Seminars in Radiation Oncology最新文献

Education as a Tool to Navigate Changing Technology in Radiation Oncology 教育是引导放射肿瘤学技术变化的工具

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2026-01-29 DOI: 10.1016/j.semradonc.2025.150998

Caitlin Gillan , Daniel A Low , Srinivas Raman

While technological innovation in radiation therapy (RT) continues to accelerate, safe and equitable adoption of emerging tools is reliant on the readiness of the workforce and the robustness of associated educational frameworks. Early experience with disruptive technologies such as intensity-modulated RT (IMRT) has taught us that fragmented or insufficient education can create an implementation barrier. The IDEPTH framework (as illustrated here using the translation of IMRT from development to mainstream implementation) describes how development and implementation of new technologies requires coordinated involvement across academia, industry, professional associations, and clinical organizations. Emerging technologies, such as artificial intelligence (AI)-enabled workflows, magnetic resonance (MR)-integrated RT, adaptive radiotherapy and particle therapy will similarly require comprehensive and scalable approaches to education. Despite progress, significant heterogeneity still exists in access to education, integration into professional curricula, and ongoing requirements for competence. Central to this challenge is that the rate at which technology is developed often outpaces the rate at which curricula, accreditation standards, and certification processes are updated. Closing this gap will be most effectively met by increased emphasis on adaptable competencies such as technological literacy, critical evaluation, and effective human-technology interaction rather than mere device-specific skills. Also, the increasing role of automation means RT must also identify legacy skills whose education emphasis is reduced to allow time and attention to the latest technologies and treatment methods. The creation and maintenance of robust, forward-oriented education systems is crucial if future innovations within radiation oncology are to be integrated in ways that are safe and of high quality.

虽然放射治疗（RT）的技术创新继续加速，但安全、公平地采用新兴工具取决于劳动力的准备程度和相关教育框架的稳健性。对强度调制RT （IMRT）等破坏性技术的早期经验告诉我们，分散或不充分的教育可能会造成实施障碍。IDEPTH框架（如此处所示，使用IMRT从开发到主流实施的翻译）描述了新技术的开发和实施如何需要学术界、工业界、专业协会和临床组织的协调参与。新兴技术，如支持人工智能（AI）的工作流程、磁共振（MR）集成RT、适应性放疗和粒子治疗，同样需要全面和可扩展的教育方法。尽管取得了进展，但在接受教育的机会、与专业课程的结合以及对能力的持续要求方面仍然存在显著的异质性。这一挑战的核心是技术发展的速度往往超过了课程、认证标准和认证过程的更新速度。要缩小这一差距，最有效的方法是增加对适应性能力的重视，如技术素养、批判性评价和有效的人机交互，而不仅仅是特定于设备的技能。同样，自动化的作用越来越大，意味着RT还必须识别遗留技能，这些技能的教育重点被减少，以便将时间和注意力放在最新的技术和治疗方法上。如果未来放射肿瘤学的创新要以安全和高质量的方式整合，那么建立和维护强大的、前瞻性的教育体系至关重要。

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引用次数: 0

Advancing Equity, Diversity, and Inclusion in Medical Education: Implications For Radiation Oncology 推进医学教育的公平性、多样性和包容性：对放射肿瘤学的启示

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2026-01-02 DOI: 10.1016/j.semradonc.2025.150997

Amanda Khan MD, PhD, FRCPC , Jennifer Croke MD, MHPE, FRCPC

Equity, diversity and inclusion (EDI) have become foundational principles across healthcare organizations and medical education aiming to address historical systemic biases, promote representation and foster inclusive environments. These efforts have patients benefits including improved care and clinical outcomes, especially in minoritized populations. Despite recent advances, women and minority groups remain underrepresented radiation oncology training programs, leadership roles, and academic positions. Embedding EDI early in medical education and training is essential for diversifying the workforce, reducing barriers to entry, and preparing future physicians to deliver equitable care. Organizational and institutional efforts are also important and require strong leadership commitment, accountability and resource allocation. The paper provides an overview of EDI within medical education, with a focus on radiation oncology, and outlines strategies to advance equity, diversity, and inclusion across the specialty.

