Gérard M, Jumeau R, Pichon B, Biau J, Blais E, Horion J, Noël G
Département de radiothérapie et de physique médicale, centre Henri-Becquerel, rue d'Amiens, 76000 Rouen, France; Service de radio-oncologie, CHUV, 46, rue du Bugnon, 1011 Lausanne, Suisse.
Service de radio-oncologie, CHUV, 46, rue du Bugnon, 1011 Lausanne, Suisse.
Cancer Radiother. 2017 Oct;21(6-7):636-647. doi: 10.1016/j.canrad.2017.08.108.
Cerebral radiation-induced toxicities after radiotherapy (RT) of brain tumors are frequent. The protection of organs at risk (OAR) is crucial, especially for brain tumors, to preserve cognition in cancer survivors. Dose constraints of cerebral OAR used in conventional RT, radiosurgery (SRS) and stereotactic radiotherapy (SRT) are debated. In fact, they are based on historical cohorts or calculated with old mathematical models. Values of α/β ratio of cerebral OAR are also controversial leading to misestimate the equivalent dose in 2Gy fractions or the biological equivalent dose, especially during hypofractionated RT. Although recent progresses in medical imaging, the diagnosis of radionecrosis remains difficult. In this article, we propose a large review of dose constraints used for three major cerebral OAR: the brain stem, the hippocampus and the brain.
脑肿瘤放疗（RT）后脑部辐射诱导的毒性很常见。保护危及器官（OAR）至关重要，尤其是对于脑肿瘤，以保留癌症幸存者的认知功能。传统放疗、放射外科（SRS）和立体定向放疗（SRT）中使用的脑部OAR剂量限制存在争议。事实上，它们基于历史队列或用旧的数学模型计算得出。脑部OAR的α/β比值也存在争议，导致在估算2Gy分次等效剂量或生物等效剂量时出现错误，尤其是在大分割放疗期间。尽管医学成像最近取得了进展，但放射性坏死的诊断仍然困难。在本文中，我们对用于三个主要脑部OAR（脑干、海马体和大脑）的剂量限制进行了全面综述。
