Moderne Bestrahlungstechniken

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• 作者：PD Dr. H.A. Wolff (1)
  
  1. Klinik f眉r Strahlentherapie und Radioonkologie ; Universit盲tsmedizin G枚ttingen ; Robert-Koch-Stra脽e 40 ; 37075 ; G枚ttingen ; Deutschland
  
• 关键词：Intensit盲tsmodulierte Radiotherapie ; Rektumkarzinom ; Multimodale Therapie ; Individualisierung ; Moderne Bestrahlungstechniken ; Intensity modulated radiotherapy ; Rectal cancer ; Multimodal treatment ; Individualization ; Modern irradiation techniques
• 刊名：Der Onkologe
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：21
• 期：2
• 页码：111-116
• 全文大小：458 KB
• 参考文献：1. Arbea L, Ramos Li, Martinez-Monge R et al (2010) Intensity-modulated radiation therapy (IMRT) vs. 3D conformal radiotherapy (3DCRT) in locally advanced rectal cancer (LARC): dosimetric comparison and clinical implications. Radiat Oncol 5:17 CrossRef
  2. Aschele C, Friso Ml, Pucciarelli S et al (2005) A phase I-II study of weekly oxaliplatin, 5-fluorouracil continuous infusion and preoperative radiotherapy in locally advanced rectal cancer. Ann Oncol 16:1140鈥?146 CrossRef
  3. Chen YJ, Liu A, Tsai PT et al (2005) Organ sparing by conformal avoidance intensity-modulated radiation therapy for anal cancer: dosimetric evaluation of coverage of pelvis and inguinal/femoral nodes. Int J Radiat Oncol Biol Phys 63:274鈥?81 CrossRef
  4. Crane CH, Janjan NA, Mason K et al (2002) Preoperative chemoradiation for locally advanced rectal cancer: emerging treatment strategies. Oncology (Williston Park) 16:39鈥?4
  5. De Castro G Jr, Snitcovsky IM, Gebrim EM et al (2007) High-dose cisplatin concurrent to conventionally delivered radiotherapy is associated with unacceptable toxicity in unresectable, non-metastatic stage IV head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 264:1475鈥?482 CrossRef
  6. Dr枚ge L, Weber H, Herrmann M et al (2014) Monozentrischer Vergleich der Effekte einer Intensit盲tsmodulierten Rotationsbestrahlung (VMAT) oder 3D-konformalen Therapie bei Patienten mit lokal fortgeschrittenem Rektumkarzinom. In: DEGRO 2014. Springer, D眉sseldorf, S聽88
  7. Franzmann EJ, Lundy DS, Abitbol AA et al (2006) Complete hypopharyngeal obstruction by mucosal adhesions: a complication of intensive chemoradiation for advanced head and neck cancer. Head Neck 28:663鈥?70 CrossRef
  8. Guerrero Urbano MT, Henrys AJ, Adams EJ et al (2006) Intensity-modulated radiotherapy in patients with locally advanced rectal cancer reduces volume of bowel treated to high dose levels. Int J Radiat Oncol Biol Phys 65:907鈥?16 CrossRef
  9. Jemal A, Siegel R, Ward E et al (2009) Cancer statistics, 2009. CA Cancer J Clin 59:225鈥?49 CrossRef
  10. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft Dk, Awmf) S3-Leitlinie Kolorektales Karzinom, Langversion 1.0, AWMF, Registrierungsnummer: 021-007OL. http://leitlinienprogramm-onkologie.de/Leitlinien.7.0.html
  11. Lin A, Ben-Josef E (2007) Intensity-modulated radiation therapy for the treatment of anal cancer. Clin Colorectal Cancer 6:716鈥?19 CrossRef
  12. Midgley R, Kerr D (1999) Colorectal cancer. Lancet 353:391鈥?99 CrossRef
  13. Milano MT, Jani AB, Farrey KJ et al (2005) Intensity-modulated radiation therapy (IMRT) in the treatment of anal cancer: toxicity and clinical outcome. Int J Radiat Oncol Biol Phys 63:354鈥?61 CrossRef
  14. Nagtegaal ID, Gosens MJ, Marijnen CA et al (2007) Combinations of tumor and treatment parameters are more discriminative for prognosis than the present TNM system in rectal cancer. J Clin Oncol 25:1647鈥?650 CrossRef
  15. Richetti A, Fogliata A, Clivio A et al (o J) Neo-adjuvant chemo-radiation of rectal cancer with volumetric modulated arc therapy: summary of technical and dosimetric features and early clinical experience. Radiat Oncol 5:14
  16. Rodel C, Sauer R (2007) Integration of novel agents into combined-modality treatment for rectal cancer patients. Strahlenther Onkol 183:227鈥?35 CrossRef
  17. Samuelian JM, Callister MD, Ashman JB et al (2012) Reduced acute bowel toxicity in patients treated with intensity-modulated radiotherapy for rectal cancer. Int J Radiat Oncol Biol Phys 82:1981鈥?987 CrossRef
  18. Sauer R, Becker H, Hohenberger W et al (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351:1731鈥?740 CrossRef
  19. Schirmer MA, Mergler CP, Rave-Frank M et al (2012) Acute toxicity of radiochemotherapy in rectal cancer patients: a risk particularly for carriers of the TGFB1 Pro25 variant. Int J Radiat Oncol Biol Phys 83:149鈥?57 CrossRef
  20. Vorwerk H, Hermann RM, Christiansen H et al (2007) A special device (double-hole belly board) and optimal radiation technique to reduce testicular radiation exposure in radiotherapy of rectal cancer. Radiother Oncol 84:320鈥?27 CrossRef
  21. Vorwerk H, Liersch T, Rothe H et al (2009) Gold markers for tumor localization and target volume delineation in radiotherapy for rectal cancer. Strahlenther Onkol 185:127鈥?33 CrossRef
  22. Wolff HA, Conradi LC, Beissbarth T et al (2013) Gender affects acute organ toxicity during radiochemotherapy for rectal cancer: long-term results of the German CAO/ARO/AIO-94 phase III trial. Radiother Oncol 108:48鈥?4 CrossRef
  23. Wolff HA, Conradi LC, Schirmer M et al (2011) Gender-specific acute organ toxicity during intensified preoperative radiochemotherapy for rectal cancer. Oncologist 16:621鈥?31 CrossRef
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-0415

文摘

Background Radiotherapy is one of the three fundamental modalities in the multimodal treatment of patients with locally advanced rectal cancer. Due to the good overall prognosis, therapy-related side effects play an important role in the long-term quality of life of these patients. An optimized treatment including modern irradiation techniques, such as intensity modulated radiotherapy (IMRT) could lead to lower doses to the organs at risk and therefore help to protect against chronic toxicity, especially with respect to intensified therapy regimens. Objectives and results This article outlines the role of modern radiotherapy within multimodal treatment concepts of rectal cancer and the importance of an optimized course of therapy and the technical development of irradiation techniques are discussed. As only very few long-term data for IMRT of rectal cancer exist, a possible effect on tumor response and the occurrence of side effects are discussed also based on the results of other tumor entities. In summary a significant benefit of the new techniques for the treatment of rectal is self-evident. Discussion and conclusion The multimodal treatment of rectal cancer should be performed under standardized and optimized conditions. Based on the initial data and experience with other tumor entities, the widespread introduction of IMRT could help to reduce both acute and chronic side effects in the treatment of rectal cancer patients without compromising tumor control. For a final assessment, additional long-term data from controlled studies and larger patient numbers are needed.