Department of Radiation Oncology, Champalimaud Centre for the Unknown, Avenida Brasilia, 1400-038 Lisbon, Portugal.
Nat Rev Urol. 2016 Jul;13(7):400-8. doi: 10.1038/nrurol.2016.106. Epub 2016 Jun 14.
Moderate hypofractionation of radiotherapy is widely considered a viable alternative to conventional fractionation for the treatment of patients with organ-confined prostate cancer, but stereotactic body radiotherapy (SBRT) is rapidly emerging as a novel treatment modality for this disease. Advances in treatment planning, image guidance, target position reproducibility and on-line tracking, coupled with a compelling radiobiological rationale, have promoted SBRT as a safe and effective treatment. Dose escalation to the tumour tissue through a decreased number of radiation fractions improves patient comfort and convenience, as well as treatment cost-effectiveness, compared with conventional radiotherapy regimens. Several clinical trials have investigated moderate and extreme hypofractionation of radiotherapy in patients with prostate cancer. Evidence is accumulating which suggests that the use of moderately hypofractionated radiotherapy can be recommended regardless of cancer risk group. Regimens of extremely hypofractionated radiotherapy have shown very good short-term efficacy and safety outcomes, but appropriately designed trials with extended follow-up monitoring are required to confirm long-term outcomes.
中等分割放射治疗被广泛认为是治疗局限性前列腺癌患者的一种可行的替代常规分割治疗的方法，但立体定向体部放射治疗（SBRT）作为一种新的治疗方法正在迅速兴起。治疗计划、图像引导、靶区位置重复性和在线跟踪方面的进展，加上令人信服的放射生物学原理，促进了 SBRT 的安全性和有效性。与常规放疗方案相比，通过减少放射次数来增加肿瘤组织的剂量，可以提高患者的舒适度和便利性，以及治疗的成本效益。多项临床试验研究了前列腺癌患者中等分割和大分割放射治疗。越来越多的证据表明，无论癌症风险组如何，使用中度分割放射治疗都可以得到推荐。极分割放射治疗方案显示出非常好的短期疗效和安全性结果，但需要设计适当的、具有长期随访监测的试验来确认长期结果。
