Jäkel O, Schulz-Ertner D, Karger C P, Nikoghosyan A, Debus J
Deutsches Krebsforschungszentrum (DKFZ), Department for Medical Physics, INF 280, 69120 Heidelberg, Germany.
Technol Cancer Res Treat. 2003 Oct;2(5):377-87. doi: 10.1177/153303460300200503.
Starting with the pioneering work at the University of California in Berkeley in 1977, heavy ion radiotherapy has been of increasing interest especially in Japan and Europe in the last decade. There are currently 3 facilities treating patients with carbon ions, two of them in Japan within a clinical setting. In Germany, a research therapy facility is in operation and the construction of a new hospital based facility at the Heidelberg university will be started soon. An outline of the current status of heavy ion radiotherapy is given with emphasis to the technical aspects of the respective facilities. This includes a description of passive and active beam shaping systems, as well as their implications for treatment planning and dosimetry. The clinical trials and routine treatments performed at the German heavy ion facility are summarized. An overview over the upcoming new facilities and their technical possibilities is given. It is discussed what the necessary improvements are to fully exploit the potential of these facilities. Especially the new Heidelberg facility with the possibility of active beam scanning in combination with the first isocentric gantry for ions and offering beams of protons, helium, oxygen and carbon ions has implications on treatment planning, dosimetry and quality assurance. The necessary and ongoing developments in these areas are summarized. The new facilities also offer the possibilities to perform more extensive clinical studies and to explore future indications for radiotherapy with heavy ions. An overview over the indications and treatment schemes is also given.
自1977年加利福尼亚大学伯克利分校开展开创性工作以来，重离子放射治疗在过去十年中受到越来越多的关注，尤其是在日本和欧洲。目前有3家机构在用碳离子治疗患者，其中两家在日本，处于临床应用阶段。在德国，一家研究性治疗机构正在运营，海德堡大学一座新的医院型设施也即将开工建设。本文概述了重离子放射治疗的现状，重点介绍了各机构的技术方面。这包括对被动和主动束流整形系统的描述，以及它们对治疗计划和剂量测定的影响。总结了德国重离子治疗机构进行的临床试验和常规治疗情况。概述了即将建成的新设施及其技术可能性。讨论了充分发挥这些设施潜力所需的改进措施。特别是新的海德堡设施，它能够进行主动束流扫描，并配备首个离子等中心机架，还能提供质子、氦离子、氧离子和碳离子束，这对治疗计划、剂量测定和质量保证都有影响。总结了这些领域必要且正在进行的发展情况。新设施还提供了开展更广泛临床研究以及探索重离子放射治疗未来适应症的可能性。本文还概述了适应症和治疗方案。
