体部立体定向放射治疗在颅外转移灶中的应用

doi:10.3760/cma.j.issn.1673-422X.2014.11.007

摘要/Abstract

摘要： 在恶性肿瘤颅外转移灶的治疗中体部立体定向放射治疗（SBRT）已得到有效的应用。SBRT具有肿瘤靶区剂量分布集中、靶区周边剂量梯度变化大及靶区周边正常组织受量较小等特点。SBRT放射生物学特点、SBRT治疗机制、SBRT如何整合至全身系统性治疗均得到了进一步的探究。

关键词: 肿瘤转移, 立体定向放射治疗

Abstract: Stereotactic body radiation therapy (SBRT) has been applied in extracranial metastases effectively, with the characteristics of concentrated dose distribution in target region, great dose gradient change in surrounding region and low dose in normal tissue beside target region. The radiation biology characteristics of SBRT, therapeutic mechanism, integration of SBRT into standard systemic therapy regimens have been studied further.

Key words: Neoplasm metastases, Stereotactic body radiation therapy

林钢, 王准, 许亚萍. 体部立体定向放射治疗在颅外转移灶中的应用[J]. 国际肿瘤学杂志, 2014, 41(11): 820-823.

LIN Gang, WANG Zhun, XU Ya-Ping. Application of stereotactic body radiotherapy in extracranial metastases[J]. Journal of International Oncology, 2014, 41(11): 820-823.

