Jensen A D, Langer C
Klinik für Strahlentherapie, Universitätsklinikum Gießen und Marburg, Klinikstr. 33, 35392, Gießen, Deutschland.
FB 20 (Medizin), Philipps-Universität Marburg, Marburg, Deutschland.
HNO. 2021 Apr;69(4):263-277. doi: 10.1007/s00106-020-00961-7. Epub 2020 Nov 12.
Dysphagia and xerostomia are still among the most important acute and late side effects of radiotherapy. Technical developments over the past two decades have led to improved diagnostics and recognition as well as understanding of the causes of these side effects. Based on these findings and advances in both treatment planning and irradiation techniques, the incidence and severity of treatment-associated radiogenic late sequelae could be clearly reduced by the use of intensity-modulated radiotherapy (IMRT), which could contribute to marked long-term improvements in the quality of life in patients with head and neck cancer. Highly conformal techniques, such as proton therapy have the potential to further reduce treatment-associated side effects in head and neck oncology and are currently being prospectively tested within clinical trial protocols at several centers.
吞咽困难和口干仍然是放疗最重要的急慢性副作用。过去二十年的技术发展使得对这些副作用的诊断、识别以及病因的理解都有所改善。基于这些发现以及治疗计划和照射技术的进步,使用调强放疗(IMRT)可明显降低与治疗相关的放射性晚期后遗症的发生率和严重程度,这有助于显著长期改善头颈癌患者的生活质量。高度适形技术,如质子治疗,有可能进一步减少头颈肿瘤学中与治疗相关的副作用,目前多个中心正在临床试验方案中对其进行前瞻性测试。