头颈部肿瘤在自适应放疗中的研究进展

王志强; 李荣清; 张勇

头颈部肿瘤在自适应放疗中的研究进展

昆明医科大学第一附属医院肿瘤放疗科

基金项目:

基金：国家自然科学基金资助项目(81560462); 云南省自然科学基金资助项目(2016FB150); 云南省科技厅“惠民”基金资助项目(2014RA072);

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出版历程
- 收稿日期: 2016-06-10

Progress in Research of Adaptive Radiation Therapy for Head and Heck Cancer

Funds:

基金：国家自然科学基金资助项目(81560462); 云南省自然科学基金资助项目(2016FB150); 云南省科技厅“惠民”基金资助项目(2014RA072);

摘要

摘要: 放射治疗是头颈部肿瘤治疗中非常重要的治疗手段之一.其中调强放射治疗(intensity-modulated radiotherapy,IMRT)具有更好的适形性和均匀性,正逐步取代传统二维放射治疗成为头颈部肿瘤主流的放射治疗手段.但是调强放疗过程中,摆位误差,治疗方法和解剖结构的变化等,影响调强放射治疗的精准性,可能导致靶区欠量和(或)造成额外的并发症.自适应放射治疗是一种新型的放疗技术,它通过患者的先前的治疗图像、受照射剂量等反馈信息对原治疗计划重新优化和调整,能够修正调强放射治疗过程中的肿瘤靶区范围和提高疗效.在自适应放射治疗(adaptive radiotherapy,ART)技术的应用下,放疗技术会更加精准化、个体化.对ART技术在头颈部肿瘤中的研究现状作一综述.
- 自适应放疗 /
- 头颈部肿瘤 /
- 精准放疗
Abstract: Radiotherapy is one of the most important treatment method for head and neck cancer.The intensity-modulated radiotherapy(IMRT) has better conformal property and uniformity.IMRT is gradually replacing conventional radiation therapy and has become the mainstream radical treatment for head and neck cancer.During IMRT,the patient treatment positioning,inter-treatment,and intra-treatment variation of organ position,size,and shape impact the accuracy of radiation dose delivery.This method may cause target less and(or) additional complications.Adaptive radiotherapy(ART) is a new radiotherapy technology.Based on the patient's pre-treatment images and relative information such as dose deviation,ART can able to compensate the target coverage and clinical outcome.Under the help of ART technique,radiotherapy can be more accurate and more personalized.This paper reviews the research status of ART technology in head and neck cancerby retrospective studying the related literature at home and abroad.
- Adaptiveradiotherapy /
- Head and neck cancer /
- Precise radiotherapy

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参考文献(27)

