Grimm M, Wenz F
Klinik für Strahlentherapie und Radioonkologie, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68135, Mannheim, Deutschland.
Urologe A. 2016 Mar;55(3):326-32. doi: 10.1007/s00120-016-0042-4.
Radiation therapy is an established cornerstone in the treatment of prostate cancer. Significant advances in the techniques and therapeutic concepts have been made in recent decades.
The objective of this article is to provide an overview of current standards of care and recent technical and conceptional developments.
Three-dimensional conformal radiotherapy has long been the standard of care for percutaneous radiotherapy. The development of intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) have increased the precision of treatment, thus, reducing side effects and allowing dose escalation. LDR (low dose rate) and HDR (high dose rate) brachytherapy alone or in combination are a treatment option in localized prostate cancer with a distinct side effect profile. The roles of proton therapy and stereotactic radiotherapy should be further investigated in prospective trials.
放射治疗是前列腺癌治疗中既定的基石。近几十年来,技术和治疗理念取得了重大进展。
本文的目的是概述当前的护理标准以及近期的技术和概念发展。
三维适形放疗长期以来一直是经皮放疗的护理标准。调强放射治疗(IMRT)和图像引导放射治疗(IGRT)的发展提高了治疗精度,从而减少了副作用并允许剂量递增。单独或联合使用的低剂量率(LDR)和高剂量率(HDR)近距离放射治疗是局限性前列腺癌的一种治疗选择,具有独特的副作用特征。质子治疗和立体定向放射治疗的作用应在前瞻性试验中进一步研究。