Tang Qiuying, Zhao Feng, Yu Xiaokai, Wu Lingyun, Lu Zhongjie, Yan Senxiang
Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Quant Imaging Med Surg. 2018 Jun;8(5):514-524. doi: 10.21037/qims.2018.06.06.
The delivery of high dose radiotherapy to tumors is often limited by the proximity of the surrounding radiosensitive normal tissues, even using modern techniques such as intensity modulated radiation therapy (IMRT). Previous studies have reported that placement of a spacer can effectively displace normal tissues. So that they are some distance away from the lesion, thus allowing for the safe delivery of high-dose radiation. The application of radioprotective spacers was first reported 30 years ago regarding radiotherapy of tongue and abdominal cancers; more recently, they are increasingly being used in prostate cancer. This review focuses on the published data concerning the features of different types of spacers and their application in various tumor sites. Placement-related complications and the cost-effectiveness of the spacers are also discussed. With the increasing use of high-precision radiotherapy in clinical practice, especially the paradigm-changing stereotactic body radiotherapy (SBRT), more robust studies are warranted to further establish the role of radioprotective spacers through materials development and novel placement techniques.
即使使用强度调制放射治疗（IMRT）等现代技术，向肿瘤输送高剂量放疗通常也会受到周围放射敏感正常组织的限制。先前的研究报告称，放置间隔物可以有效地移位正常组织。从而使它们与病变保持一定距离，从而允许安全地输送高剂量辐射。放射防护间隔物的应用最早于30年前报道用于舌癌和腹部癌的放疗；最近，它们越来越多地用于前列腺癌。本综述重点关注已发表的有关不同类型间隔物的特征及其在各种肿瘤部位应用的数据。还讨论了与放置相关的并发症和间隔物的成本效益。随着高精度放疗在临床实践中的使用越来越多，尤其是具有范式变革意义的立体定向体部放疗（SBRT），有必要进行更有力的研究，以通过材料开发和新颖的放置技术进一步确立放射防护间隔物的作用。
