放射治疗在胆道肿瘤中的作用
Role of radiation therapy in biliary tract cancer
郭琪 1岳金波1
作者信息
- 1. 山东大学齐鲁医学院,山东济南 250012;山东省肿瘤防治研究院(山东省肿瘤医院)放疗科,山东第一医科大学(山东省医学科学院),山东济南 250117
- 折叠
摘要
目的 对胆道肿瘤放射治疗研究现状进行综述分析,为放疗技术临床应用提供实践参考.方法 以"胆道肿瘤、胆管癌、放射治疗"为中文关键词,以"biliary tract cancer,cholangiocarcinoma,radiotherapy"为英文关键词检索PubMed以及CNKI等期刊全文数据库2006-2022年发表的相关文献.纳入标准:(1)有放射治疗参与的临床研究;(2)包括肝内胆管癌、肝外部胆管癌、胆囊癌辅助放疗、新辅助放疗、姑息放疗、胆道肿瘤放疗时机和放疗靶区勾画的研究.排除标准:重复、数据陈旧和存在争议的研究.最终纳入文献76篇.结果 放射治疗技术广泛应用于胆道肿瘤的各个治疗阶段.放射治疗作为辅助治疗方式不仅可以改善术后患者预后,降低局部复发,作为新辅助治疗方式还能降低患者分期,增加R0切除的手术机会.对于不可切除的胆道肿瘤患者,放射治理也能延长患者生存期.在不同原发部位肿瘤中,放射治疗在不同程度上影响了患者预后.放射治疗应用广阔,但仍面临高级别证据匮乏,既往回顾性研究结论相互矛盾等问题.结论 辅助放疗、新辅助放疗和姑息放疗等多种放疗方式及治疗模式有助于促进胆道肿瘤患者的局部控制和生存,应该根据原发部位不同,将放射治疗与其他治疗方式有效结合,开展个体化治疗模式.研究新的高级别证据有助于深化放射治疗的理解和应用.
Abstract
Objective To review its current application in tumor management,and provide a practical reference for the ap-plication of radiotherapy for biliary tract tumors.Methods The published research on radiotherapy for biliary tract tumors was searched in PubMed and CNKI from 2006 to 2022,with"biliary tumors,cholangiocarcinoma,radiotherapy"as the keywords.Inclusion Criteria:(1)Clinical studies with radiotherapy participation.(2)Adjuvant,neoadjuvant,palliative radiotherapy for intrahepatic,extrahepatic cholangiocarcinoma and gallbladder cancer,timing of radiotherapy for biliary tumors and delineation of radiotherapy targets.Exclusion criteria were defined as related literature with repetitive and out-dated data.Seventy-six articles were analyzed.Results Radiotherapy is widely used in all stages of treatment of biliary tract tumors.Radiotherapy as an adjuvant therapy can not only improve the prognosis of postoperative patients and reduce local recurrence,but also reduce patient staging and increase the chance of R0 resection as neoadjuvant therapy.For pa-tients with unresectable biliary tumors,radiation therapy can also prolong survival.In tumors at different primary sites,radiation therapy has impacted the patient's prognosis to varying degrees.Radiotherapy is widely available,but it still faces challenges such as a lack of high-level evidence and conflicting conclusions from previous retrospective studies.Con-clusions Adjuvant,neoadjuvant,palliative and other radiotherapy methods and treatment modes can help promote local control and survival of patients with biliary tumors,and radiotherapy should be effectively combined with other treatment methods according to the different primary sites to carry out individualized treatment modes.Research into new high-level evidence can help deepen the understanding and application of radiotherapy.
关键词
胆道肿瘤/胆管癌/放射治疗/放化疗/综述Key words
biliary tract cancer/cholangiocarcinoma/radiotherapy/chemoradiotherapy/review literature引用本文复制引用
基金项目
国家自然科学基金(82272753)
山东省自然科学基金(ZR2021LZL002)
白求恩肿瘤放疗转化医学研究基金(flzh202103)
出版年
2024
NETL
NSTL
万方数据