公平、多样性和包容性（EDI）已成为医疗保健组织和医学教育的基本原则，旨在解决历史上的系统性偏见，促进代表性和培育包容性环境。这些努力使患者受益，包括改善护理和临床结果，特别是在少数民族人群中。尽管最近取得了进展，但妇女和少数群体在放射肿瘤学培训项目、领导角色和学术职位上的代表性仍然不足。将EDI尽早纳入医学教育和培训，对于实现劳动力多样化、减少进入壁垒以及为未来的医生提供公平护理做好准备至关重要。组织和机构的努力也很重要，需要强有力的领导承诺、责任和资源分配。本文概述了医学教育中的EDI，重点是放射肿瘤学，并概述了在整个专业中促进公平、多样性和包容性的策略。

引用次数: 0

Radiation Therapy for Non-Malignant Central Nervous System Tumors, Disorders, and Illnesses — Current Applications and Future Directions 非恶性中枢神经系统肿瘤、紊乱和疾病的放射治疗-目前的应用和未来的方向

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2025-12-12 DOI: 10.1016/j.semradonc.2025.08.005

Felix Ehret , Charles Leland Rogers , James Fontanesi , George D. Wilson , Bhargava S. Chitti , John Starner , Baho Sidiqi , Anuj Goenka , Michael Schulder , Anna M.E. Bruynzeel , Joost J.C. Verhoeff , Alexander C. MacDonagh , Hannah I. Park , Helen A. Shih , Lawrence Kleinberg

Radiation therapy has a central role in the treatment of various malignant central nervous system tumors, including gliomas, high-grade meningiomas, and brain metastases. This also applies to a plethora of non-malignant central nervous system lesions, such as vestibular schwannomas and arteriovenous malformations, and, in specific situations, for selected functional and psychiatric disorders. In patients with these conditions, the goal of radiation therapy is generally to preserve and stabilize function. In addition, as these illnesses, with some exceptions such as arteriovenous malformations, are rarely life-threatening, the risks of radiation therapy must be interpreted in a different context than for patients with malignancy. Given the continuous and growing interest in the use of radiation therapy for non-malignant tumors and functional conditions, this review summarizes the current and future directions in central nervous system applications, addressing its use for the management of vestibular schwannomas, arteriovenous malformations, trigeminal neuralgia, tremor, Alzheimer’s disease, and other psychiatric conditions, such as obsessive-compulsive disorder, addiction, and eating disorders.

放射治疗在各种恶性中枢神经系统肿瘤的治疗中起着核心作用，包括胶质瘤、高级别脑膜瘤和脑转移瘤。这也适用于大量的非恶性中枢神经系统病变，如前庭神经鞘瘤和动静脉畸形，在特定情况下，也适用于选定的功能和精神障碍。对于患有这些疾病的患者，放射治疗的目标通常是保持和稳定功能。此外，由于这些疾病，除了一些例外，如动静脉畸形，很少危及生命，放射治疗的风险必须在与恶性肿瘤患者不同的背景下解释。鉴于对非恶性肿瘤和功能性疾病使用放射治疗的持续和日益增长的兴趣，本综述总结了目前和未来在中枢神经系统应用的方向，讨论了其在前庭神经鞘瘤、动静脉畸形、三叉神经痛、震颤、阿尔茨海默病和其他精神疾病（如强迫症、成瘾和饮食失调）治疗中的应用。

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引用次数: 0

Radiation Therapy for Benign Diseases and Premalignant Conditions 良性疾病和癌前病变的放射治疗

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2025-12-12 DOI: 10.1016/j.semradonc.2025.08.006

Tony Y. Eng , Houda Bahig , Tiffany W. Chen , Karthik P. Meiyappan , David Roberge

