Turcas Andrada, Kelly Sarah M, Clementel Enrico, Cernea Dana
The European Society for Paediatric Oncology (SIOPE), Brussels, Belgium.
The European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium.
Clin Transl Radiat Oncol. 2022 Nov 11;38:96-103. doi: 10.1016/j.ctro.2022.11.003. eCollection 2023 Jan.
Tomotherapy is a method of delivering rotational IMRT offering various advantages, notably for complex and large targets such as the cranio-spinal axis. This systematic literature review reports on main clinical outcomes and toxicities in patients with various cancer types that received whole craniospinal axis irradiation (CSI) using Tomotherapy and offers a comprehensive comparison between Tomotherapy and other radiotherapy delivery techniques. Databases including PubMed, PubMed Central, Embase, and Cochrane were searched using the keywords "tomotherapy" AND "craniospinal". Fifty-six papers were included in the review. Patient population was adult in 9 papers, paediatric in 26 papers and mixed in 14 papers. Patients treated with helical Tomotherapy had similar disease-specific clinical outcomes and toxicities as patients treated using other techniques. Compared to any other technique, Tomotherapy provides better target coverage, homogeneity, and conformity in 23, 34 and 22 reports. Tomotherapy showed better organ-at-risk sparing for the thyroid, parotids, cochlea, eyes, heart and esophagus. Beam-On-Time (BOT) was reported to be longer for Tomotherapy in most studies (Median BOT: HT = 11 min, VMAT = 5.49 min, 3DCRT = 1.46 min). In conclusion, Tomotherapy offers good cranio-spinal axis coverage with improved homogeneity and conformity compared to other techniques, but with a considerably longer treatment time. Clinical outcome and toxicities suggest using Tomotherapy for CSI is efficient and safe.
断层放射治疗是一种提供旋转调强放疗的方法，具有多种优势，特别是对于如颅脊髓轴等复杂和较大的靶区。本系统文献综述报告了使用断层放射治疗进行全颅脊髓轴照射（CSI）的各类癌症患者的主要临床结局和毒性反应，并对断层放射治疗与其他放射治疗技术进行了全面比较。使用关键词“断层放射治疗”和“颅脊髓”检索了包括PubMed、PubMed Central、Embase和Cochrane在内的数据库。该综述纳入了56篇论文。患者群体中，9篇论文为成人患者，26篇为儿童患者，14篇为混合患者。接受螺旋断层放射治疗的患者与使用其他技术治疗的患者具有相似的疾病特异性临床结局和毒性反应。与任何其他技术相比，断层放射治疗在23篇、34篇和22篇报告中分别提供了更好的靶区覆盖、均匀性和适形性。断层放射治疗在保护甲状腺、腮腺、耳蜗、眼睛、心脏和食管等危及器官方面表现更佳。在大多数研究中，断层放射治疗的照射时间（BOT）据报道更长（中位BOT：螺旋断层放射治疗=11分钟，容积调强弧形放疗=5.49分钟，三维适形放疗=1.46分钟）。总之，与其他技术相比，断层放射治疗能提供良好的颅脊髓轴覆盖，均匀性和适形性更佳，但治疗时间明显更长。临床结局和毒性反应表明，使用断层放射治疗进行全颅脊髓轴照射是有效且安全的。
