Pointreau Y, Kreps S, Hennequin C
Service Corad, Pôle Henry-S-Kaplan, CHU Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France.
Cancer Radiother. 2010 Jul;14(4-5):246-9. doi: 10.1016/j.canrad.2010.03.014. Epub 2010 Jul 7.
Ionizing radiation is frequently used for cancers with a curative intent for many patients. The total dose delivered on the tumour plays a major factor for locoregional control. Increasing the dose to the tumour volume is generally correlated with an increased dose to normal tissue. Dose constraints to organs at risk must be taken into account for the planning of external beam radiation. A high dose will generate more acute and late side effects. Medical doctors should record these toxicities prospectively. Registration and grading should be simple, reproducible and sensitive in order to obtain an accurate and appropriate evaluation for each organ. Several scales have been published in the literature (WHO, EORTC/RTOG, LENT-SOMA, NCI CTCAE) but none have a satisfactory level. The National Cancer Institute has proposed several version of the CTCAE and its latest version 4.0, currently appears to be the most adapted. The advantage of using only this common and universal classification will be to harmonize practices and have a common language.
电离辐射经常被用于许多有治愈意图的癌症患者。肿瘤所接受的总剂量对局部区域控制起着主要作用。增加肿瘤体积的剂量通常与正常组织剂量增加相关。在进行外照射放疗计划时，必须考虑对危及器官的剂量限制。高剂量会产生更多的急性和晚期副作用。医生应前瞻性地记录这些毒性反应。登记和分级应该简单、可重复且敏感，以便对每个器官进行准确和恰当的评估。文献中已经发表了几种量表（世界卫生组织、欧洲癌症研究与治疗组织/美国放射肿瘤学会、晚期效应正常组织不良反应评价标准、美国国立癌症研究所常见不良反应事件评价标准），但没有一个达到令人满意的水平。美国国立癌症研究所已经提出了几个版本的常见不良反应事件评价标准，其最新版本4.0目前似乎是最合适的。仅使用这种通用分类的优点是使实践标准化并拥有共同语言。