Radiation therapy (RT), traditionally reserved for malignant conditions, has emerged as a valuable tool in the management of select benign tumors and proliferative disorders. In clinical scenarios where surgery is not feasible, incomplete, or associated with significant morbidity, RT offers a noninvasive and effective alternative, often yielding excellent local control and long-term symptom relief. For instance, although surgery is relatively safe and effective, radiation is the preferred treatment for many patients with acoustic neuroma. Many benign entities have demonstrated favorable responses to radiation [1]. Among these, paragangliomas (PGL)—notably glomus jugulare tumors—have emerged as prime examples where RT plays a critical role. These tumors, while histologically benign, often present with local invasiveness, cranial nerve involvement, and high recurrence rates, making complete surgical resection difficult and frequently associated with significant morbidity. Beyond PGLs, RT has shown promise in a range of other benign conditions, including many benign vascular and lymphoid disorders [2, 3, 4]. These entities, although benign, may behave in an infiltrative or recurrent manner, necessitating a multidisciplinary approach to treatment. In particular, localized lymphoid lesions may benefit from RT. This section focuses specifically on the role of RT in the management of PGL, pheochromocytoma (PCC), hemangioma, ameloblastoma, angiofibroma, Castleman disease, cutaneous pseudolymphoma, and adamantinoma. Other benign entities are discussed in a separate section of the current issue.

放射治疗（RT），传统上保留为恶性条件，已成为一个有价值的工具，在管理选择良性肿瘤和增生性疾病。在临床情况下，手术是不可行的，不完整的，或与显著的发病率相关，RT提供了一个无创和有效的选择，往往产生良好的局部控制和长期的症状缓解。例如，虽然手术相对安全有效，但对于许多听神经瘤患者来说，放疗是首选的治疗方法。许多良性实体对辐射[1]表现出良好的反应。其中，副神经节瘤（PGL）——尤其是颈静脉球瘤——已成为RT发挥关键作用的主要例子。这些肿瘤虽然在组织学上是良性的，但通常表现为局部侵袭，累及颅神经，复发率高，使得完全手术切除变得困难，并且经常伴有显著的发病率。除了pgl， RT在一系列其他良性疾病中也显示出前景，包括许多良性血管和淋巴系统疾病[2,3,4]。这些实体虽然是良性的，但可能表现为浸润性或复发性，需要多学科的治疗方法。特别是，局部淋巴病变可能受益于放疗。本节特别关注放疗在PGL、嗜铬细胞瘤（PCC）、血管瘤、成釉细胞瘤、血管纤维瘤、Castleman病、皮肤假性淋巴瘤和金刚素瘤治疗中的作用。其他良性实体将在本期的单独章节中讨论。

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引用次数: 0

Genetic and Carcinogenic Risks of Radiotherapy for Nonmalignant Diseases 非恶性疾病放射治疗的遗传和致癌风险

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2025-12-12 DOI: 10.1016/j.semradonc.2025.11.001

Jean L. Nakamura MD

Radiotherapy is a valuable treatment option for a variety of nonmalignant diseases. As the indications for low-dose radiotherapy to benign conditions evolve, it is prudent to consider risks and how these might weigh against the benefits of therapy. Radiation-induced malignancies are one consideration and are more likely associated with higher doses of radiation and genetic cancer susceptibility. Radiotherapy for nonmalignant diseases typically involves doses much lower than those associated with radiation-induced malignancies. In addition, treatments are employed for conditions that are more common in the older patient population, whereas much of the historical experience with radiation-induced malignancies involves children and young adults. The low doses associated with radiotherapy for nonmalignant diseases and the patient population in whom these treatments are employed makes the estimated risk of radiation-induced carcinogenesis low. Specific factors that increase the concern for radiation-induced malignancies include repeated radiotherapy to the same site, leading to cumulative increasing dosage, radiotherapy in younger individuals, and those with known germline mutations in DNA repair genes.

