Эволюционное развитие технологий лучевой терапии местно-распространенного рака шейки матки

Автор: Солодкий В.А., Титова В.А., Паньшин Г.А.

Журнал: Вестник Российского научного центра рентгенорадиологии Минздрава России @vestnik-rncrr

Рубрика: Обзоры, лекции

Статья в выпуске: 4 т.22, 2022 года.

Бесплатный доступ

За последние два десятилетия парадигмы лучевой терапии полностью перешли от двумерного подхода (2D), основанного исключительно на анатомических костныхориентирах, к трехмерному (3D) индивидуальному дозиметрическому планированию под визуальным контролем с учетом различия в размере, положении опухоли и органов риска (ОР) для более точного подведения очаговых доз к клиническим мишеням с одновременным максимальным щажением ОР. В данной статье кратко представлены достижения в области дистанционной лучевой терапии (ДЛТ) и автоматизированной брахитерапии (БТ) для лечения местнораспространенного рака шейки матки. Внимание акцентировано на исторической эволюции от технологий 2D-лучевой терапии к 3D-конформной лучевой терапии (3D CRT) с последующим переходом к лучевой терапии с модулированной интенсивностью (IMRT), которая в настоящее время становится стандартом планирования и реализации ДЛТ. Обсуждены достижения БТ, в частности, эволюция от манчестерской системы БТ в условиях низкой мощности дозы излучения до внедряемой в настоящее время адаптивной БТ под трехмерным визуальным контролем (3D-IGABT). В этом контексте уделено внимание недавно проведенным крупным когортным исследованиям, которые показали значительное улучшение местного контроля (МК) и снижение токсичности, связанной с применением технологии 3D-IGABT. Кратко отмечены и другие технологические достижения в лучевой терапии инвазивного местнораспространенного рака шейки матки.

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Местно-распространенный рак шейки матки, дистанционная лучевая терапия, брахитерапия, эволюция технологий лучевой терапии

Короткий адрес: https://sciup.org/149142263

IDR: 149142263

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