参考文献

［1］ Hiraki M, Nishimura J, Ohtsuka M, et al. Impact of stereotactic body radiotherapy on colorectal cancer with distant metastases［J］. Oncol Rep, 2014, 31(2):795799. ［2］ Mehta N, Selch M, Wang PC, et al. Safety and efficacy of stereotactic body radiation therapy in the treatment of pulmonary metastases from high grade sarcoma［J］. Sarcoma, 2013, 2013:360214. ［3］ Baschnagel AM, Mangona VS, Robertson JM, et al. Lung metastases treated with imageguided stereotactic body radiation therapy［J］. Clin Oncol (R Coll Radiol), 2013, 25(4):236241. ［4］ Habermehl D, Herfarth KK, Bermejo JL, et al. Singledose radiosurgical treatment for hepatic metastasestherapeutic outcome of 138 treated lesions from a single institution［J］. Radiat Oncol, 2013, 8:175. ［5］ Garg AK, Shiu AS, Yang J, et al. Phase 1/2 trial of singlesession stereotactic body radiotherapy for previously unirradiated spinal metastases［J］. Cancer, 2012, 118(20):50695077. ［6］ Bae SH, Kim MS, Cho CK, et al. High dose stereotactic body radiotherapy using three fractions for colorectal oligometastases［J］. J Surg Oncol, 2012, 106(2):138143. ［7］ Park HJ, Kim HJ, Won JH, et al. Stereotactic Body Radiotherapy (SBRT) for Spinal Metastases: Who Will Benefit the Most from SBRT?［J］. Technol Cancer Res Treat, 2014， In Press. ［8］ Kirkpatrick JP, Brenner DJ, Orton CG. The linearquadratic model is inappropriate to model high dose per fraction effects in radiosurgery［J］. Medical Phys, 2009, 36(8):33813384. ［9］ Brown JM, Carlson DJ, Brenner DJ. The tumor radiobiology of SRS and SBRT: are more than the 5 Rs involved?［J］. Int J Radiat Oncol Biol Phys Int J Radiat Oncol Biol Phys, 88(2):254262. ［10］ Fuks Z, Kolesnick R. Engaging the vascular component of the tumor response［J］. Cancer Cell, 2005, 8(2):8991. ［11］ Lee Y, Auh SL, Wang Y, et al. Therapeutic effects of ablative radiation on local tumor require CD8+ T cells: changing strategies for cancer treatment［J］. Blood, 2009, 114(3):589595. ［12］ Rusthoven KE, Kavanagh BD, Cardenes H, et al. Multiinstitutional phase Ⅰ/Ⅱ trial of stereotactic body radiation therapy for liver metastases［J］. J Clin Oncol, 2009, 27(10):15721578. ［13］ Rule W, Timmerman R, Tong L, et al. Phase Ⅰ doseescalation study of stereotactic body radiotherapy in patients with hepatic metastases［J］. An Surg Oncol, 2011, 18(4):10811087. ［14］ Timmerman R, Paulus R, Galvin J, et al. Stereotactic body radiation therapy for inoperable early stage lung cancer［J］. JAMA, 2010, 303(11):10701076. ［15］ Dhakal S, Corbin KS, Milano MT, et al. Stereotactic body radiotherapy for pulmonary metastases from softtissue sarcomas: excellent local lesion control and improved patient survival［J］. Int J Radiat Oncol Biol Phys, 2012, 82(2):940945. ［16］ Inoue T, Oh RJ, Shiomi H, et al. Stereotactic body radiotherapy for pulmonary metastases. Prognostic factors and adverse respiratory events［J］. Strahlenther Onkol, 2013, 189(4):285292. ［17］ Ricardi U, Filippi AR, Guarneri A, et al. Stereotactic body radiation therapy for lung metastases［J］. Lung Cancer, 2012, 75(1):7781. ［18］ Han K, Cheung P, Basran PS, et al. A comparison of two immobilization systems for stereotactic body radiation therapy of lung tumors［J］. Radiother Oncol, 2010, 95(1):103108. ［19］ Ahmed KA, Stauder MC, Miller RC, et al. Stereotactic body radiation therapy in spinal metastases［J］. Int J Radiat Oncol Biol Phys, 2012, 82(5):e803809. ［20］ Sahgal A, Ames C, Chou D, et al. Stereotactic body radiotherapy is effective salvage therapy for patients with prior radiation of spinal metastases［J］. Int J Radiat Oncol Biol Phys, 2009, 74(3):723731. ［21］ Massicotte E, Foote M, Reddy R, et al. Minimal access spine surgery (MASS) for decompression and stabilization performed as an outpatient procedure for metastatic spinal tumours followed by spine stereotactic body radiotherapy (SBRT): first report of technique and preliminary outcomes［J］. Technol Cancer Res Treat, 2012, 11(1):1525. ［22］ Boehling NS, Grosshans DR, Allen PK,et al. Vertebral compression fracture risk after stereotactic body radiotherapy for spinal metastases［J］. J Neurosurg Spine, 2012, 16(4):379386. ［23］ Alongi F, Arcangeli S, Filippi AR, et al. Review and uses of stereotactic body radiation therapy for oligometastases［J］. Oncologist, 2012, 17(8):11001107. ［24］ Salama JK, Hasselle MD, Chmura SJ, et al. Stereotactic body radiotherapy for multisite extracranial oligometastases: final report of a dose escalation trial in patients with 1 to 5 sites of metastatic disease［J］. Cancer, 2012, 118(11):29622970. ［25］ Ranck MC, Golden DW, Corbin KS, et al. Stereotactic body radiotherapy for the treatment of oligometastatic renal cell carcinoma［J］. Am J Clin Oncol, 2013, 36(6):589595. ［26］ Blanco AI, Teh BS, Amato RJ. Role of radiation therapy in the management of renal cell cancer［J］. Cancers, 2011, 3(4):40104023. ［27］ Hui Z, Tretiakova M, Zhang Z, et al. Radiosensitization by inhibiting STAT1 in renal cell carcinoma［J］. Int J Radiat Oncol Biol Phys Int J Radiat Oncol Biol Phys, 2009, 73(1):288295. ［28］ Kijima T, Koga F, Fujii Y,et al. Zoledronic acid sensitizes renal cell carcinoma cells to radiation by downregulating STAT1［J］. PLoS One, 2013, 8(5):e64615. ［29］ Wersll PJ, Blomgren H, Lax I, et al. Extracranial stereotactic radiotherapy for primary and metastatic renal cell carcinoma［J］. Radiother Oncol， 2005， 77(1):8895. ［30］ Anbalagan S, Pires IM, Blick C, et al. Radiosensitization of renal cell carcinoma in vitro through the induction of autophagy［J］. Radiother Oncol, 2012, 103(3):388393. ［31］ Seung SK, Curti BD, Crittenden M, et al. Phase 1 study of stereotactic body radiotherapy and interleukin2tumor and immunological responses［J］. Sci Transl Med, 2012, 4(137):137ra74. ［32］ Kao J, Chen CT, Tong CC, et al. Concurrent sunitinib and stereotactic body radiotherapy for patients with oligometastases : Final report of a prospective clinical trial［J］. Target Oncol, 2014, 9(2): 145153. ［33］ De Ruysscher D, Wanders R, van Baardwijk A, et al. Radical treatment of nonsmallcell lung cancer patients with synchronous oligometastases: longterm results of a prospective phase Ⅱ trial (Nct01282450) ［J］. J Thorac Oncol, 2012, 7(10):15471555.

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