Hennequin C, Guillerm S, Quero L
Radiation oncology department, hôpital Saint-Louis, AP-HP, Paris, France.
Radiation oncology department, hôpital Saint-Louis, AP-HP, Paris, France.
Cancer Radiother. 2019 Oct;23(6-7):500-502. doi: 10.1016/j.canrad.2019.07.156. Epub 2019 Aug 20.
Fractionation was established more than fifty years ago as the best way to obtain a differential effect between tumors and normal tissues. However, new technologies allowed today to spare critical organs from the radiation fields. And so protracted courses of irradiation are no longer required. Hypofractionation have clear practical advantages over classical fractionation: it saves the patient time; it saves money for public health system; it reduces pressure on radiotherapy units. In several localization, it has proved to be as efficient as classical fractionation without increasing late effects. In prostate cancer, some radiobiological considerations argue in favor of a better efficiency, but clinical trials did not demonstrated differences in biological control. In conclusion, for all diseases where hypofractionation was demonstrated efficient, it must be fully implemented. Invoice procedures must be adapted to maintain a sufficient level of reimbursement of radiotherapy centers.
五十多年前就确立了分次放疗作为在肿瘤与正常组织之间获得差异效应的最佳方法。然而，如今的新技术能够使关键器官免受辐射野的影响。因此，不再需要长时间的照射疗程。与传统分次放疗相比，大分割放疗具有明显的实际优势：它节省了患者的时间；为公共卫生系统节省了资金；减轻了放疗单位的压力。在多个部位，已证明其与传统分次放疗一样有效，且不会增加晚期效应。在前列腺癌中，一些放射生物学考量支持其具有更高的效率，但临床试验并未证明在生物学控制方面存在差异。总之，对于所有已证明大分割放疗有效的疾病，都必须全面实施。发票程序必须进行调整，以维持放疗中心足够的报销水平。