[1] 殷蔚伯.肿瘤放射治疗的进展[J].医疗装备,2006,19(10):7-8.
[2]	[2]REALI A,ANGLESIO S M,MORTELLARO G,et al.Volumetric and positional changes of planning target volumes and organs at risk using computed tomography imaging during intensity-modulated radiation therapy for head-neck cancer:An"old"adaptive radiation therapy approach[J].Radiol Med,2014,119(9):714-720.
[3]	[3]JIN X,HU W,SHANG H,et al.CBCT-based volumetric and dosimetric variation evaluation of volumetric modulated arc radiotherapy in the treatment of nasopharyngeal cancer patients[J].Radiat Oncol,2013,118(8):279-284.
[4]	[4]NUTTING C M,MORDEN J P,HARRINGTON K J,et al.Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer(PARSPORT):A phase 3 multicentre randomised controlled trial[J].Lancet Oncol,2011,12(2):127-136.
[5]	[5]SALAMA J K,HADDAD R I,KIES M S,et al.Clinical practice guidance for radiotherapy planning after induction chemotherapy in locoregionally advanced head-and-neck cancer[J].Int J Radiat Oncol Biol Phys,2009,75(3):725-733.
[6]	[6]HANSEN E K,BUCCI M K,QUIVEY J M,et al.RepeatCT imaging and replanning during the course of IMRT for head-and-neck cancer[J].Int J Radiat Oncol Biol Phys,2006,64(2):355-362.
[7]	[7]MACKIE T R,HOLMES T,SWERDLOFF S,et al.Tomotherapy:A new concept for the delivery of dynamic conformal radiotherapy[J].Med Phys,1993,20(6):1709-1719.
[8]	[8]YAN D,WONG J,VICINI F,et al.Adaptive modification of treatment planning to minimize the deleterious effects of treatment setup errors[J].Int J Radiat Oncol Biol Phys,1997,38(1):197-206.
[9]	[9]YAN D,VICINI F,WONG J,et al.Adaptive radiation therapy[J].Phys Med Biol,1997,42(1):123-132.
[10]	[10]WU Q,CHI Y,CHEN P Y,et al.Adaptive replanning strategies accounting for shrinkage in head and neck IMRT[J].Int J Radiat Oncol Biol Phys,2009,75(3):924-932.
[11]	[11]SCHWARTZ D L,GARDEN A S,THOMAS J,et al.Adaptive radiotherapy for head-and-neck cancer:Initial clinical outcomes from a prospective trial[J].Int J Radiat Oncol Biol Phys,2012,83(3):986-993.
[12]	[12]CAPELLE L,MACKENZIE M,FIELD C,et al.Adaptive radiotherapy using helical tomotherapy for head and neck cancer in definitive and postoperative settings:Initial results[J].Clin Oncol(R Coll Radiol),2012,24(3):208-215.
[13]	[13]LOO H,FAIRFOUL J,CHAKRABARTI A,et al.Tumour shrinkage and contour change during radiotherapy increase the dose to organs at risk but not the target volumes for head and neck cancer patients treated on the Tomo Therapy Hi Art system[J].Clin Oncol(R Coll Radiol),2011,23(1):40-47.
[14]	[14]DEN R B,DOEMER A,KUBICEK G,et al.Daily image guidance with cone-beam computed tomography for head-and-neck cancer intensity-modulated radiotherapy:A prospective study[J].Int J Radiat Oncol Biol Phys,2010,76(5):1353-1359.
[15]	[15]DE BOER H C,VAN SORNSEN DE KOSTE J R,CREUTZBERG C L,et al.Electronic portal image assisted reduction of systematic set-up errors in head and neck irradiation[J].Radiother Oncol,2001,61(3):299-308.
[16]	[16]VAN LIN E N,VAN DER VIGHT L,HUIZENGA H,et al.Set-up improvement in head and neck radiotherapy using a 3D off-line EPID-based correction protocol and a customised head and neck support[J].Radiother Oncol,2003,68(2):137-148.
[17]刘婷婷.图像引导调强放疗在头颈部肿瘤治疗中的应用[D].乌鲁木齐:新疆医科大学硕士论文集,2013.
[18]	[18]SIMONE C B,LY D.Comparison of intensity-modulated radiotherapy,adaptive radiotherapy,proton radiotherapy,and adaptive proton radiotherapy for treatment of locally advanced head and neck cancer[J].Radiother Oncol,2011,101(3):376-382.
[19]	[19]CASTADOT P,LEE J A,GEETS X,et al.Adaptive radiotherapy of head and neck cancer[J].Semin Radiat Oncol,2010,20(2):84-93.
[20]	[20]WANG X,LU J,XIONG X,et al.Anatomic and dosimetric changes during the treatment course of intensity-modulated radiotherapy for locally advanced nasopharyngeal carcinoma[J].Med Dosim,2010,35(2):151-157.
[21]	[21]DUMA M N,KAMPFER S,SCHUSTER T,et al.Adaptive radiotherapy for soft tissue changes during helical tomotherapy for head and neck cancer[J].Strahlenther Onkol,2012,188(3):243-247.
[22]张勇乾.螺旋断层放射治疗头颈部肿瘤患者的实际受照射剂量研究[D].石家庄:河北医科大学硕士论文集,2013.
[23]	[23]HAN C,CHEN Y J,LIU A,et al.Actual dose variation of parotid glands and spinal cord for nasopharyngeal cancer patients during radiotherapy[J].Int J Radiat Oncol Biol Phys,2008,70(4):1256-1262.
[24]魏双,郝俊芳,杨新华,等.鼻咽癌调强放疗每周腮腺动态变化的临床分析[J].中国癌症杂志,2013,13(3):211-217.
[25]张希梅,曹建忠,罗京伟,等.鼻咽癌调强放疗中腮腺体积变化的临床动态研究[J].癌症进展,2009,7(4):431-435.
[26]杜镭.局部晚期鼻咽癌螺旋断层治疗中腮腺及脊髓实际受量研究[J].中华放射肿瘤学杂志,2010,19(4):292-295.
[27]尚凯.自适应放疗研究进展[J].中华放射肿瘤学杂志,2013,22(6):505-508.

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