Lukens J Nicholas, Gamez Mauricio, Hu Kenneth, Harrison Louis B
Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA.
Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ.
Semin Oncol. 2014 Dec;41(6):831-47. doi: 10.1053/j.seminoncol.2014.09.015. Epub 2014 Oct 31.
Brachytherapy consists of placing radioactive sources within, or directly adjacent to a tumor, and is a means of delivering highly targeted and conformal radiation. While its history dates back to the origins of the field, in recent years brachytherapy treatment paradigms have been evolving considerably. This has been driven primarily by advancements in imaging, which allow for precise placement of sources and applicators under image guidance, and volume-based optimization to ensure adequate tumor coverage while sparing adjacent normal tissue. There has been a shift towards high-dose-rate (HDR) brachytherapy for many of the disease sites treated with brachytherapy. Simultaneously, with increasingly conformal treatment, there has been a shift towards utilization of higher doses per fraction, over fewer fractions, for specific disease sites where hypofractionation is believed to confer a radiobiological benefit. Here we review recent data and trends for those disease sites and conditions that are commonly treated with brachytherapy, including prostate, gynecologic, breast, head and neck, and skin cancers and salvage of recurrent disease.
近距离放射治疗是将放射源置于肿瘤内部或紧邻肿瘤的位置，是一种提供高靶向性和适形放射的手段。虽然其历史可追溯到该领域的起源，但近年来近距离放射治疗的治疗模式一直在显著演变。这主要是由成像技术的进步推动的，成像技术允许在图像引导下精确放置放射源和施源器，并进行基于体积的优化，以确保在保护相邻正常组织的同时充分覆盖肿瘤。对于许多接受近距离放射治疗的疾病部位，已转向高剂量率（HDR）近距离放射治疗。同时，随着治疗适形性的提高，对于那些认为超分割能带来放射生物学益处的特定疾病部位，已转向在较少的分割次数中使用更高的每次分割剂量。在此，我们回顾了那些常用近距离放射治疗的疾病部位和病症的近期数据及趋势，包括前列腺癌、妇科癌症、乳腺癌、头颈癌、皮肤癌以及复发性疾病的挽救治疗。
