立体定向放射治疗转移性肺转移。

IF 2.9 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Japanese Journal of Radiology Pub Date : 2022-10-01 Epub Date: 2022-09-13 DOI:10.1007/s11604-022-01323-9
Tomoki Kimura, Toshiki Fujiwara, Tsubasa Kameoka, Yoshinori Adachi, Shinji Kariya
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引用次数: 2

摘要

虽然全身治疗是转移性疾病患者的标准治疗方法,但最近的一些报告表明,对低转移性疾病(OMD)患者增加局部治疗,包括立体定向全身放射治疗(SBRT)可以提高生存率。肺是许多实体瘤最常见的远处转移部位,SBRT的策略,如剂量-分数计划、时间等,将根据原发肿瘤的类型、位置和OMD的模式而有所不同。这篇综述描述了SBRT对肺部OMD患者的治疗目的的作用。首先,根据原发肿瘤类型的差异,许多研究表明,sbrt介导的局部控制(LC)对结直肠癌(CRC)肺OMD患者的成功程度低于非CRC肿瘤患者。此外,较高的剂量-分数方案似乎与较高的LC相关;因此,相对于其他肿瘤,结直肠癌肺OMD患者可能需要不同的SBRT治疗策略。二是部位差异,其中SBRT治疗外周性肺肿瘤的安全性已经比较完善,但对包括肺OMD在内的中枢性肺肿瘤的安全性仍存在争议。为了确定最佳的剂量-分数方案,还需要来自前瞻性研究的进一步数据。第三,根据OMD模式、转移数量和SBRT时间的差异,大多数患者和同步或异时性OMD患者的1-5个病变被认为是SBRT的良好候选者。我们的结论是,在确定包括SBRT在内的局部治疗的合适适应症方面仍然存在一些问题,需要进一步的前瞻性研究来解决这些问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Stereotactic body radiation therapy for metastatic lung metastases.

Stereotactic body radiation therapy for metastatic lung metastases.

Stereotactic body radiation therapy for metastatic lung metastases.

Stereotactic body radiation therapy for metastatic lung metastases.

Although systemic therapy is standard management for patients with metastatic disease, several recent reports have indicated that an addition of local therapies including stereotactic body radiation therapy (SBRT) for patients with oligometastatic disease (OMD) could improve survival. The lung is the most common site of distant metastasis from many solid tumors, and the strategy of SBRT, such as dose-fraction schedules, timing, etc., would be different depending on the type of primary tumor, location, and patterns of OMD. This review describes the role of SBRT with curative-intent for patients with pulmonary OMD for each of these variables. First, differences according to the type of primary tumor, for which many studies suggest that SBRT-mediated local control (LC) for patients with pulmonary OMD from colorectal cancer (CRC) is less successful than for those from non-CRC tumors. In addition, higher dose-fraction schedules seemed to correlate with higher LC; hence, different SBRT treatment strategies may be needed for patients with pulmonary OMD from CRC relative to other tumors. Second, differences according to location, where the safety of SBRT for peripheral pulmonary tumors has been relatively well established, but safety for central pulmonary tumors including pulmonary OMD is still considered controversial. To determine the optimal dose-fraction schedules, further data from prospective studies are still needed. Third, differences according to the patterns of OMD, the number of metastases and the timing of SBRT whereby 1-5 lesions in most patients and patients with synchronous or metachronous OMD are considered good candidates for SBRT. We conclude that there are still several problems in defining suitable indications for local therapy including SBRT, and that further prospective studies are required to resolve these issues.

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来源期刊
Japanese Journal of Radiology
Japanese Journal of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
5.00
自引率
4.80%
发文量
133
审稿时长
4-8 weeks
期刊介绍: Japanese Journal of Radiology is a peer-reviewed journal, officially published by the Japan Radiological Society. The main purpose of the journal is to provide a forum for the publication of papers documenting recent advances and new developments in the field of radiology in medicine and biology. The scope of Japanese Journal of Radiology encompasses but is not restricted to diagnostic radiology, interventional radiology, radiation oncology, nuclear medicine, radiation physics, and radiation biology. Additionally, the journal covers technical and industrial innovations. The journal welcomes original articles, technical notes, review articles, pictorial essays and letters to the editor. The journal also provides announcements from the boards and the committees of the society. Membership in the Japan Radiological Society is not a prerequisite for submission. Contributions are welcomed from all parts of the world.
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