国际淋巴瘤放射治疗协作组（ILROG）现代放射治疗照射野与剂量指南——结外淋巴瘤（ENL）  

Modern radiation therapy for extranodal lymphomas：field and dose guidelines from internationallymphomaradiation oncology group

作　　者：杨颛搏 刘欣 亓姝嫡 李晔雄 

机构地区：[1]中国医学科学院北京协和医学院,北京100005 [2]国家癌症中心、中国医学科学院北京协和医学院肿瘤医院放疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2017年第9期971-984,共14页Chinese Journal of Radiation Oncology

摘　　要：ENL约占NHL总数的1/3。放疗常用于初始治疗（尤其是惰性结外淋巴瘤）、系统治疗后的巩固治疗、挽救性治疗以及姑息治疗。由于ENL临床表现多种多样,可以累及全身各器官,病理亚型丰富,给常规临床诊疗以及开展前瞻性和回顾性研究带来诸多困难。不同中心或医生使用的放疗方法亦不尽相同。迄今,ENL的放疗缺乏相关指南。本文中ILROG专家们统一了ENL治疗原则,同时阐述了常见ENL的模拟定位、靶区定义和计划制定,并详尽介绍了放疗靶区勾画方法。本文应用的ISRT新原则,与之前发表的HL和结内NHL指南相同。本文靶区基于ICRU文件,与实体肿瘤相同。此外,本文根据组织分型、解剖结构、治疗目的以及放疗前可能应用的其他治疗模式,为不同器官淋巴瘤放疗给予特殊推荐。Extranodal lymphomas （ENLs） comprise about a third of all non-Hodgkin lymphomas （NHL）.Radiation therapy （RT） is frequently used as either primary therapy （particularly for indolent ENL）,consolidation after systemic therapy,salvage treatment,or palliation. The wide range of presentations of ENL,involving any organ in the body and the spectrum of histological sub-types,poses a challenge both for routine clinical care and for the conduct of prospective and retrospective studies. This has led to uncertainty and lack of consistency in RT approaches between centers and clinicians. Thus far there is a lack of guidelines for the use of RT in the management of ENL.This report presents an effort by the International Lymphoma Radiation Oncology Group （ILROG） to harmonize and standardize the principles of treatment of ENL,and to address the technical challenges of simulation,volume definition and treatment planning for the most frequently involved organs. Specifically,detailed recommendations for RT volumes are provided. We have applied the same modern principles of involved site radiation therapy as previously developed and published as guidelines for Hodgkin lymphoma and nodal NHL.We have adopted RT volume definitions based on the International Commission on Radiation Units and Measurements （ICRU）,as has been widely adopted by the field of radiation oncology for solid tumors. Organ-specific recommendations take into account histological subtype,anatomy,the treatment intent,and other treatment modalities that may be have been used before RT.

关 键 词：淋巴瘤/放射疗法 靶区勾画 应用指南 

分 类 号：R730.55[医药卫生—肿瘤] R733.1[医药卫生—临床医学]