原发性脊柱骨肿瘤的放射治疗

Radiation therapy for primary osseous spine tumor

原发性脊柱骨肿瘤的治疗是临床工作中的难点,治疗过程中最大的挑战在于提高肿瘤局部控制率和最大程度保留神经功能之间的权衡取舍。手术是原发性脊柱骨肿瘤的一线治疗方式。然而,由于患者基础情况、肿瘤大小、位置等限制因素,手术治疗仍有其局限性。过去,常规放疗常常作为手术的辅助治疗方式;但常规放疗往往因为靶区邻近脊髓而使靶区放射剂量不足,进而导致远期预后不佳。随着放疗技术的不断发展,放射治疗在原发性脊柱骨肿瘤的治疗中发挥着越来越重要的作用。在原发性脊柱肿瘤的治疗领域,最新的放疗技术使肿瘤区域受照剂量在增加的同时将正常组织受照剂量控制在可耐受的范围内成为可能,这些放疗技术包括调强放射治疗、立体定向体部放射治疗、质子及重离子治疗以及近距离治疗。

The significant treatment challenges of primary osseous spine tumor are achieving good local control while preserving neurologic function. Surgery is the first - line treatment choice of primary osseous spine tumor. However, sometimes the surgery cannot be done because of the medical conditions of patients or the size and the location of the tumor. In the past, conventional external beam radiation was used as adjuvant therapy. The dose of conventional exter-nal beam radiation often is not enough because the target region is too close to the spinal cord leading to poor long - term prognosis. Modern radiation techniques make it possible to increase the dose of target region while sparing normal tissue. These RT modalities include intensity - modulated radiation therapy, stereotactic body radiotherapy, proton therapy, carbon ion therapy and brachytherapy.