Burkoň P, Slavik M, Kazda T, Pospíšil P, Prochazka T, Vrzal M, Šlampa P
Klin Onkol. 2019 Winter;32(1):10-24. doi: 10.14735/amko201910.
Stereotactic body radiotherapy (SBRT) is used to treat localized tumor lesions and consists of applying high doses of radiation to a small number of fractions using specially equipped linear accelerators, modern immobilization devices, and imaging methods, which are considered special, advanced techniques in modern day radiotherapy. SBRT is a very well tolerated, non-invasive, short-term treatment that does not require hospitalization or any complicated preparation. Compared to standard radiotherapy techniques, SBRT allows, due to its precision, significantly higher doses to be applied to the target with less damage to surrounding healthy tissues. If dose constraints are not exceeded, the risk of damage to tissues and organs around the irradiated volume is reduced to minimum. The principle of SBRT is the application of ablative doses of radiation that cause necrosis of the irradiated tissue.
The aim of this review is to provide a basic overview of SBRT indications, radiation doses used, and potential side effects. It is not intended to be a detailed description of treatment itself (such as discussion of patient fixation systems, management of respiratory movements, or image guided strategies of treatment). This review also discusses rarer indications for SBRT, such as pancreatic carcinoma or hepatocellular carcinoma.
Advances in image navigation, radiation planning, and dose application have enabled successful introduction of SBRT as a treatment regimen for many primary tumors and oligometastatic disease. If surgery is not possible or the patient refuses surgery, it is always reasonable to consider SBRT. SBRT has curative potential for the treatment of primary lung or prostate tumors. High-dose irradiation of oligometastases of various primary tumors can lead to long-term survival without disease symptoms, delay administration of toxic systemic therapies, and improve the quality of life of oncological patients. Key words radiotherapy - stereotactic body radiotherapy - review - ablative radiotherapy - lung cancer - prostate cancer - oligometastatic disease This work was supported in part by the Ministry of Health, Czech Republic - Conceptual Development of Research Organization (MMCI 00209805). The results of this research have been acquired within CEITEC 2020 (LQ1601) project with the financial contribution made by the Minis-try of Education, Youths and Sports of the Czech Republic within special support paid from the National Programme for Sustainability II funds. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 30. 10. 2018 Accepted: 4. 11. 2018.
立体定向体部放疗（SBRT）用于治疗局限性肿瘤病灶，是利用特殊配备的直线加速器、现代固定装置和成像方法，将高剂量辐射分少量分次给予，这些在现代放疗中被视为特殊的先进技术。SBRT耐受性良好、无创、短期治疗，无需住院或任何复杂准备。与标准放疗技术相比，SBRT因其精确性，能在对周围健康组织损伤较小的情况下，向靶区给予显著更高剂量的辐射。如果不超过剂量限制，照射体积周围组织和器官的损伤风险可降至最低。SBRT的原理是应用能导致照射组织坏死的消融剂量辐射。
本综述旨在提供SBRT适应症、所用辐射剂量及潜在副作用的基本概述。并非对治疗本身进行详细描述（如患者固定系统的讨论、呼吸运动管理或图像引导治疗策略）。本综述还讨论了SBRT较罕见的适应症，如胰腺癌或肝细胞癌。
图像导航、放疗计划和剂量应用方面的进展已使SBRT成功作为多种原发性肿瘤和寡转移疾病的治疗方案得以引入。如果无法进行手术或患者拒绝手术，考虑SBRT总是合理的。SBRT对原发性肺癌或前列腺癌的治疗具有治愈潜力。对各种原发性肿瘤的寡转移灶进行高剂量照射可导致长期无病生存，延迟给予毒性全身治疗，并改善肿瘤患者的生活质量。关键词放疗 - 立体定向体部放疗 - 综述 - 消融放疗 - 肺癌 - 前列腺癌 - 寡转移疾病 本研究部分得到捷克共和国卫生部 - 研究组织概念发展项目（MMCI 00209805）的支持。本研究结果是在CEITEC 2020（LQ1601）项目中获得的，由捷克共和国教育、青年和体育部在国家可持续发展计划II基金的特别支持下提供资金。作者声明他们在研究中使用的药物、产品或服务方面不存在潜在利益冲突。编辑委员会声明该手稿符合ICMJE对生物医学论文的推荐标准。提交日期：2018年10月30日 接受日期：2018年11月4日
