Yamazaki Hideya, Fushiki Masato, Mizowaki Takashi
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Department of Radiation Oncology, Nagahama City Hospital, Nagahama, Shiga, Japan.
J Radiat Res. 2017 Jan;58(1):71-78. doi: 10.1093/jrr/rrw059. Epub 2016 Sep 8.
The aim of this study was to survey the current status of reirradiation (Re-RT) and patterns of practice in Japan. An email questionnaire was sent to Kansai Cancer Therapist Group partner institutions, using questions similar to those in the Canadian radiation oncologist (RO) survey (2008). A total of 34 ROs from 28 institutions returned the survey. All 28 institutions experienced Re-RT cases in 2014. However, 26 of the 28 institutions (93%) reported difficulty in obtaining Re-RT case information from their respective databases. Responses from 19 institutions included the number of Re-RT cases; this rose from 183 in the period 2005-2009 (institution median = 4; 2-12.9) to 562 in the period 2010-2014 (institution median = 26; 2-225). Important considerations for indication of Re-RT were age (65%), performance status (83%), life expectancy (70%), absence of distant metastases (67%), and interval since previous treatment (73%). Previous total radiation dose (48%), volume of tissue irradiated (72%), and the biologically equivalent dose (BED; 68.5%) were taken into account during Re-RT planning. These factors were similar to those considered in the Canadian survey; however, the present study did not consider age. In eight site-specific scenarios, barring central nervous system recurrence, more than 90% of ROs agreed to perform Re-RT, which was higher than the percentage observed in the Canadian survey. Re-RT cases have increased in number and aroused interest among ROs in this decade of advanced technology. However, consensus building to establish guidelines for the practice and prospective evaluation of Re-RT is required.
本研究旨在调查日本再程放疗（Re-RT）的现状及实践模式。向关西癌症治疗师集团的合作机构发送了一份电子邮件调查问卷，问题与加拿大放射肿瘤学家（RO）调查（2008年）中的问题相似。来自28家机构的34名RO回复了调查。所有28家机构在2014年都有Re-RT病例。然而，28家机构中有26家（93%）报告称难以从各自的数据库中获取Re-RT病例信息。19家机构的回复包括Re-RT病例数；这一数字从2005 - 2009年期间的183例（机构中位数 = 4；2 - 12.9）增加到2010 - 2014年期间的562例（机构中位数 = 26；2 - 225）。Re-RT指征的重要考虑因素包括年龄（65%）、体能状态（83%）、预期寿命（70%）、无远处转移（67%）以及距上次治疗的间隔时间（73%）。再程放疗计划制定过程中会考虑先前的总辐射剂量（48%）、受照射组织体积（72%）和生物等效剂量（BED；68.5%）。这些因素与加拿大调查中考虑的因素相似；然而，本研究未考虑年龄。在八种特定部位的情况下，除中枢神经系统复发外，超过90%的RO同意进行Re-RT，这一比例高于加拿大调查中的观察值。在这一先进技术的十年中，Re-RT病例数量有所增加，并引起了RO的关注。然而，需要建立共识以制定Re-RT实践指南和前瞻性评估。
