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摘要: 在过去的几十年中,儿童神经母细胞瘤(neuroblastoma,NB)的放射治疗经历了不断的发展,确立了其在综合治疗中的作用。为了探索放疗在NB中的确切作用,有必要进行更多的前瞻性随机试验,以提供更多证据来指导制定最佳放疗方案。本文分析了NB的主要多机构前瞻性试验以及大型回顾性研究的证据,以确定当前的放疗标准和诸多争议;对放疗的适应证、辐射剂量分割、时间、靶区和治疗计划进行了回顾;总结了基于证据的共识,并讨论了有待解决的临床问题。Abstract: Radiotherapy for pediatric neuroblastoma has undergone continuous evolution in recent decades to establish its role in combined modality management. Despite extensive clinical experience, the precise role of radiotherapy in neuroblastoma remains unclear. Its evolution is still far from over, and more prospective randomized trials are needed to provide more evidence to guide development of optimal radiotherapy treatment schedules. This review analyzes evidence from major multi-institutional prospective trials as well as large retrospective institutional series of neuroblastoma cases to determine the current radiotherapy standards and controversies. The indications for radiotherapy, radiation dose-fractionation, timing, target volumes, and treatment planning are reviewed. A summary of evidence-based consensus recommendations is presented, and unresolved aspects are discussed.
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Key words:
- neuroblastoma /
- radiotherapy /
- pediatrics
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