Russell N S, Bartelink H
Department of Radiotherapy, The Netherlands Cancer Intitute/Antoni van Leeuwenhoekhuis, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.
Cancer Treat Rev. 1999 Dec;25(6):365-76. doi: 10.1053/ctrv.1999.0141.
Some of the major changes in radiotherapy over the last years are reviewed in this paper. Radiotherapy has played a role in the changes in oncological practice including an increase in organ-sparing treatment and achieving good local control and improving survival. About half of all breast cancer patients are now treated with breast conserving therapy. Organ preservation, usually with multimodality therapy, has also been further developed in the treatment of cancers in the head and neck, anus, bladder and soft tissue sarcomas. Developments in radiobiology have led to the development of new fractionation schedules. Hyperfractionation allows an increase in the tumour dose whilst sparing normal tissues and accelerated fractionation combats accelerated tumour proliferation during treatment. Advances in accelerator technology and computerized treatment planning have enabled the development of three-dimensional conformal radiotherapy. This gives the oportunity to spare normal tissues and escalate the dose to the tumour. Quality control and standardization of dosimetry and treatment delivery at departmental and international level has also improved treatment results.
本文回顾了过去几年放射治疗的一些主要变化。放射治疗在肿瘤学实践的变革中发挥了作用，包括增加器官保留治疗、实现良好的局部控制以及提高生存率。现在，大约一半的乳腺癌患者接受保乳治疗。在头颈部癌、肛门癌、膀胱癌和软组织肉瘤的治疗中，通常采用多模态疗法的器官保留也得到了进一步发展。放射生物学的发展导致了新的分割方案的出现。超分割允许增加肿瘤剂量，同时保护正常组织，加速分割则可对抗治疗期间肿瘤的加速增殖。加速器技术和计算机化治疗计划的进步推动了三维适形放疗的发展。这为保护正常组织并提高肿瘤剂量提供了机会。部门和国际层面剂量测定和治疗实施的质量控制与标准化也改善了治疗效果。
