Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Radiation Oncology, Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, Netherlands.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Radiation Oncology, Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, Netherlands.
Lung Cancer. 2018 Sep;123:142-148. doi: 10.1016/j.lungcan.2018.07.002. Epub 2018 Jul 4.
The use of stereotactic ablative radiotherapy (SABR) for central lung tumors is increasing. Centrally located lung tumors can be subdivided into two categories, namely the 'moderately central' tumors where the planning target volume is located within 2 cm of the proximal bronchial tree, and the 'ultracentral' tumors where a planning target volume (PTV) overlaps the trachea or main stem bronchi. The toxicity of SABR appears acceptable when 'moderately central' tumors are treated using techniques that comply with organs at risk tolerance doses used for prospective trials and in recent publications. A high toxicity is seen when ultracentral tumors are treated using SABR, and conventional radiotherapy appears more appropriate in such tumors as the true normal organ tolerance doses remain unknown. When ultracentral tumors are treated with non-SABR hypofractionated radiotherapy, a homogenous dose distribution in the planning target volume and limitation of both normal organ maximum point doses and volumes receiving high doses seems to be needed.
立体定向消融放疗（SABR）在中央肺肿瘤中的应用正在增加。中央肺肿瘤可分为两类，即“中度中央”肿瘤，其靶区位于近端支气管树 2cm 以内，以及“超中央”肿瘤，其中靶区（PTV）与气管或主支气管重叠。当使用符合前瞻性试验和近期出版物中使用的风险器官耐受剂量的技术治疗“中度中央”肿瘤时，SABR 的毒性似乎可以接受。当使用 SABR 治疗超中央肿瘤时，会观察到高毒性，而在这种肿瘤中，常规放疗似乎更合适，因为真正的正常器官耐受剂量仍然未知。当使用非 SABR 超分割放疗治疗超中央肿瘤时，似乎需要在靶区中实现均匀的剂量分布，并限制正常器官最大点剂量和高剂量体积。
