Centre for Experimental Radiation Oncology, St George Cancer Care Centre, Kogarah, NSW 2217, Australia.
Biomed Res Int. 2013;2013:749203. doi: 10.1155/2013/749203. Epub 2013 May 16.
Despite the latest technological advances in radiotherapy, cancer control is still challenging for several tumour sites. The survival rates for the most deadly cancers, such as ovarian and pancreatic, have not changed over the last decades. The solution to the problem lies in the change of focus: from local treatment to systemic therapy. The aim of this paper is to present the current status as well as the gaps in radiotherapy and, at the same time, to look into potential solutions to improve cancer control and survival.
The currently available advanced radiotherapy treatment techniques have been analysed and their cost-effectiveness discussed. The problem of systemic disease management was specifically targeted.
Clinical studies show limited benefit in cancer control from hadron therapy. However, targeted therapies together with molecular imaging could improve treatment outcome for several tumour sites while controlling the systemic disease.
The advances in photon therapy continue to be competitive with the much more expensive hadron therapy. To justify the cost effectiveness of proton/heavy ion therapy, there is a need for phase III randomised clinical trials. Furthermore, the success of systemic disease management lies in the fusion between radiation oncology technology and microbiology.
尽管放射治疗技术在最近取得了进步，但对于一些肿瘤部位，癌症的控制仍然是一个挑战。过去几十年来，最致命的癌症（如卵巢癌和胰腺癌）的存活率没有变化。解决问题的办法在于改变重点：从局部治疗转为全身治疗。本文旨在介绍放射治疗的现状和差距，同时寻找提高癌症控制和生存率的潜在解决方案。
分析了目前可用的先进放射治疗技术，并讨论了它们的成本效益。特别针对全身疾病管理问题进行了研究。
临床研究表明，强子治疗在癌症控制方面的获益有限。然而，靶向治疗结合分子成像可能会改善一些肿瘤部位的治疗效果，同时控制全身疾病。
光子治疗的进展继续与昂贵得多的强子治疗相竞争。为了证明质子/重离子治疗的成本效益，需要进行 III 期随机临床试验。此外，全身疾病管理的成功在于放射肿瘤学技术和微生物学的融合。
