多分次立体定向放射治疗在椎体转移肿瘤治疗中的作用及应用前景

摘要

Spine metastasis stereotactic body radiation therapy delivers conformal high radiation dose to the tumor target, and steep falloff dose gradients protect adjacent normal structures, especially spinal cord. Some studies demonstrated stereotactic body radiation therapy for metastatic tumors of the spine is safe and clinically effective. This technique markedly improved local control with an excellent symptomatic response compared with conventional external beam radiation therapy techniques, and is beginning to change the treatment paradigms for metastatic spine disease both as post-operative adjuvant therapy and primary definitive local treatment. Although the technique is being increasingly used in clinical practice, the optimal fractionation schedule remains uncertain. Based on the research of radiobiologic principles, radiological physics and clinical data, multiple session stereotactic body radiation therapy has some advantage in clinic.%椎体转移肿瘤的立体定向放射治疗可以给予靶区适形的高剂量，同时形成陡峭的剂量梯度，有利于保护周围正常组织，特别是脊髓。与常规放射治疗相比较，立体定向放射治疗提高肿瘤局部控制率并有利于缓解症状，成为椎体转移瘤术后辅助治疗及根治性治疗新的治疗模式。尽管该技术在临床中应用越来越广泛，但目前仍没有优化的分割方案。文献评阅表明基于放射生物、物理以及临床方面的相关研究，多分次立体定向放射治疗在临床中具有一定的优势。