Freeman C R, Lehnert S
Division of Radiation Oncology, McGill University, Montreal, Quebec.
Neurol Clin. 1991 May;9(2):351-62.
It has become increasingly evident that conventional, once-daily, radiotherapy dose-fractionation schedules, developed over the years on the basis of observed normal tissue reactions, may not be ideal for all clinical situations. Differences in kinetics between normal and malignant tissues, especially repair of radiation injury in normal tissues and repopulation in tumors, suggest modifications to conventional dose-fractionation schedules that might be expected to result in an improved therapeutic ratio. Of these, hyperfractionation and accelerated treatment regimens appear to hold the most promise. The theoretical basis for these altered schedules is reviewed as is the clinical experience accumulated to date. The implications for treatment of children with brain tumors are presented.
多年来基于观察到的正常组织反应而制定的传统每日一次放射治疗剂量分割方案，可能并非适用于所有临床情况，这一点已日益明显。正常组织与恶性组织之间动力学的差异，尤其是正常组织中辐射损伤的修复和肿瘤中的再增殖，提示对传统剂量分割方案进行调整，有望提高治疗增益比。其中，超分割和加速治疗方案似乎最具前景。本文综述了这些改变方案的理论基础以及迄今为止积累的临床经验，并阐述了对儿童脑肿瘤治疗的意义。
