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立体定向体部放射治疗(SBRT)治疗肾细胞癌:技术方面、生物学原理和当前文献的概述。

Stereotactic body radiation therapy (SBRT) on renal cell carcinoma, an overview of technical aspects, biological rationale and current literature.

机构信息

Department of Radiation Oncology, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Italy.

Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata General Hospital, Rome, Italy.

出版信息

Crit Rev Oncol Hematol. 2018 Nov;131:24-29. doi: 10.1016/j.critrevonc.2018.08.010. Epub 2018 Aug 28.

Abstract

BACKGROUND

Stereotactic body radiotherapy (SBRT) is characterized by the delivery of high doses of ionizing radiation in few fractions. It is highly effective in achieving local control, and, due to the high biological effective dose administered, it seems to overcome the radioresistance of renal cell carcinoma (RCC). Thus, SBRT could constitute a treatment option for the management of localized RCC in patients who are not surgical candidates. In this paper, we report an overview about data from the current evidence about SBRT in patients affected by localized RCC.

MATERIALS AND METHODS

A non-systematic review was performed, including data from both retrospective and prospective studies focusing on the use of SBRT for localized RCC and its biological rationale. Furthermore, ongoing trials on this issue are reported.

CONCLUSION

Currently, SBRT might be considered a treatment alternative in inoperable patients affected by primary RCC. Currently, dose-escalation to 48 Gy in 3-4 fractions are effective and well tolerated. Emerging role of immune therapies in RCC patients warrant further studies to explore interactions between SBRT and immune response.

摘要

背景

立体定向体部放疗(SBRT)的特点是在少数几次分割中给予高剂量的电离辐射。它在实现局部控制方面非常有效,并且由于给予的高生物有效剂量,它似乎克服了肾细胞癌(RCC)的放射抵抗性。因此,SBRT 可能成为不能手术的局部 RCC 患者的一种治疗选择。本文报告了关于 SBRT 治疗局部 RCC 患者的现有证据的概述。

材料和方法

进行了非系统性综述,包括来自回顾性和前瞻性研究的数据,重点是 SBRT 治疗局部 RCC 及其生物学原理。此外,还报告了正在进行的相关试验。

结论

目前,SBRT 可能被认为是不能手术的原发性 RCC 患者的一种治疗选择。目前,48Gy 分 3-4 次分割的剂量递增是有效且耐受良好的。免疫治疗在 RCC 患者中的新作用需要进一步研究以探索 SBRT 与免疫反应之间的相互作用。

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