Introduction: Total skin irradiation (TSI) is a radiotherapy technique used to treat cutaneous lymphomas, such as mycosis fungoides. A key aspect of the success of the treatment is the correct positioning of the patient, which ensures a homogeneous distribution of radiation over the skin surface, minimizing exposure to the surrounding healthy tissues.Materials and Methods: Following the preferred reporting items for systematic review and meta-analysis (PRISMA) extension for scoping reviews and the Arksey and O’Malley framework, electronic searches of EMBASE, PubMed, SCOPUS, and the Web of Science were conducted to identify original studies detailing positioning techniques for TSI in clinical practice.Results: A total of 44 studies were included, reporting a range of positioning techniques used in TSI. The selected articles were divided into four categories: Stanford, rotational, tomotherapy, and mixed (including studies comparing two or more of the previously mentioned techniques). Articles concerning the Stanford technique were predominant (n= 33; 75.0%), followed by those addressing the rotational technique (n= 5; 11.4%), tomotherapy (n= 3; 6.8%), and mixed (n= 3; 6.8%). Studies on the Stanford technique described both the original method and its modifications, including variations such as the lying position, and analyzed its strengths and limitations. Research on the rotational method examined different device configurations and implementation strategies to optimize dose distribution and treatment efficiency. Mixed articles compared the Stanford and rotational techniques, highlighting their similar dose uniformity while examining differences in treatment efficiency and practical implementation.Conclusions: Despite its widespread use, the Stanford technique is associated with challenges that have led to the exploration of alternative positioning strategies. The rotational technique addresses some of these limitations, while tomotherapy offers advanced immobilization but raises toxicity concerns. Future research should focus on optimizing the balance between efficacy, safety, and practicality of treatment in clinical settings.
引言：全身皮肤照射（TSI）是一种用于治疗皮肤淋巴瘤（如蕈样肉芽肿）的放射治疗技术。治疗成功的关键在于患者的正确摆位，以确保辐射在皮肤表面的均匀分布，同时最大限度地减少对周围健康组织的照射。 材料与方法：遵循范围综述的系统综述和荟萃分析首选报告项目（PRISMA）扩展指南及Arksey和O'Malley框架，对EMBASE、PubMed、SCOPUS和Web of Science数据库进行电子检索，以识别详细描述TSI临床实践中摆位技术的原始研究。 结果：共纳入44项研究，报告了TSI中使用的多种摆位技术。所选文章分为四类：斯坦福技术、旋转技术、断层放疗技术及混合技术（包括比较两种或以上前述技术的研究）。涉及斯坦福技术的文章占主导地位（n=33；75.0%），其次是旋转技术（n=5；11.4%）、断层放疗技术（n=3；6.8%）和混合技术（n=3；6.8%）。关于斯坦福技术的研究描述了原始方法及其改良方案，包括卧位等变体，并分析了其优势与局限性。旋转方法的研究探讨了不同的设备配置和实施策略，以优化剂量分布和治疗效率。混合类文章比较了斯坦福技术与旋转技术，在分析治疗效率和实际操作差异的同时，强调了两者在剂量均匀性方面的相似性。 结论：尽管斯坦福技术应用广泛，但其存在的挑战促使人们探索替代摆位策略。旋转技术解决了部分局限性，而断层放疗技术虽提供先进的固定方式，却引发了毒性担忧。未来研究应着重优化临床环境中疗效、安全性与实用性之间的平衡。
Patient Positioning and Treatment Techniques in Total Skin Irradiation: A Scoping Review
肿瘤(癌症)患者之家