Cho Oyeon, Chun Mison
Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
Radiat Oncol J. 2018 Dec;36(4):254-264. doi: 10.3857/roj.2018.00500. Epub 2018 Dec 31.
This article reviewed new trends and controversial issues, including the intensification of chemotherapy and recent brachytherapy (BT) advances, and also reviewed recent consensuses from different societies on the management of locally advanced cervical cancer (LACC). Intensive chemotherapy during and after radiation therapy (RT) was not recommended as a standard treatment due to severe toxicities reported by several studies. The use of positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) for pelvic RT planning has increased the clinical utilization of intensity-modulated radiation therapy (IMRT) for the evaluation of pelvic lymph node metastasis and pelvic bone marrow. Recent RT techniques for LACC patients mainly aim to minimize toxicities by sparing the normal bladder and rectum tissues and shortening the overall treatment time by administering a simultaneous integrated boost for metastatic pelvic lymph node in pelvic IMRT followed by MRI-based image guided adaptive BT.
本文回顾了新趋势和有争议的问题，包括化疗的强化及近期近距离放疗（BT）的进展，还回顾了不同学会关于局部晚期宫颈癌（LACC）管理的近期共识。由于多项研究报告的严重毒性，放疗（RT）期间及之后的强化化疗不被推荐作为标准治疗。正电子发射断层扫描 - 计算机断层扫描（PET-CT）和磁共振成像（MRI）在盆腔RT计划中的应用增加了调强放射治疗（IMRT）在评估盆腔淋巴结转移和盆腔骨髓方面的临床应用。LACC患者的近期RT技术主要旨在通过 sparing正常膀胱和直肠组织来最小化毒性，并通过在盆腔IMRT中对转移性盆腔淋巴结进行同步整合加量，随后进行基于MRI的图像引导适应性BT来缩短总治疗时间。 （注：原文中“sparing”可能有误，推测应为“sparing”，意为“ sparing正常膀胱和直肠组织来最小化毒性” ）
