Chan S, Rowbottom L, McDonald R, Bjarnason G A, Tsao M, Danjoux C, Barnes E, Popovic M, Lam H, DeAngelis C, Chow E
Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Clin Oncol (R Coll Radiol). 2017 Apr;29(4):231-238. doi: 10.1016/j.clon.2016.12.005. Epub 2016 Dec 26.
Circadian rhythm-dependent cell cycle progression produces daily variations in radiosensitivity. This literature review aims to summarise the data on whether radiotherapy outcomes differ depending on administration time. A literature search was conducted on Ovid Medline, Embase, Cochrane Central Register of Controlled Trials and PubMed using key words such as 'radiotherapy', 'circadian rhythm', 'treatment outcome' and 'survival'. Articles evaluating the correlation between radiotherapy time and outcomes in cancer patients were included and relevant information was extracted. Nine studies met the inclusion criteria. Four investigated lung cancer patients undergoing stereotactic radiosurgery for brain metastases, with one study observing improved local control and survival in patients treated in the morning. Another two studies with breast and cervical cancer patients observed that the prevalence of toxicities was higher in afternoon and morning cohorts, respectively. Two studies in head and neck cancer patients found trends indicating morning patients experienced less oral mucositis. Increased toxicities and biochemical failure rates were associated with evening treatment in prostate cancer patients. As inconsistencies in the literature exist regarding the time dependency of radiotherapy outcomes, further investigation is warranted.
昼夜节律依赖性细胞周期进程导致放射敏感性出现每日变化。这篇文献综述旨在总结关于放疗结果是否因给药时间而异的数据。使用“放疗”“昼夜节律”“治疗结果”和“生存”等关键词在Ovid Medline、Embase、Cochrane对照试验中央注册库和PubMed上进行了文献检索。纳入了评估癌症患者放疗时间与结果之间相关性的文章，并提取了相关信息。九项研究符合纳入标准。四项研究调查了接受立体定向放射外科治疗脑转移瘤的肺癌患者，其中一项研究观察到上午接受治疗的患者局部控制和生存率有所提高。另外两项针对乳腺癌和宫颈癌患者的研究分别观察到，下午和上午队列中毒性的发生率更高。两项针对头颈癌患者的研究发现有趋势表明上午接受治疗的患者口腔黏膜炎较少。前列腺癌患者夜间治疗与毒性增加和生化失败率升高有关。由于关于放疗结果的时间依赖性，文献中存在不一致之处，因此有必要进行进一步研究。
