Giraud P, Tournat H, Kreps S, Bibault J-E, Dautruche A, Fabiano E, Feutren T, Durdux C
Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, 75006 Paris, France.
Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, 75006 Paris, France.
Cancer Radiother. 2019 Oct;23(6-7):496-499. doi: 10.1016/j.canrad.2019.07.124. Epub 2019 Aug 27.
Stereotactic radiotherapy of oligometastases, mono- or hypofractionated, represents a fundamental change in the practice of the specialty as it was developed for a century. Despite the great heterogeneity of sites, techniques, and doses, most studies found a high local control rate, around 70 to 90% at 2 years, and reduced toxicity, around 5% of grade 3 at 2 years. Four main phase II and III trials are underway in France. Future research concerns the association of stereotactic radiotherapy with immunotherapy or different conventional chemotherapy protocols, the identification of the best clinical presentations, and optimization of fractionation and biological dose for poor prognosis localizations.
寡转移瘤的立体定向放射治疗,无论是单次分割还是低分割,都代表了该专业一个世纪以来实践中的根本变革。尽管在部位、技术和剂量方面存在很大异质性,但大多数研究发现局部控制率较高,2年时约为70%至90%,毒性降低,2年时3级毒性约为5%。法国正在进行四项主要的II期和III期试验。未来的研究涉及立体定向放射治疗与免疫治疗或不同传统化疗方案的联合、最佳临床表现的识别以及预后不良部位的分割和生物剂量优化。