Finger Paul T
The New York Eye Cancer Center, 115 East 61st Street, New York, NY 10065, USA.
Surv Ophthalmol. 2009 Sep-Oct;54(5):545-68. doi: 10.1016/j.survophthal.2009.06.004.
Radiation therapy is widely used for the treatment of orbital tumors and inflammatory disease. Both external beam teletherapy and implant brachytherapy radiation techniques are employed. External beam radiation therapy is the most common. It involves directing an external radiation source towards the eye, sinuses, and orbit. Whereas most patients are treated with linear accelerator-derived external beam radiation therapy, proton, neutron stereotactic radiosurgery, gamma knife, and intensity-modulated radiation therapy have become more available in developed countries. Radiation can be used alone or together with surgery or chemotherapy. Implant radiation therapy (brachytherapy) is also used to treat orbital tumors. Brachytherapy involves surgical placement of radiation sources within the tumor or targeted volume. Characteristically conformal, brachytherapy increases the dose within the target while maximally decreasing exposure of normal tissues. Orbital brachytherapy can be used to boost the dose to the target volume prior to orbital external beam radiation therapy. Herein, I explore the unique challenges associated with irradiation of the orbit, basic radiobiology, doses, indications, and results of treatment. The tolerances of normal ocular and orbital tissues are reported. This review of the literature offers a unique perspective, synthesizing the world's experience on the use of orbital radiation therapy.
放射治疗广泛应用于眼眶肿瘤和炎症性疾病的治疗。外照射远距离治疗和植入近距离放射治疗技术均有应用。外照射放射治疗最为常见。它包括将外部辐射源对准眼睛、鼻窦和眼眶。虽然大多数患者接受的是直线加速器产生的外照射放射治疗，但在发达国家，质子、中子立体定向放射外科、伽玛刀和调强放射治疗已越来越普及。放射治疗可单独使用，也可与手术或化疗联合使用。植入放射治疗（近距离放射治疗）也用于治疗眼眶肿瘤。近距离放射治疗包括将放射源手术植入肿瘤或靶区内。近距离放射治疗具有适形性，可增加靶区内的剂量，同时最大程度减少对正常组织的照射。眼眶近距离放射治疗可在眼眶外照射放射治疗前用于增加靶区剂量。在此，我探讨与眼眶照射相关的独特挑战、基本放射生物学、剂量、适应症及治疗结果。报告了正常眼和眼眶组织的耐受性。这篇文献综述提供了一个独特的视角，综合了全球在眼眶放射治疗应用方面的经验。
