Huertas A, Oldrini S, Nesseler J-P, Courrech F, Rétif P, Charra-Brunaud C, Peiffert D
Department of Radiotherapy, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54500 Vandœuvre-lès-Nancy, France.
Department of Radiotherapy, Institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54500 Vandœuvre-lès-Nancy, France.
Cancer Radiother. 2017 Apr;21(2):155-163. doi: 10.1016/j.canrad.2016.09.014. Epub 2017 Feb 21.
The treatment of cervical cancers according to FIGO staging is well defined. For FIGO stage IB2 or more, chemoradiotherapy followed by uterovaginal brachytherapy boost is the standard treatment. Surgery is the preferred choice for less advanced tumors. However, most French institutions propose preoperative brachytherapy followed by hysterectomy with pelvic lymphadenectomy for FIGO stage IB1 tumors over 2cm. Brachytherapy is also used for the boost after adjuvant pelvic external beam radiotherapy. Tridimensional dosimetry with optimization allows better treatment planning, delivering high doses to target volumes with limited irradiation to the organs at risk. We will discuss the indications of brachytherapy for FIGO stage IB1 tumors and the principles of pulsed-dose rate and high-dose rate techniques.
根据国际妇产科联盟（FIGO）分期对宫颈癌进行的治疗已明确界定。对于FIGO IB2期及以上患者，标准治疗是先进行放化疗，随后进行子宫阴道近距离放疗强化治疗。对于病情不太严重的肿瘤，手术是首选治疗方式。然而，大多数法国机构建议，对于肿瘤直径超过2cm的FIGO IB1期肿瘤，先进行术前近距离放疗，然后进行子宫切除术及盆腔淋巴结清扫术。近距离放疗也用于辅助盆腔外照射放疗后的强化治疗。三维剂量测定与优化可实现更好的治疗计划，在对危及器官的照射有限的情况下，向靶区输送高剂量。我们将讨论FIGO IB1期肿瘤近距离放疗的适应证以及脉冲剂量率和高剂量率技术的原理。
