宫颈癌骨髓保护调强放疗的研究进展  

Research progress on the bone-marrow sparing intensity-modulated radiotherapy for cervicalcancer

作　　者：王佳楠 于茜 粟秋月 刘冬梅 夏静琪 杨姗姗[1] Wang Jia'nan;Yu Xi;Su Qiuyue;Liu Dongmei;Xia Jingqi;Yang Shanshan(Department of Gynecological Radiotherapy,Harbin Medical University Cancer Hospital,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院妇科放疗,哈尔滨150081

出　　处：《中华放射肿瘤学杂志》2023年第8期731-735,共5页Chinese Journal of Radiation Oncology

基　　金：中华国际医学交流基金会肿瘤精准放疗星火计划(2019-N-11-11);国家自然科学基金(81872460)。

摘　　要：以顺铂为基础的同步放化疗已成为局部晚期宫颈癌的标准治疗方法。与单纯放射治疗相比,同步放化疗提高了患者的局部控制率和生存率,但同时也增加了急性血液学不良反应的发生率。急性血液学不良反应的发生会导致治疗中断、疗程延长等,甚至影响疗效及预后。因此,如何降低同步放化疗引起的急性血液学不良反应的发生率和严重程度是临床研究的热点。研究表明,急性血液学不良反应与盆腔骨髓照射剂量体积参数之间存在相关性,随着现代放疗技术的不断发展,调强放疗以及图像引导放射治疗等精确放疗技术可在保证肿瘤组织照射剂量的同时,实现对周围正常组织的保护。本文将重点讨论宫颈癌放疗过程中保护骨髓的可行性并总结近年来的研究进展.The cisplatin-based concurrent chemoradiotherapy(CCRT)has been accepted as a standard treatment for most locally advanced cervical cancer.Compared with radiation therapy alone,CCRT can increase tumor control and survival rates,whereas it also can increase the incidence of acute hematological toxicity,which results in the treatment interruption or delay,and may even affect clinical efficacy and prognosis of patients.Therefore,how to reduce the incidence and severity of acute hematological toxicity induced by CCRT is a hot spot of clinical research.Previous studies have demonstrated that the occurrence of hematological toxicity is associated with the volume and dose of irradiated pelvic bone marrow.With the development of modern radiotherapy technology,precise radiotherapy technologies,such as intensity-modulated radiotherapy(IMRT)and image-guided radiotherapy(IGRT),not only guaranteed the enough dose for tumor,but also realized the protection of normal tissues.This article will focus on the feasibility of bone marrow sparing during CCRT for cervical cancer,and summarize the research progress in recent years.

关 键 词：宫颈肿瘤 同步放化疗法 骨髓保护 调强放射治疗 研究进展 

分 类 号：R737.33[医药卫生—肿瘤] R730.55[医药卫生—临床医学]