Dutta Suresh, Nguyen Nam Phong, Vock Jacqueline, Kerr Christine, Godinez Juan, Bose Satya, Jang Siyoung, Chi Alexander, Almeida Fabio, Woods William, Desai Anand, David Rick, Karlsson Ulf Lennart, Altdorfer Gabor
Medicine and Radiation Oncology PA , San Antonio, TX , USA.
Department of Radiation Oncology, Howard University , Washington, DC , USA.
Front Oncol. 2015 Mar 17;5:64. doi: 10.3389/fonc.2015.00064. eCollection 2015.
Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT), and 2-dimensional intracavitary brachytherapy. Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron-emission tomography and magnetic resonance imaging has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT) may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT), allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer.
宫颈癌的传统放疗依赖于临床检查、三维适形放疗（3D-CRT）和二维腔内近距离放疗。对于早期小宫颈癌，确定性放疗已取得了良好的局部控制和生存率。对于体积较大和局部晚期疾病，加用化疗改善了预后，但毒性仍然很大。正电子发射断层扫描和磁共振成像等新的成像技术改善了放疗计划中的肿瘤勾画。图像引导放疗（IGRT）可能会降低全盆腔放疗的治疗毒性，因为它有保护骨髓、肠道和膀胱的潜力。全盆腔IGRT期间肿瘤缩小可能会优化图像引导近距离放疗（IGBT），从而为宫颈癌患者实现更好的局部控制并降低毒性。IGRT和IGBT应纳入未来宫颈癌的前瞻性研究中。
