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近年国内腔内放疗已开始推广后装技术,对国内外各型后装机评价的报告逐渐增多,由于观察角度不同,观点各异。有些报告用治疗效果来评价设备,我们认为这个标准值得商榷。 客观影响放射治疗效果的因素很多,如病例选择标准、临床分期的宽严程度、肿瘤类型、病理分级、有无合并症、患者一般情况好坏、治疗方案是否合理、治疗是否精心等,均可影响治疗效果。而后装机是治疗工具,对上述各种因素均无影响。后装机性能对疗效的影响,只是放射源容器部分,即源的排列和分布是否合理,能否形成临床治疗所需要的理想的放射剂量分布曲线。在临床病例条件相同的情况下,如果放射源分布理想,则可以提高局部控制率,降低直肠与膀胱的反应。如果剂量分布不理想,则效果相反。因此,放射源的排列分布是否合理,是评价后装机的主要标准,这一点应该明确。以下综合报道对后装机的评价有参考价值。
In recent years, intracavitary radiotherapy in the country has begun to promote post-installation technology. Reports on evaluations of various types of post-installed machines at home and abroad have gradually increased. Views differ depending on the observation angle. Some reports evaluate the equipment with therapeutic effects. We think this standard is open to question. There are many factors that affect the efficacy of radiotherapy objectively, such as case selection criteria, severity of clinical stage, tumor type, pathological grade, presence or absence of comorbidities, general condition of the patient, whether the treatment plan is reasonable, and whether the treatment is meticulous. Affect the treatment effect. The installed machine is a treatment tool and has no influence on the above factors. The effect of post-installation performance on therapeutic efficacy is only whether the source container is arranged or distributed reasonably, and whether the ideal radiation dose distribution curve required for clinical treatment can be formed. In the case of the same clinical condition, if the radiation source is ideally distributed, the local control rate can be increased and the rectum and bladder reaction can be reduced. If the dose distribution is not ideal, the effect is reversed. Therefore, whether or not the distribution of radiation sources is reasonable is the main criterion for evaluating the installed capacity. This should be made clear. The following comprehensive report has reference value for the evaluation of the post-installation machine.