从放射生物学角度辨析局部晚期非小细胞肺癌的放射治疗剂量

Analysis of Radiotherapy Dose on Local Advanced Non-small Cell Lung Cancer from Radiation Biological Perspective

放射生物学理论指导下,通过不同肺癌细胞株的放射敏感性不同、不同肺腺癌亚分型化放疗反应不同、微环境与代谢因素影响肿瘤的放射杀灭效应、放化疗剂量不足造成残留细胞侵袭转移能力增强的反作用和放射损伤与修复等大量实验结论,论述局部晚期非小细胞肺癌同期放化疗剂量与最终效应取决于各种放射生物学因素、异质性、综合治疗措施等。所以,应该客观辩证分析,不过度拘泥于RTOG0617结果的60Gy标准剂量限制,要在尽量减少正常组织损伤和保护重要器官基础上,予以个体化高剂量放疗,并指出标准剂量模式不适用于大分割放射治疗。

In this paper,a lot of conclusions of experiments on radiation effects were reviewed via guiding by the radiation biological theories.They were the different radiation sensitivities among different lung cancer cell lines,the different responses to chemoradiotherapy among different subtypes of lung adenocarcinoma,the affects on radiation killing effects of tumors with microenvironment and metabolic factors.In addition,the counter effect which residual cells after irradiated at low dose become more abilities of invasion and metastasis and DNA damage and repair,etc.had been discussed.It is stated that radiation dose and effects on local advanced non-small cell lung cancer during concurrent chemoradiotherapy depended upon the various radiobiological factors,heterogeneities,comprehensive treatment measures and so on.Therefore,irradiation on local advanced non-small cell lung cancer should not be rigidly limited to the standard dose of 60Gy during chemoradiotherapy.Individual high doses should be irradiated after we made objective dialectical analysis.Also,the standard dose 60Gy is not suitable for hypofractionated radiation therapy.