Clemente Stefania, Nigro Roberta, Oliviero Caterina, Marchioni Chiara, Esposito Marco, Giglioli Francesca Romana, Mancosu Pietro, Marino Carmelo, Russo Serenella, Stasi Michele, Strigari Lidia, Veronese Ivan, Landoni Valeria
Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata Rionero in Vulture, Potenza, Italy.
Azienda Sanitaria Locale Rieti, Roma, Italy.
Int J Radiat Oncol Biol Phys. 2015 Jan 1;91(1):182-95. doi: 10.1016/j.ijrobp.2014.08.006.
The increasing use of moderate (<35 fractions) and extreme (<5 fractions) hypofractionated radiation therapy in prostate cancer is yielding favorable results, both in terms of maintained biochemical response and toxicity. Several hypofractionation (HF) schemes for the treatment of prostate cancer are available, although there is considerable variability in the techniques used to manage intra-/interfraction motion and deliver radiation doses. We performed a review of the published studies on HF regimens as a topic of interest for the Stereotactic Ablative Radiotherapy working group, which is part of the Italian Association of Medical Physics. Aspects of organ motion management (imaging for contouring, target volume definition, and rectum/bladder preparation) and treatment delivery (prostate localization, image guided radiation therapy strategy and frequency) were evaluated and categorized to assess outcome relative to disease control and toxicity. Despite the heterogeneity of the data, some interesting trends that emerged from the review might be useful in identifying an optimum HF strategy.
在前列腺癌治疗中，越来越多地使用中等剂量分割（<35次分割）和大分割（<5次分割）的低分割放射治疗，在维持生化反应和毒性方面均取得了良好效果。目前有几种用于治疗前列腺癌的低分割（HF）方案，尽管在用于处理分次内/分次间运动和给予放射剂量的技术方面存在很大差异。作为意大利医学物理协会下属的立体定向消融放疗工作组感兴趣的一个主题，我们对已发表的关于HF方案的研究进行了综述。对器官运动管理（用于轮廓勾画的成像、靶体积定义以及直肠/膀胱准备）和治疗实施（前列腺定位、图像引导放射治疗策略和频率）方面进行了评估和分类，以评估相对于疾病控制和毒性的结果。尽管数据存在异质性，但综述中出现的一些有趣趋势可能有助于确定最佳的HF策略。
