Department of Radiation Biology, Institute for Cancer Research, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
Semin Radiat Oncol. 2010 Apr;20(2):138-46. doi: 10.1016/j.semradonc.2009.11.008.
Recently, there has been much interest in how to use information on patient-specific tumor biology and normal tissue function to individualize cancer treatment. In radiation therapy, dose may be escalated to radioresistant regions within a tumor, or regions of particular functional importance in normal organs may be preferentially spared. However, tumor and normal tissue biology may change during treatment, and adaptation of therapy may be necessary to ensure that optimal therapy is delivered. Furthermore, changes in tumor and normal tissue biology during early treatment may be predictive for the outcome of radiotherapy, and this information could be used for individual adaptation of the remaining part of the treatment. In the present study, we address variations that may occur in tumor and normal tissue radiobiological properties during radiotherapy, and how these may be related to the response to treatment. Moreover, we discuss the criteria for when to adapt treatment and how this adaptation should be performed. Finally, we discuss to what degree biologically adapted radiotherapy may be expected to improve treatment outcome and which issues need to be resolved for this strategy to reach its full potential.
最近，人们对如何利用患者特定的肿瘤生物学和正常组织功能信息来实现癌症治疗个体化产生了浓厚的兴趣。在放射治疗中，可以在肿瘤内的放射性抗性区域提高剂量，或者优先保护正常器官中具有特定功能重要性的区域。然而，肿瘤和正常组织生物学在治疗过程中可能会发生变化，因此可能需要调整治疗以确保提供最佳治疗。此外，治疗早期肿瘤和正常组织生物学的变化可能对放射治疗的结果具有预测性，并且可以将这些信息用于治疗剩余部分的个体化适应。在本研究中，我们探讨了放射治疗过程中肿瘤和正常组织放射生物学特性可能发生的变化，以及这些变化如何与治疗反应相关。此外，我们还讨论了何时需要调整治疗以及如何进行这种调整的标准。最后，我们讨论了生物适应性放射治疗在多大程度上可以提高治疗效果，以及为了充分发挥这一策略的潜力需要解决哪些问题。
