放疗在非小细胞肺癌治疗中地位和研究进展

The position and progress of rediotherapy in NSCLC

放疗仍是非小细胞肺癌(NSCLC)重要的局部治疗手段。新的放疗技术如适形放疗,PET/CT参与靶区确定,摆位和器官移动所导致误差的测定等已被用于临床,并指导病人的个体化的治疗。新的放疗技术临床应用有望提高手术完全切除后的IIIa期患者生存疗效。对于不能耐手术的早期患者或局部晚期患者,放疗布野为累及野照射,放疗剂量递增也因为采用了新的放疗技术而成为可能。正常肺放疗剂量体积因子有一定预测放射性肺损伤并指导临床作用。

Thoracic radiotherapy has been a key component of local treatment for the patients with non small cell lung cancer(NSCLC)。Many state of the art technologies, such as conformal radiotherapy, integration of PET imaging into target definition, measures of set-up and movement uncertainties have been used in the clinic and guided the treatment of individual patient. The treatment outcome of postoperative radiotherapy using new techniques has been improved for stage IIIa resected NSCLC. For the patients with inoperable or local advanced NSCLC,the involved field radiotherapy had been used. Dose escalation has become possible in recent years because of improved radiation technology to spare normal tissues. Introduction of risk estimation of normal lung based on dose-volume analysis for dose prescription may further optimise individual treatment