High-dose rate endorectal brachytherapy for rectal cancer: A state-of-the-art review,Cancer Science

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High-dose rate endorectal brachytherapy for rectal cancer: A state-of-the-art review
Cancer Science ( IF 4.5 ) Pub Date : 2023-09-13 , DOI: 10.1111/cas.15959
Tian Cheng _{1,

2} , Ran Peng ₃ , Ang Qu ₃ , Hao Wang _{1,

3}

Affiliation

Rectal cancer is a common malignancy that requires multidisciplinary treatment. By utilizing the dose–response relationship in rectal cancer radiotherapy, increasing the radiotherapy dose can improve clinical complete remission rates. High-dose rate endorectal brachytherapy (HDREBT) is a novel technique that delivers high doses of radiotherapy directly to the tumor via an endorectal applicator, sparing the adjacent normal tissues from excessive radiation exposure. HDREBT includes contact X-ray brachytherapy and high-dose-rate intracavitary brachytherapy. We introduce the latest developments in applicators and imaging techniques for HDREBT in rectal cancer and summarize the current evidence on the efficacy, safety, and feasibility of HDREBT as a neoadjuvant, definitive, or palliative treatment option for all stages of rectal cancer patients. We also discuss the potential advantages and challenges of HDREBT in achieving organ preservation and improving the quality of life of rectal cancer patients. HDREBT has shown promising results in achieving high complete response rates, enabling nonoperative management, improving organ preservation rates, and providing effective palliation in rectal cancer patients. More studies are needed to optimize its dose and fractionation schemes in different clinical scenarios.

中文翻译：

直肠癌高剂量率直肠内近距离治疗：最先进的综述

直肠癌是一种常见的恶性肿瘤，需要多学科治疗。利用直肠癌放疗中的剂量反应关系，增加放疗剂量可以提高临床完全缓解率。高剂量率直肠内近距离放射治疗 (HDREBT) 是一种新技术，通过直肠内施放器直接向肿瘤提供高剂量放射治疗，使邻近正常组织免受过度辐射照射。HDREBT包括接触式X射线近距离治疗和高剂量率腔内近距离治疗。我们介绍了 HDREBT 在直肠癌中的施放器和成像技术的最新进展，并总结了 HDREBT 作为直肠癌各阶段患者的新辅助、确定性或姑息性治疗选择的有效性、安全性和可行性的当前证据。我们还讨论了 HDREBT 在实现直肠癌患者器官保存和改善生活质量方面的潜在优势和挑战。HDREBT 在实现高完全缓解率、实现非手术治疗、提高器官保存率以及为直肠癌患者提供有效姑息治疗方面显示出有希望的结果。需要更多的研究来优化其在不同临床情况下的剂量和分次方案。

更新日期：2023-09-13

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