Zhang Shuo, Yu Yong-Hua, Zhang Yong, Qu Wei, Li Jia
Radiation Oncology Ward 2, Shandong Cancer Hospital and Institute Jinan, China ; School of Medical and Life Sciences, Shandong Academy of Medical Sciences, Jinan University Jinan, China.
Radiation Oncology Ward 2, Shandong Cancer Hospital and Institute Jinan, China.
Am J Cancer Res. 2015 Jan 15;5(2):854-68. eCollection 2015.
The role of radiotherapy (RT) in the management of urinary bladder cancer has undergone several alterations along the last decades. Recently, many protocols have been developed supporting the use of multi-modality therapy, and the concept of organ preservation began to be reconsidered. Advances in radiotherapy planning, verification, and delivery provide a method to optimize radiotherapy for bladder cancer and overcome difficulties which have previously limited the success of this treatment. They offer the opportunity to enhance the therapeutic ratio by reducing the volume of normal tissue irradiated and by increasing radiation dose or using more intensive fractionation and synchronous chemotherapy regimes. These techniques have a large potential to improve the therapeutic outcome of bladder cancer. In the near future, it should be possible to offer selected patients with muscle-invasive bladder cancer an organ-sparing, yet effective combined-modality treatment. In this review, we aim to present the role of radiotherapy in the management of muscle invasive bladder cancer. Alternative methods of improving treatment accuracy such as helical tomotherapy, adaptive radiotherapy and radiochemotherapy are also discussed.
在过去几十年中，放射治疗（RT）在膀胱癌治疗中的作用经历了多次变化。最近，已经制定了许多方案来支持多模态治疗的使用，并且器官保留的概念开始被重新审视。放射治疗计划、验证和实施方面的进展提供了一种优化膀胱癌放射治疗并克服先前限制该治疗成功的困难的方法。它们提供了通过减少受照射正常组织的体积、增加辐射剂量或使用更密集的分割和同步化疗方案来提高治疗比的机会。这些技术具有改善膀胱癌治疗结果的巨大潜力。在不久的将来，应该能够为选定的肌肉浸润性膀胱癌患者提供一种保留器官但有效的联合治疗方法。在这篇综述中，我们旨在介绍放射治疗在肌肉浸润性膀胱癌治疗中的作用。还讨论了提高治疗准确性的替代方法，如螺旋断层放疗、自适应放疗和放化疗。
