Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
Semin Oncol. 2013 Jun;40(3):297-307. doi: 10.1053/j.seminoncol.2013.04.005.
There have been significant advancements in the quality and precision of radiation therapy (RT) for prostate cancer over the past two decades. The development and implementation of intensity-modulated radiation therapy has allowed for RT dose-escalation without parallel increases in treatment morbidity. Moreover, integration of androgen deprivation therapy with definitive RT has led to improvements in outcomes for certain subgroups of prostate cancer patients. In this review, we highlight several ongoing and developing technical advances that hold promise for further optimizing RT care, including proton beam therapy, inter- and intra-fractional image-guided dose-delivery, methods for improved target volume definition, and development of techniques for safely performing hypofractionation and stereotactic body radiotherapy. We also discuss the importance of investigating the potential benefit of integrating novel systemic therapies with prostate RT to further improve outcomes for patients with locally advanced prostate cancer.
在过去的二十年中，前列腺癌的放射治疗（RT）质量和精度有了显著提高。强度调制放射治疗的发展和应用使得 RT 剂量递增成为可能，而治疗发病率并没有平行增加。此外，雄激素剥夺治疗与根治性 RT 的结合，使某些前列腺癌亚组患者的治疗效果得到改善。在这篇综述中，我们重点介绍了几项正在进行和发展中的技术进步，这些进步有望进一步优化 RT 治疗，包括质子束治疗、分次内和分次间图像引导剂量传递、改进靶区定义的方法以及开发安全进行低分割和立体定向体放射治疗的技术。我们还讨论了研究将新型全身治疗与前列腺 RT 相结合的潜在益处的重要性，以进一步改善局部晚期前列腺癌患者的治疗效果。
