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癌症治疗中使用大分割放射治疗的挑战与机遇:来自韩国、日本、新加坡和澳大利亚的区域视角

Challenges and Opportunities With the Use of Hypofractionated Radiation Therapy in Cancer Care: Regional Perspectives From South Korea, Japan, Singapore, and Australia.

作者信息

Akimoto Tetsuo, Aoyama Hidefumi, Chua Melvin L K, Jayamanne Dasantha, Mizowaki Takashi, Morris Lucinda, Onishi Hiroshi, Song Si Yeol, Zeidan Youssef H, Sharma Ricky A

机构信息

Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba, Japan.

Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

出版信息

Adv Radiat Oncol. 2023 Jun 14;8(6):101291. doi: 10.1016/j.adro.2023.101291. eCollection 2023 Nov-Dec.

Abstract

Hypofractionated radiotherapy schedules provide higher per-fraction radiation doses delivered in fewer fractions than conventional schedules. This novel delivery method is supported by a large body of clinical trial evidence across various cancer sites in both curative and palliative settings. Hypofractionation is associated with benefits such as lower costs, improved patient access and increased treatment precision, which has led to its inclusion in various treatment guidelines. Despite this, utilization is not uniform across cancer sites and geographic regions due to reasons such as reimbursement models, nuances in healthcare systems, and professional culture. Key factors to ensure patients benefit from access to high quality radiotherapy include publishing clinical evidence, cross-country collaboration to fill knowledge gaps, reviewing reimbursement models, and improving patient advocacy in treatment decision-making.

摘要

与传统放疗方案相比,大分割放疗方案每次分割所给予的辐射剂量更高,分割次数更少。这种新的放疗方式在治愈性和姑息性治疗环境下,已获得大量针对各种癌症部位的临床试验证据的支持。大分割放疗具有成本更低、患者就医更便捷以及治疗精度更高等优点,这使其被纳入各种治疗指南。尽管如此,由于报销模式、医疗系统的细微差别以及专业文化等原因,大分割放疗在不同癌症部位和地理区域的应用并不统一。确保患者从高质量放疗中获益的关键因素包括公布临床证据、开展跨国合作以填补知识空白、审查报销模式以及在治疗决策中加强患者宣传。

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