Mancosu Pietro, Clemente Stefania, Landoni Valeria, Ruggieri Ruggero, Alongi Filippo, Scorsetti Marta, Stasi Michele
Humanitas Clinical and Research Hospital, Rozzano, Milano, Italy.
Azienda Ospedaliera Universitaria Federico II Napoli, Italy.
Phys Med. 2016 Mar;32(3):479-84. doi: 10.1016/j.ejmp.2016.03.011. Epub 2016 Apr 6.
Emerging data are showing the safety and the efficacy of Stereotactic Body Radiation Therapy (SBRT) in prostate cancer management. In this context, the medical physicists are regularly involved to review the appropriateness of the adopted technology and to proactively study new solutions. From the physics point of view there are two major challenges in prostate SBRT: (1) mitigation of geometrical uncertainty and (2) generation of highly conformal dose distributions that maximally spare the OARs. Geometrical uncertainties have to be limited as much as possible in order to avoid the use of large PTV margins. Furthermore, advanced planning and delivery techniques are needed to generate maximally conformal dose distributions. In this non-systematic review the technology and the physics aspects of SBRT for prostate cancer were analyzed. In details, the aims were: (i) to describe the rationale of reducing the number of fractions (i.e. increasing the dose per fraction), (ii) to analyze the features to be accounted for performing an extreme hypo-fractionation scheme (>6-7Gy), and (iii) to describe technological solutions for treating in a safe way. The analysis of outcomes, toxicities, and other clinical aspects are not object of the present evaluation.
新出现的数据显示了立体定向体部放射治疗（SBRT）在前列腺癌治疗中的安全性和有效性。在此背景下，医学物理师经常参与审查所采用技术的适用性，并积极研究新的解决方案。从物理学角度来看，前列腺SBRT存在两个主要挑战：（1）减轻几何不确定性；（2）生成高度适形的剂量分布，以最大程度地减少对危及器官（OARs）的照射。必须尽可能限制几何不确定性，以避免使用较大的计划靶区（PTV）边界。此外，需要先进的计划和 delivery 技术来生成最大程度适形的剂量分布。在这篇非系统性综述中，分析了前列腺癌SBRT的技术和物理方面。具体而言，目的是：（i）描述减少分次次数（即增加每次分次剂量）的原理，（ii）分析实施超分割方案（>6 - 7Gy）时应考虑的特征，以及（iii）描述安全治疗的技术解决方案。对结果、毒性和其他临床方面的分析不是本评估的对象。 （注：原文中“delivery”未翻译完整，可能是“输送”等意思，需结合完整语境确定准确含义）
