Department of Radiation Oncology, Peking University Third Hospital, Beijing, China; Department of Radiation Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
Brachytherapy. 2021 Mar-Apr;20(2):454-466. doi: 10.1016/j.brachy.2020.11.009. Epub 2020 Dec 24.
Brachytherapy (BT) is a minimally invasive anticancer radiotherapeutic modality where the tumor is directly irradiated via a radioactive source that is precisely implanted in or adjacent to the tumor. BT for lung cancer may be conducted in the form of endobronchial BT and radioactive seed implantation (RSI-BT), mainly for nonsmall cell lung cancer (NSCLC). For patients with early-stage lung cancer who are not suitable for surgery or external beam radiotherapy (EBRT), BT may be used as an alternative treatment, and curative results could be achieved in certain patients with cancer confined to the trachea lumen. For patients with locally advanced/metastatic lung cancer, BT could be selectively applied alone or as a boost to EBRT, which could improve the local tumor control and patient's survival. In addition, BT is also useful as a salvage treatment in select patients with locally recurrent/residual lung cancer that failed other treatments (e.g., surgery, chemotherapy, and EBRT). However, clinical outcomes are mainly obtained from retrospective studies. Prospective studies are limited and needed. In recent years, the introduction of modern image guidance, novel radioactive seeds, BT treatment planning systems (BT-TPS), after-loading technique, and three-dimensional printing template (3D-PT) assistance, among others, have potentially improved the clinical outcomes of BT. However, a comprehensive review of BT with newly published literature was lacking. This review is to discuss BT for NSCLC based on recent literature published in PubMed.
近距离放射治疗（Brachytherapy，BT）是一种微创抗癌放射治疗方法，通过将放射性源精确植入或放置在肿瘤附近来直接照射肿瘤。肺癌 BT 可采用支气管内 BT 和放射性粒子植入（Radioactive Seed Implantation，RSI-BT）的形式进行，主要用于非小细胞肺癌（Non-Small Cell Lung Cancer，NSCLC）。对于不适合手术或外束放射治疗（External Beam Radiotherapy，EBRT）的早期肺癌患者，BT 可作为替代治疗方法，对于癌症局限于气管腔的患者可能达到治愈效果。对于局部晚期/转移性肺癌患者，BT 可单独或作为 EBRT 的增敏剂应用，可提高局部肿瘤控制率和患者生存率。此外，BT 还可作为其他治疗方法（如手术、化疗和 EBRT）失败的局部复发性/残留肺癌患者的挽救治疗方法。然而，临床结果主要来自回顾性研究，前瞻性研究有限且需要进一步开展。近年来，现代图像引导、新型放射性粒子、BT 治疗计划系统（BT-TPS）、后装技术以及三维打印模板（3D-PT）辅助等的应用，可能改善了 BT 的临床结果。然而，对于新发表文献的 BT 综述较为缺乏。本综述旨在根据在 PubMed 上发表的最新文献，讨论 NSCLC 的 BT 治疗。
