从临床实践因素再论局部晚期非小细胞肺癌放射治疗的剂量问题  

Radiation Therapy Dosage for Locally Advanced Non-Small Cell Lung Cancer Based on Clinical Practice

作　　者：李文辉 Li Wenhui(Department of Radiation Oncology,Yunnan Cancer Hospital&The Third Affiliated Hospital of Kunming Medical University&Yunnan Cancer Centery Kunming 650118,Yunnan,China)

机构地区：[1]云南省肿瘤医院/昆明医科大学第三附属医院/云南省癌症中心放射治疗中心,昆明650118

出　　处：《肿瘤预防与治疗》2020年第6期457-462,共6页Journal of Cancer Control And Treatment

基　　金：国家自然科学基金(编号:81660504)。

摘　　要：局部晚期非小细胞肺癌放射治疗的剂量问题还不止于放疗技术和放射生物学,更包括证据基础上的临床因素、生存期与生存质量等实际问题。肿瘤分期、综合治疗原则、全程管理、干预药物和精细化的靶区定义与照射技术等因素影响照射剂量。放射生物学原理指导下的"中间剂量"与更高剂量照射的探讨也提示利用图像引导放射治疗、四维放疗技术和深吸气屏气等最新精细化放射治疗技术,可以严格限制危及器官照射剂量,减少相关毒性,有利于更高剂量的个体化的放射治疗。The issue on radiation dosage on locally advanced non-small cell lung cancer is related not only to radiotherapy techniques and radiation oncology but also clinical factors based on the evidence,life span and qualities of life and so on.Those,such as tumor Staging,principles of comprehensive treatment,full managements,intervention drugs and refined target definition and irradiation techniques,etc.can influence on radiation dose.The investigations on the intermediate or the higher radiation doses guided by the principles of radiobiology suggested that it is benefit of a higher dose individualized radiation therapy via fine irradiation techniques,eg.Image-guided radiation therapy,4-dimensional radiotherapy and deep inhalation breath hold technique to strictly limiting irradiation exposure to organs at risk and reduction of related toxicity.

关 键 词：非小细胞肺癌 放射治疗 RTOG 0617 

分 类 号：R734.2[医药卫生—肿瘤] R730.55[医药卫生—临床医学]