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局部晚期非小细胞肺癌的放射治疗剂量：“最大耐受剂量”还是“尽可能低剂量”？

Radiotherapy Dosing for Locally Advanced Non-Small Cell Lung Carcinoma: "MTD" or "ALARA"?

作者信息

Ohri Nitin

机构信息

Radiation Oncology, Albert Einstein College of Medicine, The Bronx, NY, United States.

Radiation Oncology, Montefiore Medical Center, The Bronx, NY, United States.

出版信息

Front Oncol. 2017 Sep 21;7:205. doi: 10.3389/fonc.2017.00205. eCollection 2017.

DOI:10.3389/fonc.2017.00205
PMID:28983464
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5613081/
Abstract

Locally advanced non-small cell lung cancer (LA-NSCLC) is typically treated with thoracic radiotherapy, often in combination with cytotoxic chemotherapy. Despite tremendous advances in the evaluation, treatment techniques, and supportive care measures provided to LA-NSCLC patients, local disease progression and distant metastases frequently develop following definitive therapy. A recent landmark randomized trial demonstrated that radiotherapy dose escalation may reduce survival rates, highlighting our poor understanding of the effects of thoracic radiotherapy for LA-NSCLC. Here, we present rationale for further studies of radiotherapy dose escalation as well as arguments for exploring relatively low radiotherapy doses for LA-NSCLC.

摘要

局部晚期非小细胞肺癌（LA-NSCLC）通常采用胸部放疗进行治疗，常联合细胞毒性化疗。尽管在LA-NSCLC患者的评估、治疗技术和支持性护理措施方面取得了巨大进展，但在确定性治疗后，局部疾病进展和远处转移仍经常发生。最近一项具有里程碑意义的随机试验表明，放疗剂量增加可能会降低生存率，这凸显了我们对LA-NSCLC胸部放疗效果的了解不足。在此，我们阐述了进一步研究放疗剂量增加的理论依据，以及探讨LA-NSCLC相对低放疗剂量的理由。

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