Hathout Lara, Williams Terence M, Jabbour Salma K
Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ.
The Ohio State University, James Cancer Hospital, Columbus, OH 43210, USA.
Curr Colorectal Cancer Rep. 2017 Feb;13(1):61-72. doi: 10.1007/s11888-017-0351-z. Epub 2017 Mar 10.
Three-dimensional conformal radiation therapy (3DCRT) has been the standard technique in the treatment of rectal cancer. The use of new radiation treatment technologies such as intensity-modulated radiation therapy (IMRT), proton therapy (PT), stereotactic body radiation therapy (SBRT) and brachytherapy (BT) has been increasing over the past 10 years. This review will highlight the advantages and drawbacks of these techniques.
IMRT, PT, SBRT and BT achieve a higher target coverage conformity, a higher organ at risk sparing and enable dose escalation compared to 3DCRT. Some studies suggested a reduction in gastrointestinal and hematologic toxicities and an increase in the complete pathologic response rate; however, the clinical benefit of these techniques remains controversial.
The results of these new techniques seem encouraging despite conclusive data. Further trials are required to establish their role in rectal cancer.
三维适形放射治疗（3DCRT）一直是直肠癌治疗的标准技术。在过去10年中，诸如调强放射治疗（IMRT）、质子治疗（PT）、立体定向体部放射治疗（SBRT）和近距离放射治疗（BT）等新的放射治疗技术的应用一直在增加。本综述将重点介绍这些技术的优缺点。
与3DCRT相比，IMRT、PT、SBRT和BT实现了更高的靶区覆盖适形度、更好的危及器官保护，并能够提高剂量。一些研究表明，胃肠道和血液学毒性有所降低，完全病理缓解率有所提高；然而，这些技术的临床益处仍存在争议。
尽管尚无确凿数据，但这些新技术的结果似乎令人鼓舞。需要进一步的试验来确定它们在直肠癌治疗中的作用。