放射治疗是多种非恶性疾病的一种有价值的治疗选择。随着良性疾病的低剂量放疗适应症的发展，谨慎地考虑风险以及这些风险如何与治疗的益处相权衡。辐射诱发的恶性肿瘤是一个考虑因素，更可能与高剂量辐射和遗传癌症易感性有关。非恶性疾病的放射治疗通常涉及的剂量远低于与辐射引起的恶性肿瘤相关的剂量。此外，治疗方法适用于老年患者人群中更常见的病症，而辐射诱发恶性肿瘤的历史经验大多涉及儿童和年轻人。对非恶性疾病进行放射治疗的低剂量以及使用这些治疗的患者群体使得估计的辐射致癌风险很低。增加对辐射诱发恶性肿瘤的关注的具体因素包括对同一部位的重复放疗，导致剂量累积增加，年轻个体的放疗，以及DNA修复基因中已知的种系突变。

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引用次数: 0

Periarticular Soft Tissue Disorders: Enthesopathies, Tendinopathies, and Bursitis—Pathophysiology and Radiotherapeutic Approaches 关节周围软组织疾病：腱鞘病、肌腱病和滑囊炎——病理生理学和放射治疗方法

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2025-12-12 DOI: 10.1016/j.semradonc.2025.10.002

Bobby N. Koneru , David A. Barron , Ralph Muecke , Richard Shaffer , Tarita O. Thomas , Mathias Sonnhoff , Robert M. Blach , David R. Steike , Lisa Deloch , Pranjal Kumar Singh , Heinrich Seegenschmiedt

Periarticular soft tissue disorders, encompassing enthesopathies, tendinopathies, and bursitis, contribute substantially to musculoskeletal pain and disability, particularly in adult populations. This chapter provides a comprehensive overview of the pathophysiology, clinical manifestations, and radiotherapeutic management of major periarticular syndromes, including painful shoulder syndrome, lateral epicondylitis, greater trochanteric pain syndrome, and plantar fasciitis. We detail how these conditions often present as a continuum of overlapping pathology at the enthesis, tendon, and peri‑tendinous structures, frequently driven by repetitive microtrauma, mechanical overload, degenerative changes, and low-grade inflammation. Emphasis is placed on the clinical and imaging features distinguishing key entities such as calcific tendinitis, enthesopathies, and bursitis. Special focus is given to the role of low-dose radiotherapy (LDRT) as an effective treatment option for refractory symptoms unresponsive or contraindicated to conservative management. Contemporary practice patterns, including patient selection, target volume delineation based on imaging, and technical variations between linear accelerator and orthovoltage techniques, are discussed. Data from recent prospective and retrospective studies are summarized, demonstrating notable pain reduction rates and functional improvement with LDRT, and outlining response rates, optimal dosage regimens, timing of re-irradiation, and age-based treatment considerations. The chapter concludes with practical recommendations for integrating radiotherapy into multimodal care pathways for periarticular soft tissue disorders, underscoring its utility in symptom control and functional restoration.

关节周围软组织疾病，包括腱鞘病、肌腱病和滑囊炎，是导致肌肉骨骼疼痛和残疾的主要原因，尤其是在成年人中。本章全面概述了主要关节周围综合征的病理生理学、临床表现和放射治疗管理，包括肩痛综合征、外侧上髁炎、大转子痛综合征和足底筋膜炎。我们详细介绍了这些疾病是如何在末端、肌腱和肌腱周围结构中表现为重叠病理的连续体，通常是由重复性微创伤、机械负荷、退行性变化和低度炎症引起的。重点放在临床和影像学特征区分的关键实体，如钙化肌腱炎，腱鞘病和滑囊炎。特别的重点是低剂量放疗（LDRT）的作用，作为一个有效的治疗选择的难治性症状无反应或禁忌保守管理。讨论了当代实践模式，包括患者选择，基于成像的靶体积描绘，以及线性加速器和正电压技术之间的技术变化。总结了近期前瞻性和回顾性研究的数据，证明了LDRT显著的疼痛减轻率和功能改善，并概述了反应率、最佳剂量方案、再照射时间和基于年龄的治疗考虑。本章总结了将放射治疗纳入关节周围软组织疾病的多模式护理途径的实用建议，强调了其在症状控制和功能恢复方面的效用。

