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肺癌是全球发病率和死亡率第一的恶性肿瘤,虽然放疗在NSCLC的治疗中具有可观的局部疗效,但临床上仍有部分患者出现治疗失败。放疗失败的主要原因是局部未控、复发或远处转移。与常规分割相比,大分割放疗可在不增加放疗次数的情况下提高总的放疗剂量;对于接受相同BED照射的NSCLC患者,大分割放疗除了能带来局部控制率上的增加外,还可减少治疗次数,节省治疗时间和费用,增加病人的便捷,提高医用加速器的使用效率。L-Q模型的数据在预测大分割放疗疗效时存在许多局限。除经典L-Q模型所模拟的机制外,还可能有其他机制的参与。分子影像是无创性评价放疗疗效的可靠手段,利用不同分子显像剂结合胞内特定靶分子,能够对恶性肿瘤的代谢水平、乏氧状态、增殖能力等情况进行较为准确的评估,为大分割放疗提供良好的疗效评估手段并成为研究其特殊放射生物效应的有力工具。
Lung cancer is the world’s first malignant tumor with morbidity and mortality. Although radiotherapy has considerable local efficacy in the treatment of NSCLC, some patients still have clinical failure. The main reason for the failure of radiotherapy is uncontrolled, recurrence or distant metastasis. Compared with conventional segmentation, the large fractionated radiotherapy can increase the total dose of radiotherapy without increasing the number of cases of radiotherapy; for patients with NSCLC receiving the same BED irradiation, in addition to large fractionated radiotherapy can bring local control rate increases, but also Reduce the number of treatment, saving treatment time and costs, increase patient convenience and improve the efficiency of medical accelerators. L-Q model data in the prediction of the effect of large-fractionated radiotherapy, there are many limitations. In addition to the mechanisms simulated by the classical L-Q model, other mechanisms may be involved. Molecular imaging is a noninvasive means to evaluate the efficacy of radiotherapy. Using different molecular imaging agents in combination with intracellular specific target molecules can accurately assess the level of metabolism, hypoxia, proliferation and other conditions of malignant tumors. Radiotherapy provides a good means of assessing the efficacy and is a powerful tool for studying its specific radiobiological effects.