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头颈部癌症的现代放射治疗。

Modern radiotherapy for head and neck cancer.

机构信息

Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy.

Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy.

出版信息

Semin Oncol. 2019 Jun;46(3):233-245. doi: 10.1053/j.seminoncol.2019.07.002. Epub 2019 Jul 26.

Abstract

Radiation therapy (RT) plays a key role in curative-intent treatments for head and neck cancers. Its use is indicated as a sole therapy in early stage tumors or in combination with surgery or concurrent chemotherapy in advanced stages. Recent technologic advances have resulted in both improved oncologic results and expansion of the indications for RT in clinical practice. Despite this, RT administered to the head and neck region is still burdened by a high rate of acute and late side effects. Moreover, about 50% of patients with high-risk disease experience loco-regional recurrence within 3 years of follow-up. Therefore, in recent decades, efforts have been dedicated to optimize the cost/benefit ratio of RT in this subset of patients. The aim of the present review was to highlight modern concepts of RT for head and neck cancers considering both the technological advances that have been achieved and recent knowledge that has informed the biological interaction between radiation and both tumor and healthy tissues.

摘要

放射治疗(RT)在头颈部癌症的根治性治疗中起着关键作用。它可单独用于早期肿瘤,也可与手术或同期化疗联合用于晚期肿瘤。最近的技术进步不仅改善了肿瘤学结果,而且扩大了 RT 在临床实践中的适应证。尽管如此,头颈部区域的 RT 仍然存在急性和晚期副作用发生率高的问题。此外,约 50%的高危疾病患者在随访 3 年内出现局部区域复发。因此,近几十年来,人们一直致力于优化这部分患者的 RT 成本效益比。本综述的目的是强调头颈部癌症 RT 的现代理念,既要考虑到已经取得的技术进步,也要考虑到最近的知识,这些知识阐明了辐射与肿瘤和健康组织之间的生物学相互作用。

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