Gaito Simona, Hughes Christopher, Woolf David, Radhakrishna Ganesh
Clinical Research fellow, Department of Radiotherapy, The Christie NHS Foundation Trust, Manchester M20 4BX.
ST5 (registrar), Department of Radiotherapy, The Christie NHS Foundation Trust, Manchester.
Br J Hosp Med (Lond). 2019 Apr 2;80(4):211-215. doi: 10.12968/hmed.2019.80.4.211.
This literature review clarifies the role of radiotherapy in the management of low-volume haemoptysis. Embase and Medline were interrogated, and PRISMA guidelines were then used to select relevant articles. Seventy-eight articles were considered relevant and manually reviewed. The evidence suggests that external beam radiotherapy is more effective than endobronchial brachytherapy at controlling low-volume haemoptysis. There is no evidence to recommend a combination of the two techniques. Different doses and fractionations appear equally effective, with a potential survival advantage of higher dose regimens for fitter patients. Palliative radiotherapy is effective at controlling low-volume haemoptysis. External beam radiotherapy is the first-line treatment, with endobronchial brachytherapy recommended following external beam radiotherapy failure. Choice of dose and fractionation should take into account the patient's performance status.
本综述阐明了放射治疗在少量咯血管理中的作用。检索了Embase和Medline数据库，然后使用PRISMA指南筛选相关文章。共筛选出78篇相关文章并进行人工审阅。证据表明，在控制少量咯血方面，外照射放疗比支气管内近距离放疗更有效。没有证据支持联合使用这两种技术。不同的剂量分割方案似乎同样有效，对于身体状况较好的患者，较高剂量方案可能具有生存优势。姑息性放疗在控制少量咯血方面有效。外照射放疗是一线治疗方法，若外照射放疗失败，推荐使用支气管内近距离放疗。剂量和分割方案的选择应考虑患者的身体状况。
