目的:非典型畸胎瘤/横纹肌样变(AT/RT)患者的治疗具有挑战性,特别是在很小的时候(三岁以下)。放射治疗(RT)是复杂的三联疗法的一部分。本指南的目的是为未参加临床试验的患者的临床管理提供适当的RT建议。
方法:9名欧洲专家被提名组成欧洲放射治疗和肿瘤学会(ESTRO)指南委员会。在PubMed/MEDLINE和WebofScience中进行了系统的文献检索。他们讨论并分析了有关RT在AT/RT临床管理中的作用的证据。
结果:关于诊断成像的建议,治疗原则,关于时间安排的RT注意事项,剂量,技术,目标卷定义,处于危险中的辐射敏感器官的剂量限制,伴随化疗,并考虑了后续行动。在前瞻性试验或前瞻性注册的框架内治疗AT/RT儿童至关重要。
结论:本指南总结了AT/RT患者的RT证据和临床推荐。前瞻性临床试验和国际,大型注册管理机构评估现代治疗方法将有助于更好地了解未来这些儿童的最佳治疗方法。
Treatment of patients with atypical teratoid/rhabdoid (AT/RT) is challenging, especially when very young (below the age of three years). Radiotherapy (RT) is part of a complex trimodality therapy. The purpose of this
guideline is to provide appropriate recommendations for RT in the clinical management of patients not enrolled in clinical trials.
Nine European experts were nominated to form a European Society for Radiotherapy and Oncology (ESTRO)
guideline committee. A systematic literature search was conducted in PubMed/MEDLINE and Web of Science. They discussed and analyzed the evidence concerning the role of RT in the clinical management of AT/RT.
Recommendations on diagnostic imaging, therapeutic principles, RT considerations regarding timing, dose, techniques, target volume definitions, dose constraints of radiation-sensitive organs at risk, concomitant chemotherapy, and follow-up were considered. Treating children with AT/RT within the framework of prospective trials or prospective registries is of utmost importance.
The present
guideline summarizes the evidence and clinical-based recommendations for RT in patients with AT/RT. Prospective clinical trials and international, large registries evaluating modern treatment approaches will contribute to a better understanding of the best treatment for these children in future.