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在手术后放射治疗的目标划定头癌在片重建后的头癌

Xuguang Scott Chen¹, David J Sher², Christopher Blake Sullivan³

¹Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina.

Practical radiation oncology

|April 18, 2024

概括

在片重建后,将整个片纳入临床目标体积 (CTV) 进行头癌放射治疗是标准做法. 这种方法旨在防止边缘失误和内故障,优化治疗结果.

科学领域:

在瘤学瘤学.
辐射瘤学辐射瘤学
头部和部手术头部和部手术

背景情况:

在用片重建切除头癌之后,临床目标体积 (CTV) 划分具有挑战性.
一个关键的辩论涉及是否包括整个在CTV.
之前的研究表明,当板不完全包括在内时,就会发生边缘失误和板内部故障.

研究的目的:

评估在头癌患者的CTV中包括整个的标准实践.
讨论可能考虑将剂量减少到片部分的情景.
在具体情况下,提供案例简介,说明合理的折叠板节省.

主要方法:

对临床实践和现有病例系列的审查,涉及CTV划分后的翻盖重建.
分析与CTV.Flap包含/排除相关的结果.
病例简介与详细的临床情景的介绍.

主要成果:

在CTV中包括整个板是减轻复发风险的标准做法.
手术后的辐射可以改善片的结果 (脱毛,粘膜化,减少体积).
特定情况下,可能需要将剂量减少到远端片部分,以节省相邻的原生组织.

结论:

整个板通常包含在头癌放射治疗后重建的CTV中.
虽然一般包括在内,但在某些特定情况下,选择性减少剂量到远端片区域可能是合理的.
在剂量规划中,节省靠近片的未涉及本地组织是关键考虑因素.

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