摘要
宫颈癌治疗手段主要是手术和/或放疗联合化疗,放疗包括外照射和近距离治疗(BT),而BT又包括高剂量率BT(HDR-BT)和低剂量率BT(LDR-BT)。宫颈癌预后较好,但疗后仍有部分盆腔内和/或盆腔外复发。复发后宫颈癌治疗目前欠缺高效、微创和低不良反应的治疗手段,预后差。2002年王俊杰教授将CT引导技术引入LDR-BT领域,2015年又将3D打印技术应用到BT领域,实现了LDR-BT术前计划要求,治疗精度、质量和效率大幅度提高。2018年王俊杰教授提出立体定向近距离消融治疗(SABT)概念。历时近20年对复发宫颈癌治疗的不断尝试和探讨,积累了一定经验。本共识主要基于3D打印技术辅助CT引导BT复发宫颈癌建立规范和共识,内容包括适应证选择、剂量学要求、技术流程和辐射防护等。目前3D打印技术引导BT尚缺少循证医学证据,需要多中心前瞻性的随机研究,提高循证医学等级水平。
The main treatment options for cervical cancer include surgery and/or radiotherapy combined with chemotherapy.Radiotherapy consists of external beam radiotherapy and brachytherapy(BT).BT contains high-dose-rate(HDR-BT)and low-dose-rate brachytherapy(LDR-BT).The prognosis of cervical cancer is relatively good.However,some patients experience substantial treatment failures,such as intra-pelvic and/or extra-pelvic recurrences.Recurrent cervical cancer(RCC)has poor prognosis due to lack of effective and safe approach.In 2002,Professor Wang Junjie introduced CT-guidance into the field of LDR-BT,and fully applied 3D printing technology in BT in 2015,which met the requirement of preoperative LDR-BT planning,and significantly improving the precision,quality and efficiency of BT.In 2018,Professor Wang Junjie proposed the concept of stereotactic ablation brachytherapy(SABT).Chinese experts have attempted to treat RCC with BT for nearly two decades and accumulated certain clinical experience.Based on the 3D-printing template(3D-PT)assisted CT-guidance,the standard and consensus of BT for RCC were established,including the indications,dosimetric requirements,technological procedures and radiation protection,etc.At present,there is still a lack of phageⅢclinical and evidence-based medicine for the treatment of RCC with 3D-PT guidance,which requires prospective multi-center,randomized studies to improve the evidence-based level of BT.
作者
江萍
张福泉
程光惠
王若雨
孙宝胜
王铁君
张云艳
曲昂
王俊杰
Jiang Ping;Zhang Fuquan;Cheng Guanghui;Wang Ruoyu;Sun Baosheng;Wang Tiejun;Zhang Yunyan;Qu Ang;Wang Junjie(Department of Radiation Oncology,Peking University Third Hospital,Beijing 100191,China;Department of Radiation Oncology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Radiation Oncology,China-Japan Union Hospital of Jilin University,Changchun 130033,China;Department of Radiation Oncology,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China;Department of Radiation Oncology,Jilin Cancer Hospital,Changchun 130012,China;Department of Radiation Oncology,The Second Hospital of Jilin University,Changchun 130041,China;Department of Radiation Oncology,Affiliated Cancer Hospital of Harbin Medical University,Harbin 150081,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2020年第9期721-729,共9页
Chinese Journal of Radiation Oncology
