Fionda Bruno, Placidi Elisa, Lancellotta Valentina, Rosa Enrico, De Angeli Martina, Wojcieszek Piotr, Siebert Frank-André, De Spirito Marco, Gambacorta Maria Antonietta, Tagliaferri Luca
UOC Degenze di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
UOC Fisica per le Scienze della Vita, Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
J Contemp Brachytherapy. 2024 Aug;16(4):306-309. doi: 10.5114/jcb.2024.143223. Epub 2024 Sep 20.
Historically, several classification systems have been used for brachytherapy, and they were based on the type of clinical purpose, type of implant and timing of the implant, dose-rate, and type of loading for treatment delivery. However, over the last decades, there have been some major technological advancements, including the introduction of image-guidance and possibility to modulate the dose delivered, which have led several authors (in order to highlight the differences between old technique and new approach) to label it in a different way by replacing "brachytherapy" with "interventional radiotherapy". Modern interventional procedures involve several key aspects, which contribute to the complexity of implant phase, such as implant type, imaging used during the procedure, and role of multi-disciplinary team in operating room. By assigning scores to these procedural elements, it is possible to classify the procedure's complexity using a COMIRI classification (COMplexity Index of interventional Radiotherapy Implants). The aim of the COMIRI classification system is to appropriately highlight the need for suitable resources based on the complexity level of different procedures in terms of personnel expertise, equipment availability, and multi-disciplinary teamwork.
从历史上看，近距离放射治疗曾使用过多种分类系统，这些系统基于临床目的类型、植入物类型和植入时间、剂量率以及治疗交付的加载类型。然而，在过去几十年中，出现了一些重大技术进步，包括引入图像引导和调节所输送剂量的可能性，这使得一些作者（为了突出旧技术与新方法之间的差异）用“介入放射治疗”取代“近距离放射治疗”来以不同方式对其进行命名。现代介入程序涉及几个关键方面，这些方面导致了植入阶段的复杂性，例如植入类型、程序中使用的成像以及多学科团队在手术室中的作用。通过为这些程序要素分配分数，可以使用COMIRI分类（介入放射治疗植入物复杂性指数）对程序的复杂性进行分类。COMIRI分类系统的目的是根据不同程序在人员专业知识、设备可用性和多学科团队合作方面的复杂程度，适当地突出对合适资源的需求。
