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虞鲁诗, 宋启斌, 韩光. 2017鼻咽癌国际临床靶区勾画指南解读[J]. 肿瘤防治研究, 2019, 46(1): 85-92. DOI: 10.3971/j.issn.1000-8578.2019.18.0929
引用本文: 虞鲁诗, 宋启斌, 韩光. 2017鼻咽癌国际临床靶区勾画指南解读[J]. 肿瘤防治研究, 2019, 46(1): 85-92. DOI: 10.3971/j.issn.1000-8578.2019.18.0929
YU Lushi, SONG Qibin, HAN Guang. An Interpretation of International Guideline for Delineation of Clinical Target Volumes for Nasopharyngeal Carcinoma in 2017[J]. Cancer Research on Prevention and Treatment, 2019, 46(1): 85-92. DOI: 10.3971/j.issn.1000-8578.2019.18.0929
Citation: YU Lushi, SONG Qibin, HAN Guang. An Interpretation of International Guideline for Delineation of Clinical Target Volumes for Nasopharyngeal Carcinoma in 2017[J]. Cancer Research on Prevention and Treatment, 2019, 46(1): 85-92. DOI: 10.3971/j.issn.1000-8578.2019.18.0929

2017鼻咽癌国际临床靶区勾画指南解读

An Interpretation of International Guideline for Delineation of Clinical Target Volumes for Nasopharyngeal Carcinoma in 2017

  • 摘要: 鼻咽癌作为放射治疗可达根治效果的肿瘤之一,受到全球放射治疗医师的密切关注。放射治疗的临床靶区和放疗剂量是影响鼻咽癌治疗预后的重要因素。随着对鼻咽癌生物学特性以及周围邻近组织结构研究的日益深入,原来的临床靶区勾画指南可能难以满足目前临床精准治疗的需求。因此来自全球各地的鼻咽癌专家进行了充分思考和深入探讨,于2018年在Radiotherapy and Oncology刊登了International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma一文。该指南建议鼻咽癌放射靶区CTVp1=GTVp+5mm,CTVp2=CTVp1+5mm+整个鼻咽,CTVn1=GTVn+5mm,CTVn2=CTVn1+5mm;并根据T分期对邻近组织结构的靶区勾画提出建议;同时针对危及器官的勾画以及其他争议项阐明各方观点,为临床实践提供参考。本文就该指南的具体细节进行解读。

     

    Abstract: Nasopharyngeal carcinoma (NPC), one of the carcinomas which can be radically cured by radiation therapy, is interested by radiologists. It is well known that the clinical target volumes (CTV) of radiotherapy and the dose are important factors affecting the prognosis of NPC. With the deepening of the research on the biological characteristics and the surrounding adjacent tissue structures of NPC, the existing guidelines may be difficult to meet the current needs for precision medicine. Therefore, international experts in this field made detailed consideration, exchanged opinions and finally published "International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma" on Radiotherapy and Oncology in 2018. The guideline suggested that CTVp1=GTVp+5mm margin, CTVp2=5mm expansion from CTVp1, CTVn1=GTVn+5 mm in cases with no extracapsular extension, and CTVn2=CTVn1+5mm expansion. Also, regarding adjacent structures in CTVp2, it made individual recommendations for the respective T-categories. What's more, it presented panel's discussions and consensus opinions on the delineation of the organs-at-risk (OARs) and other controversial areas. This article would like to try to interpret the details of this guideline.

     

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