Department of Radiation Oncology, Sir Charles Gardiner Hospital, Perth, Australia; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
J Thorac Oncol. 2022 Aug;17(8):961-973. doi: 10.1016/j.jtho.2022.05.003. Epub 2022 May 29.
Toxicity concerns from thoracic radiation therapy in the treatment of lung cancers have changed substantially over the past few decades. Survival in the treatment of lung cancer has markedly improved and the introduction of advanced radiation and imaging techniques to treatment planning and delivery has made reducing toxicity possible. Phase 3 dose-escalation trials have revealed that excess dose to critical organs within the thorax can negatively impact overall survival. We summarize the existing literature on the known toxicities of thoracic radiation therapy, summarize the technological advances that have made toxicity reduction possible, and provide an overview of emerging technologies and biomarkers that are being evaluated to assess future toxicity reductions.
在过去几十年中，肺癌放射治疗的毒性问题发生了重大变化。肺癌的治疗生存率有了显著提高，先进的放射和成像技术在治疗计划和实施中的应用使得降低毒性成为可能。3 期剂量递增试验表明，胸部关键器官的过量剂量会对总生存率产生负面影响。我们总结了关于胸部放射治疗已知毒性的现有文献，总结了使毒性降低成为可能的技术进步，并概述了正在评估的新兴技术和生物标志物，以评估未来的毒性降低。
