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剂量绘画放疗研究进展

Advances of Dose-painting Radiotherapy

  • 摘要: 对多数恶性肿瘤来说,根治性放疗后局部复发比较常见,可能的原因在于对计划靶区给予均匀的处方剂量,而未考虑肿瘤本身的空间异质性。先进的影像技术如正电子发射计算机断层显像和功能磁共振影像可实施剂量绘画(dose-painting, DP)放疗,从而对放疗不敏感的肿瘤给予个体化的剂量。DP放疗包括亚区域剂量绘画和数字剂量绘画。在技术上对头颈部肿瘤、肺癌、前列腺癌、肛管癌实施DP放疗具有较好的可行性,但是还需要从技术、软硬件、临床上进一步优化。

     

    Abstract: For majority of malignancies, loco-regional failure remains the common pattern after definitive radiation therapy, and the possible reason might be that a homogenous radiation dose was usually delivered to the planning target volume without taking the spatial-temporal radiosensitive heterogeneity into account. The advanced imaging techniques such as positron emission tomography-computed tomography (PET-CT) and functional magnetic resonance imaging (fMRI) make the radiation dose be delivered to the subvolume or voxel in tumor with heterogeneous radio-sensitivity, i.e. dose-painting (DP) radiotherapy. The DP radiotherapy includes DP by contours (DPBC) or numbers (DPBN). It is feasible in technique that DP radiotherapy could be executed in the cancers of head and neck, lung, prostate and anorectum. But the DP radiation therapy is warranted to be improved in technique, software and hardware as well as to be investigated in clinical practice.

     

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