自适应放射治疗（ART）策略与技术考量：来自NRG肿瘤学的ART综述现状
Adaptive Radiation Therapy (ART) Strategies and Technical Considerations: A State of the ART Review From NRG Oncology.
作者信息
Glide-Hurst Carri K, Lee Percy, Yock Adam D, Olsen Jeffrey R, Cao Minsong, Siddiqui Farzan, Parker William, Doemer Anthony, Rong Yi, Kishan Amar U, Benedict Stanley H, Li X Allen, Erickson Beth A, Sohn Jason W, Xiao Ying, Wuthrick Evan
机构信息
Department of Human Oncology, University of Wisconsin-Madison, Madison, Wisconsin.
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
出版信息
Int J Radiat Oncol Biol Phys. 2021 Mar 15;109(4):1054-1075. doi: 10.1016/j.ijrobp.2020.10.021. Epub 2020 Oct 24.
The integration of adaptive radiation therapy (ART), or modifying the treatment plan during the treatment course, is becoming more widely available in clinical practice. ART offers strong potential for minimizing treatment-related toxicity while escalating or de-escalating target doses based on the dose to organs at risk. Yet, ART workflows add complexity into the radiation therapy planning and delivery process that may introduce additional uncertainties. This work sought to review presently available ART workflows and technological considerations such as image quality, deformable image registration, and dose accumulation. Quality assurance considerations for ART components and minimum recommendations are described. Personnel and workflow efficiency recommendations are provided, as is a summary of currently available clinical evidence supporting the implementation of ART. Finally, to guide future clinical trial protocols, an example ART physician directive and a physics template following standard NRG Oncology protocol is provided.
自适应放射治疗（ART），即在治疗过程中修改治疗计划，在临床实践中越来越普遍。ART在根据危及器官的剂量增加或降低靶区剂量的同时，具有将与治疗相关的毒性降至最低的强大潜力。然而，ART工作流程增加了放射治疗计划和实施过程的复杂性，这可能会引入额外的不确定性。这项工作旨在回顾目前可用的ART工作流程以及诸如图像质量、可变形图像配准和剂量累积等技术考量。描述了ART组件的质量保证考量和最低建议。提供了人员和工作流程效率建议，以及支持ART实施的现有临床证据总结。最后，为指导未来的临床试验方案，提供了一个ART医生指令示例和一个遵循标准NRG肿瘤学方案的物理模板。
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