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引用次数: 0

Low-Dose Radiotherapy for Osteoarthritis: Current Evidence, Practical Recommendations and Future Perspectives 骨关节炎的低剂量放疗：当前证据、实用建议和未来展望

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2025-12-12 DOI: 10.1016/j.semradonc.2025.07.001

Annika Schlamann , James B. Yu , Alexander Rühle

Osteoarthritis (OA) is a widespread degenerative joint disease with increasing prevalence in aging populations. While conservative management such as physiotherapy, NSAIDs, and intraarticular injections form the mainstay of treatment, a significant proportion of patients, particularly elderly individuals or those unfit for surgery, remain symptomatic. Low-dose radiotherapy (LDRT) has re-emerged as a potential noninvasive therapeutic option based on its anti-inflammatory effects and favorable safety profile. This narrative review summarizes current clinical evidence, practical recommendations, and future directions for the use of LDRT in OA. Although some randomized controlled trials have reported no additional benefit of LDRT over sham treatment, these studies have been criticized for limited sample size, short follow-up duration, suboptimal patient selection, and deviation from standard LDRT protocols. Nevertheless, other randomized trials as well as large retrospective studies suggest clinically meaningful benefits in selected patients. Standard dosing regimens typically consist of 3.0-6.0 Gy delivered in 0.5-1.0 Gy fractions over 2-3 weeks, with a second course recommended in nonresponders. Practical considerations including patient selection, joint-specific dose planning, and patient education are essential to optimize outcomes. While the absolute risk of radiation-induced malignancy is considered negligible in elderly populations, safety measures such as shielding and cumulative dose monitoring are advised. Further large-scale, placebo-controlled studies are needed to clarify optimal dose, timing, and synergistic effects with pharmacological therapies to strengthen the role of LDRT in OA management.

骨关节炎（OA）是一种广泛的退行性关节疾病，在老年人群中发病率越来越高。虽然保守治疗，如物理治疗、非甾体抗炎药和关节内注射是主要的治疗方法，但很大一部分患者，特别是老年人或不适合手术的患者，仍然有症状。基于其抗炎作用和良好的安全性，低剂量放疗（LDRT）已重新成为一种潜在的无创治疗选择。这篇叙述性综述总结了LDRT在OA中应用的当前临床证据、实用建议和未来方向。尽管一些随机对照试验报告LDRT没有比假治疗更多的益处，但这些研究因样本量有限、随访时间短、患者选择不理想以及偏离标准LDRT方案而受到批评。然而，其他随机试验和大型回顾性研究表明，在选定的患者中有临床意义的益处。标准给药方案通常包括3.0-6.0 Gy，在2-3周内以0.5-1.0 Gy的分数给药，对无反应者建议进行第二疗程。实际考虑包括患者选择，关节特定剂量计划和患者教育是优化结果的必要条件。虽然在老年人群中，辐射诱发恶性肿瘤的绝对风险被认为可以忽略不计，但建议采取屏蔽和累积剂量监测等安全措施。需要进一步的大规模安慰剂对照研究来明确最佳剂量、时间和与药物治疗的协同作用，以加强LDRT在OA治疗中的作用。

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引用次数: 0

Radiotherapy for Other Nonmalignant Diseases 其他非恶性疾病的放射治疗

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2025-12-12 DOI: 10.1016/j.semradonc.2025.11.003

Isabel Falke MD , Ulrich Schäfer MD, PhD , Oliver Micke MD, PhD , Ralph Mücke MD, PhD , Jan Kriz MD, PhD

Radiotherapy is increasingly used for benign diseases, especially in Germany, where over 50% of radiation treatments address nonmalignant conditions such as osteoarthritis, plantar fasciitis, and Dupuytren’s disease. Low-dose regimens have shown good efficacy in pain reduction and disease stabilization, with minimal toxicity. For rarer indications like Gorham-Stout disease, pigmented villonodular synovitis, and lymphatic fistulas, evidence is limited to case series and retrospective studies. Randomized trials remain scarce, and further research is needed to evaluate long-term outcomes and patient quality of life. Radiotherapy appears safe when used appropriately, though concerns about late effects require continued monitoring. For rare diseases, collaborative data collection and biological studies may help address current evidence gaps.

