Zhao Yutong, Haworth Annette, Rowshanfarzad Pejman, Ebert Martin A
School of Physics, Mathematics and Computing, The University of Western Australia, Crawley, WA 6009, Australia.
Institute of Medical Physics, School of Physics, The University of Sydney, Camperdown, NSW 2050, Australia.
Cancers (Basel). 2023 Oct 8;15(19):4888. doi: 10.3390/cancers15194888.
Focal boost radiotherapy was developed to deliver elevated doses to functional sub-volumes within a target. Such a technique was hypothesized to improve treatment outcomes without increasing toxicity in prostate cancer treatment.
To summarize and evaluate the efficacy and variability of focal boost radiotherapy by reviewing focal boost planning studies and clinical trials that have been published in the last ten years.
Published reports of focal boost radiotherapy, that specifically incorporate dose escalation to intra-prostatic lesions (IPLs), were reviewed and summarized. Correlations between acute/late ≥G2 genitourinary (GU) or gastrointestinal (GI) toxicity and clinical factors were determined by a meta-analysis.
By reviewing and summarizing 34 planning studies and 35 trials, a significant dose escalation to the GTV and thus higher tumor control of focal boost radiotherapy were reported consistently by all reviewed studies. Reviewed trials reported a not significant difference in toxicity between focal boost and conventional radiotherapy. Acute ≥G2 GU and late ≥G2 GI toxicities were reported the most and least prevalent, respectively, and a negative correlation was found between the rate of toxicity and proportion of low-risk or intermediate-risk patients in the cohort.
Focal boost prostate cancer radiotherapy has the potential to be a new standard of care.
聚焦增敏放疗旨在向靶区内的功能亚体积输送更高剂量。该技术被认为在前列腺癌治疗中可改善治疗效果而不增加毒性。
通过回顾过去十年发表的聚焦增敏放疗计划研究和临床试验，总结并评估聚焦增敏放疗的疗效和变异性。
对专门纳入前列腺内病变（IPL）剂量递增的聚焦增敏放疗发表报告进行回顾和总结。通过荟萃分析确定急性/晚期≥2级泌尿生殖系统（GU）或胃肠道（GI）毒性与临床因素之间的相关性。
通过回顾和总结34项计划研究和35项试验，所有回顾研究均一致报告聚焦增敏放疗对靶区体积有显著剂量递增，从而对肿瘤有更高的控制率。回顾的试验报告聚焦增敏放疗与传统放疗在毒性方面无显著差异。急性≥2级GU毒性和晚期≥2级GI毒性分别是报告中最常见和最不常见的，且在队列中，毒性发生率与低风险或中风险患者比例之间存在负相关。
聚焦增敏前列腺癌放疗有可能成为一种新的治疗标准。
