量的百分比表示)。在已确定的研究中,临床和技术数据的报告存在很大差异。为了促进该技术更广泛、更统一的应用,本文就未来将全腺前列腺 BT 与 IPL 聚焦增强相结合的研究中应包含的基本项目和理想项目提出了建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A review of whole gland prostate brachytherapy with focal dose escalation to intra-prostatic lesions: Clinical efficacy and technical aspects
Focal boost to intra-prostatic lesions (IPLs) in radiotherapy could enhance treatment efficacy. Brachytherapy (BT), delivering highly conformal dose with sharp dose gradients emerges as a potentially optimal approach for precise dose escalation to IPLs. This study aims to consolidate clinical and planning studies that implemented whole gland prostate BT and focal dose escalation to IPLs, with the view to synthesize evidence on the strategy’s effectiveness and variability. In this review, we identified nine clinical studies and ten planning/simulation studies focusing on whole gland prostate BT with IPL dose escalation. From the clinical studies, the use of whole gland prostate BT with focal dose escalation in combination with external beam radiotherapy (EBRT) appears to be a safe and effective 21 form of treatment for men with T1b – T2c prostate cancer with average five-year biochemical failure22 free survival (BFFS) of 94 % (range 81.1 %−100 %) and minimal grade three toxicities reported. Both clinical and planning studies exemplified the high level of focal dose escalation achievable using BT with a mean IPL D90 % of 132 % and 146 %, respectively (expressed as a % of the whole gland prescription dose). There was considerable variation in the reporting of clinical and technical data in the identified studies. To facilitate a more widespread and uniform adoption of the technique, recommendations on essential and desirable items to be included in future studies incorporating whole gland prostate BT with focal boost to IPLs are provided.
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来源期刊
Physics and Imaging in Radiation Oncology
Physics and Imaging in Radiation Oncology Physics and Astronomy-Radiation
CiteScore
5.30
自引率
18.90%
发文量
93
审稿时长
6 weeks
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