外阴癌放射治疗进展

Progress of radiotherapy for vulvar cancer

放疗是治疗外阴癌的重要手段,可分为术前放疗、根治性放疗和术后放疗。同步化疗或许能够实现更好的临床结局,然而患者要面临不良反应加重的问题,因此应制定个体化放疗和化疗方案,严格限制剂量,避免治疗中断。推荐应用调强放疗技术,其在剂量学和临床疗效方面均优于常规放疗;可选择性使用组织间插植近距离放疗技术,但是要求术者有较高的操作经验,并且仍需进一步探讨适宜的靶区处方剂量和危及器官剂量限值。

Radiation therapy has a major role in curative treatment of vulvar cancer patients including preoperative radiotherapy,radical radiotherapy and postoperative radiotherapy.Radiation therapy with concurrent chemotherapy may be able to achieve better clinical outcomes,but the rate of acute and chronic toxicities may be higher.So we should develop individual radiotherapy and chemotherapy program,strictly limit the dose and avoid treatment interruption.It is recommended to apply intensity-modulated radiotherapy,which is supe-rior to conventional radiotherapy in dose and clinical efficacy.Interstitial brachytherapy can be used selectively,but it requires a high level of surgical experience,and the doses to target and organs at risk need to be further discussed.