放射治疗越来越多地用于良性疾病，特别是在德国，超过50%的放射治疗针对非恶性疾病，如骨关节炎、足底筋膜炎和Dupuytren病。低剂量方案在减轻疼痛和疾病稳定方面显示出良好的疗效，毒性最小。对于罕见的适应症，如Gorham-Stout病、色素绒毛结节性滑膜炎和淋巴瘘，证据仅限于病例系列和回顾性研究。随机试验仍然很少，需要进一步的研究来评估长期结果和患者的生活质量。如果使用得当，放射治疗似乎是安全的，尽管对后期效应的担忧需要继续监测。对于罕见病，协作数据收集和生物学研究可能有助于解决目前的证据差距。

引用次数: 0

Radioablation for Ventricular Tachycardia: Current Evidence and Future Perspectives 放射消融术治疗室性心动过速：当前证据和未来展望

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2025-12-12 DOI: 10.1016/j.semradonc.2025.10.003

Raffaella De Pietro , Pamela Samson , Maiwand Ahmadsei , Phillip Cuculich , Geoffrey D. Hugo , Marcin Miszczyk , Franziska Nägler , Ardan M. Saguner , Clifford Robinson , Nicolaus Andratschke

Stereotactic arrhythmia radioablation (STAR) has emerged as a novel, noninvasive therapeutic option for patients with drug- and ablation-refractory ventricular tachycardia (VT). Derived from stereotactic body radiotherapy (SBRT), STAR enables the delivery of a single, high-dose fraction of ionizing radiation to arrhythmogenic myocardial tissue with submillimeter precision while minimizing exposure to surrounding cardiac and extracardiac structures. This review summarizes current evidence regarding mechanisms of action, patient selection, treatment planning, and clinical outcomes of STAR. Preclinical and early clinical studies suggest that STAR exerts rapid antiarrhythmic effects through modulation of cardiac conduction proteins and potential structural remodeling, though long-term efficacy remains under investigation. Clinical trials and prospective registries report substantial reductions in VT burden with acceptable short-term safety, yet recurrence rates and late toxicities require further evaluation. The European STOPSTORM consortium has been established to standardize treatment protocols, harmonize target delineation, and coordinate multicenter clinical validation. As STAR continues to evolve, multidisciplinary collaboration between radiation oncologists, cardiologists, and medical physicists will be essential to define optimal practice standards, ensure patient safety, and assess long-term outcomes. STAR represents a promising paradigm shift in the management of refractory VT, offering a noninvasive alternative when conventional therapies are ineffective or infeasible.

立体定向心律失常放射消融术（STAR）已成为治疗药物和消融难治性室性心动过速（VT）的一种新颖、无创的治疗选择。STAR源自立体定向全身放射治疗（SBRT），能够以亚毫米精度向致心律失常心肌组织提供单一的高剂量电离辐射，同时最大限度地减少对周围心脏和心外结构的暴露。本文综述了目前关于STAR的作用机制、患者选择、治疗计划和临床结果的证据。临床前和早期临床研究表明，STAR通过调节心脏传导蛋白和潜在的结构重塑发挥快速抗心律失常作用，但长期疗效仍有待研究。临床试验和前瞻性登记报告了VT负担的显著减少和可接受的短期安全性，但复发率和晚期毒性需要进一步评估。欧洲STOPSTORM联盟的建立是为了标准化治疗方案，协调靶点划定，协调多中心临床验证。随着STAR的不断发展，放射肿瘤学家、心脏病专家和医学物理学家之间的多学科合作对于确定最佳实践标准、确保患者安全和评估长期结果至关重要。STAR代表了难治性室速治疗的一个有希望的范式转变，当常规治疗无效或不可用时，它提供了一种非侵入性的替代方法。

