| 刘楼,傅旖,李书月,等.在线自适应放疗在宫颈癌放射治疗中的临床应用及前沿进展[J].中华放射医学与防护杂志,2026,46(3):315-321.Liu Lou,Fu Yi,Li Shuyue,et al.Clinical applications and advances of online adaptive radiotherapy in cervical cancer treatment[J].Chin J Radiol Med Prot,2026,46(3):315-321 |
| 在线自适应放疗在宫颈癌放射治疗中的临床应用及前沿进展 |
| Clinical applications and advances of online adaptive radiotherapy in cervical cancer treatment |
| 投稿时间：2025-04-10 |
| DOI：10.3760/cma.j.cn112271-20250410-00133 |
| 中文关键词: 自适应放疗 宫颈癌 人工智能 |
| 英文关键词:Adaptive radiotherapy Cervical cancer Artificial intelligence |
| 基金项目:国家自然科学基金(81602792);江苏省卫生健康委员会面上项目(M2024004);江苏省高等学校基础科学(自然科学)研究面上项目(23KJB310023);江苏省妇幼保健科研项目(F202210);江苏省医学重点学科(ZDXK202235);放射医学与辐射防护国家重点实验室资助项目(GZK1202101);苏州市科技项目(SLT201920);苏州大学附属第一医院临床诊疗技术创新项目青年特色技术项目(2100201) |
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| 中文摘要: |
| 进入21世纪,放疗技术从二维(2D)逐步发展到影像引导放疗(IGRT),大幅提升了照射精度。然而,由于宫颈及其周围器官的充盈变化,肿瘤位置存在显著的分次间位移,传统放疗需在临床靶体积(CTV)外设置足够的安全裕度以应对运动,但仍可能出现CTV遗漏风险。针对这一问题,自适应放疗(ART)应运而生,其核心思想是在放疗过程中根据患者解剖结构的动态变化及时调整计划。在线ART能够"先调整计划再照射",在每次放疗时获取患者当日影像、自动勾画靶区危及器官、优化计划并实施,从而缩小CTV外放裕度、减少正常组织受量,被认为是宫颈癌放疗的重要方向。本综述重点探讨宫颈癌在线ART的应用现状,回顾在线ART发展的关键技术和最新研究进展,并对未来的发展方向进行展望。 |
| 英文摘要: |
| Since the beginning of the 21st century, radiotherapy has evolved from two-dimensional techniques to image-guided radiotherapy, significantly improving the accuracy of irradiation. However, due to variations in the filling status of the cervix and its surrounding organs, substantial inter-fraction displacement of the tumor can occur. Conventional radiotherapy addresses this challenge by incorporating a sufficient safety margin around the clinical target volume (CTV), yet the risk of CTV underdosing remains. To address this issue, adaptive radiotherapy (ART) has been developed, with the core concept of adjusting the treatment plan in real-time according to the dynamic changes of the anatomical structure during the course of radiotherapy. Online ART enables "plan adaptation before irradiation" by acquiring daily patient images, automatically contouring target volumes and organs at risk, optimizing the treatment plan, and delivering the adapted plan in each session. This approach reduces the required CTV margins and minimizes radiation exposure to normal tissues, and is considered an important direction for cervical cancer radiotherapy. This review focuses on the current applications of online ART in cervical cancer, examines key technologies and recent advances in its development, and discusses future development directions. |
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