Williams Vonetta M, Kahn Jenna M, Thaker Nikhil G, Beriwal Sushil, Nguyen Paul L, Arthur Douglas, Petereit Daniel, Dyer Brandon A
Department of Radiation Oncology, University of Washington, Seattle, Washington.
Department of Radiation Oncology, Oregon Health & Science University, Portland, Oregon.
Adv Radiat Oncol. 2021 Mar-Apr;6(2):100605. doi: 10.1016/j.adro.2020.10.018. Epub 2020 Nov 6.
The recent global events related to the coronavirus disease of 2019 pandemic have significantly changed the medical landscape and led to a shift in oncologic treatment perspectives. There is a renewed focus on preserving treatment outcomes while maintaining medical accessibility and decreasing medical resource utilization. Brachytherapy, which is a vital part of the treatment course of many cancers (particularly prostate and gynecologic cancers), has the ability to deliver hypofractionated radiation and thus shorten treatment time. Studies in the early 2000s demonstrated a decline in brachytherapy usage despite data showing equivalent or even superior treatment outcomes for brachytherapy in disease sites, such as the prostate and cervix. However, newer data suggest that this trend may be reversing. The renewed call for shorter radiation courses based on data showing equivalent outcomes will likely establish hypofractionated radiation as the standard of care across multiple disease sites. With shifting reimbursement, brachytherapy represents the pinnacle in hypofractionated, conformal radiation therapy, and with extensive long-term data in support of the treatment modality brachytherapy is primed for a renaissance.
近期与2019冠状病毒病大流行相关的全球事件显著改变了医学格局，并导致肿瘤治疗观点的转变。人们重新关注在保持医疗可及性和降低医疗资源利用的同时，维持治疗效果。近距离放射治疗是许多癌症（尤其是前列腺癌和妇科癌症）治疗过程的重要组成部分，它能够进行大分割放疗，从而缩短治疗时间。21世纪初的研究表明，尽管有数据显示近距离放射治疗在前列腺和宫颈等疾病部位的治疗效果相当甚至更优，但近距离放射治疗的使用量仍有所下降。然而，最新数据表明这一趋势可能正在逆转。基于显示等效结果的数据，对更短放疗疗程的新呼吁可能会使大分割放疗成为多个疾病部位的护理标准。随着报销政策的变化，近距离放射治疗代表了大分割适形放射治疗的巅峰，并且有大量长期数据支持这种治疗方式，近距离放射治疗正迎来复兴。
