Moraes Fabio Ynoe de, Siqueira Gabriela Moreira Silva de, Abreu Carlos Eduardo Cintra Vita, da Silva João Luis Fernandes, Gadia Rafael
Department of Radiation Oncology, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91, São Paulo, Brazil.
Expert Rev Anticancer Ther. 2014 Nov;14(11):1271-6. doi: 10.1586/14737140.2014.972380.
There are many available options for prostate cancer treatment, including active surveillance, surgery, brachytherapy and external beam radiotherapy. Based on a radiobiological rationale, which considers the prostate tumor as a low α/β tumor, the use of higher and fewer fractions to prostate cancer external beam radiotherapy treatment has been proposed. Instead of the traditional fractions of 1.8-2.0 Gy per day, fractions higher than 2 Gy per day were the subject of a number of studies. In addition, new technologies such as intensity-modulated radiation therapy, image-guided radiation therapy, volumetric-modulated arch therapy and others have emerged as background for changing paradigms. Meanwhile, moderate and ultra-hypofractionation have been the subject of studies in recent years. Some moderate hypofractionation data from randomized controlled trials are ready to use, though other non-inferiority data are still lacking. The data on ultra-hypofractionation are still very new and require further evaluation to determine its long-term safety and efficacy.
前列腺癌的治疗有多种选择，包括主动监测、手术、近距离放射治疗和外照射放疗。基于将前列腺肿瘤视为低α/β值肿瘤的放射生物学原理，有人提出在前列腺癌外照射放疗中采用更高剂量且分割次数更少的方案。与传统的每天1.8 - 2.0 Gy的分割剂量不同，每天剂量高于2 Gy的分割方案成为了多项研究的主题。此外，诸如调强放射治疗、图像引导放射治疗、容积调强弧形治疗等新技术的出现，成为了改变治疗模式的背景。与此同时，中等分割和超分割近年来一直是研究的主题。一些来自随机对照试验的中等分割数据已可供使用，不过其他非劣效性数据仍很缺乏。超分割的数据仍然非常新，需要进一步评估以确定其长期安全性和有效性。
