Søvik Aste, Malinen Eirik, Olsen Dag Rune
Department of Radiation Biology, Institute for Cancer Research, Rikshospitalet University Hospital, Oslo, Norway.
Int J Radiat Oncol Biol Phys. 2009 Mar 1;73(3):650-8. doi: 10.1016/j.ijrobp.2008.11.001.
There is increasing interest in how to incorporate functional and molecular information obtained by noninvasive, three-dimensional tumor imaging into radiotherapy. The key issues are to identify radioresistant regions that can be targeted for dose escalation, and to develop radiation dose prescription and delivery strategies providing optimal treatment for the individual patient. In the present work, we review the proposed strategies for biologic image-guided dose escalation with intensity-modulated radiation therapy. Biologic imaging modalities and the derived images are discussed, as are methods for target volume delineation. Different dose escalation strategies and techniques for treatment delivery and treatment plan evaluation are also addressed. Furthermore, we consider the need for response monitoring during treatment. We conclude with a summary of the current status of biologic image-based dose escalation and of areas where further work is needed for this strategy to become incorporated into clinical practice.
如何将通过非侵入性三维肿瘤成像获得的功能和分子信息纳入放射治疗，这一问题正引发越来越多的关注。关键问题在于识别可进行剂量递增的放射抗拒区域，并制定为个体患者提供最佳治疗的放射剂量处方和输送策略。在本研究中，我们回顾了关于调强放射治疗中生物影像引导剂量递增的提议策略。讨论了生物成像模态及其衍生图像，以及靶区勾画方法。还探讨了不同的剂量递增策略、治疗输送技术和治疗计划评估方法。此外，我们考虑了治疗期间进行反应监测的必要性。最后，我们总结了基于生物影像的剂量递增的现状，以及为使该策略纳入临床实践还需进一步开展工作的领域。