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引用次数: 0

Radiotherapy for Nonmalignant Eye Diseases: Graves’ Ophthalmopathy – Pseudotumor Orbitae 非恶性眼病的放射治疗：Graves眼病-眼窝假瘤

IF 3.2 3区医学 Q3 ONCOLOGY

Seminars in Radiation Oncology

Pub Date : 2025-12-12 DOI: 10.1016/j.semradonc.2025.11.005

Michael Heinrich Seegenschmiedt , Hans Theodor Eich , Gabriele Reinartz

Orbital radiotherapy (RT) is an effective treatment for moderate-to-severe Graves´ ophthalmopathy (GO), especially when combined with steroids, as it reduces painful eye symptoms associated with retroorbital and eye lid soft tissue swelling, improves eye movement, and can decrease the need for prolonged steroid therapy. It is generally well-tolerated; common side effects include temporary dryness and conjunctivitis, with rare long-term risks like cataracts and a very small theoretical risk of radiation-induced cancer. RT benefits are rarely immediate and improved symptoms are typically observed several weeks to months after the treatment. GO is treated with the retrobulbar space considered as clinical target volume (CTV). Retrobulbar RT is carried out either with lateral opposing fields or with intensity modulated radiotherapy (IMRT) while protecting the radiosensitive lenses considered as organs at risk (OAR). The dose concept should be adapted to the respective phase of the disease: in the early purely inflammatory phase a single dose 0.3-2.0 Gy applied in 8 daily fractions up to a total dose of 2.4-16 Gy is sufficient and well tolerated; in the more advanced inflammatory to fibrotic phase single doses of 1.8-2.0 Gy applied in 8-10 fractions 5 times weekly up to a total dose of 16-20 Gy are required to gain improvement of symptoms. To avoid severe ophthalmologic symptoms, the efficacy of radiation could also be improved by using a reduced single dose of only 1 Gy and extending the duration of therapy with the radiation applied only once a week. In GO with manifest ocular muscle dysfunction, antiproliferative external beam RT has a Grade B recommendation, supported by Level 2 evidence.

眶放射治疗（RT）是中重度Graves眼病（GO）的有效治疗方法，特别是与类固醇联合治疗时，因为它可以减轻与眶后和眼睑软组织肿胀相关的眼部疼痛症状，改善眼球运动，并可以减少长期类固醇治疗的需要。它通常是耐受性良好的；常见的副作用包括暂时性的皮肤干燥和结膜炎，还有白内障等罕见的长期风险，理论上辐射诱发癌症的风险很小。放疗的益处很少是立竿见影的，通常在治疗后几周到几个月才会观察到症状的改善。球后间隙作为临床靶体积（CTV）治疗氧化石墨瘤。球后放射治疗可采用侧对野或强度调制放疗（IMRT），同时保护被认为是危险器官（OAR）的放射敏感晶状体。剂量概念应适应疾病的各个阶段：在纯粹炎症期早期，单次剂量0.3-2.0戈瑞，分8次每日施用，总剂量为2.4-16戈瑞，这是足够的，并且耐受性良好；在较晚期的炎症至纤维化阶段，需要单次剂量1.8-2.0 Gy，分8-10次，每周5次，总剂量为16-20 Gy，以改善症状。为了避免严重的眼科症状，也可以通过减少单次剂量仅为1戈瑞和延长治疗时间（每周一次）来提高辐射的疗效。在有明显眼肌功能障碍的氧化石墨膜患者中，抗增殖性外束放疗的推荐级别为B级，有2级证据支持。

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引用次数: 0