论著摘要 |【多模态】肺癌的个性化放射治疗(PRT)(双语版)

2017-12-28 17:56:15 admin 0

Personalized Radiation Therapy (PRT) for Lung Cancer.

发表日期: 2015.12.25   来源:Advances in Experimental Medicine and Biology. 2016;890:175-202.

作者:

Jian-Yue Jin1, Feng-Ming (Spring) Kong2.

作者介绍:

1. Cancer Center, Georgia Regents University, Augusta, GA, USA.

2. Cancer Center, Georgia Regents University, Augusta, GA, USA. fkong@gru.edu.

摘要

本章回顾并讨论了四个不同层次的肺癌个性化放射治疗(PRT)的方法和策略:(1)基于患者组织学,病程,肿瘤体积和肿瘤位置的临床已经建立的PRT; (2)基于治疗期间的图像响应的个性化自适应放射治疗(RT);(3)基于生物标志物的PRT; (4)个性化划分计划。根据肿瘤组织学,病程,大小/位置,以及与全身治疗的联合,目前肺癌的RT实践是部分个体化的。放射治疗中,由PET-CT图像引导适应性治疗的方法正在多中心试验中检验。放射治疗中,图像检测到的治疗响应也可以进一步使剩余的治疗方案个性化。研究生物标志物引导的PRT的研究正在进行。生物标志物包括基因组学,蛋白组学,小RNA,细胞因子,肿瘤和血液样本的代谢组学,以及PET,CT,SPECT图像的放射组学。最后,可以对每个单独患者进行个性化RT划分计划来使治疗增益最大化。未来的PRT应基于从所有这些层面获得的知识的综合考虑,以及考虑如成本和有效性等社会价值。

Abstact

This chapter reviews and discusses approaches and strategies of personalized radiation therapy (PRT) for lung cancers at four different levels: (1) clinically established PRT based on a patient’s histology, stage, tumor volume and tumor locations; (2) personalized adaptive radiation therapy (RT) based on image response during treatment; (3) PRT based on biomarkers; (4) personalized fractionation schedule. The current RT practice for lung cancer is partially individualized according to tumor histology, stage, size/location, and combination with use of systemic therapy. During-RT PET-CT image guided adaptive treatment is being tested in a multicenter trial. Treatment response detected by the during-RT images may also provide a strategy to further personalize the remaining treatment. Research on biomarker-guided PRT is ongoing. The biomarkers include genomics, proteomics, microRNA, cytokines, metabolomics from tumor and blood samples, and radiomics from PET, CT, SPECT images. Finally, RT fractionation schedule may also be personalized to each individual patient to maximize therapeutic gain. Future PRT should be based on comprehensive considerations of knowledge acquired from all these levels, as well as consideration of the societal value such as cost and effectiveness.

关键词:

自适应放疗,生物标记物,肺癌,个性化放射治疗,影像组学

Keywords:

Adaptive radiation therapy; Biomarkers; Lung cancer; Personalized radiation therapy; Radiomics

阅读原文:PMID: 26703805  DOI: 10.1007/978-3-319-24932-2_10


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