放射疗法中的心脏肿瘤问题：现代递送技术的心脏和心脏子结构毒性
Cardio-oncology concerns in radiotherapy: Heart and cardiac substructure toxicities from modern delivery techniques
影响因子:5.60000
分区:医学2区 Top / 血液学2区 肿瘤学2区
发表日期:2024 Dec
作者:
Ioana-Claudia Costin, Corina Cinezan, Loredana G Marcu
摘要
由于大量研究报道，由于辐射引起的心脏事件，心脏肿瘤学引起了更多关注。鉴于这一点，目前的文献概述旨在涵盖过去15年以来的所有研究，以评估由于治疗进化而导致的心脏剂量变化，以及治疗计划习俗的变化，不仅纳入了整个心脏，还包括心脏亚基。现代治疗技术，尤其是质子疗法，与所有评估的肿瘤部位相比，与更具成熟的放射疗法相比，具有优越的心脏差异。强度调节，尤其是呼吸门控，与心脏有关的剂量 - 体积参数显着改善。虽然过去的研究将平均心脏剂量视为心脏毒性的唯一参考，但在计划期间对其他心脏子结构进行剂量法规的建议越来越普遍。
Abstract
Cardio-oncology is lately gaining more attention due to radiation-induced cardiac events reported by a very large number of studies. In view of this, the current overview of the literature aimed to encompass all studies from the past 15 years to assess changes in cardiac dose due to treatment evolution, as well as the changes in treatment planning customs to incorporate not only the heart as a whole but also cardiac substructures. Modern treatment techniques, particularly proton therapy, offers superior cardiac sparing compared to more established radiotherapy, for all evaluated tumor sites. Intensity modulation, particularly coupled with respiratory gating shows significant improvement in dose-volume parameters pertaining to the heart. While past studies considered mean heart dose as the only reference for cardiac toxicities, recommendations for the other cardiac substructures to be dosimetrically assessed during planning are becoming more common.