Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105-3678, USA.
Cancer J. 2009 Jul-Aug;15(4):298-305. doi: 10.1097/PPO.0b013e3181b6d4b7.
Pediatric caregivers and parents are eager to know the role of proton beam therapy (PBT) in the treatment of children with brain and solid tumors and other diseases for which radiation therapy is indicated. Although the number of children treated with PBT for the most common pediatric tumors is relatively small and outcome data are clearly lacking, modeling radiation dose, volume, and outcomes based on photon benchmark data and clinical experience suggest an advantage for PBT and an opportunity to reduce or eliminate many of the early and late effects of radiation therapy. As the number of centers available to treat children increases, it is incumbent on those with access to this modality to optimize other critical aspects of radiotherapy and cancer care and follow-up that are requisite to achieving disease control and high-quality survivorship. Even though the focus of pediatric radiation oncology is weighted toward side effect reduction, there is an opportunity for dose escalation or biologically optimized radiotherapy in a number of diseases or settings in which high-dose irradiation is considered unapproachable. Justification for PBT in pediatric patients should be realized once the costs of treating acute symptoms, growth hormone deficiency, orthopedic deformities, and secondary malignancies are studied and reduced.
儿科护理人员和家长急切地想了解质子束疗法 (PBT) 在治疗儿童脑肿瘤和实体瘤及其他需要放疗的疾病中的作用。虽然接受 PBT 治疗最常见的儿科肿瘤的儿童数量相对较少，且明确缺乏疗效数据，但基于光子基准数据和临床经验对放射剂量、体积和结果进行建模表明 PBT 具有优势，并有机会减少或消除许多放疗的早期和晚期效应。随着可用于治疗儿童的中心数量增加，有机会利用这种治疗方式优化放疗和癌症治疗及随访的其他关键方面，这些方面是实现疾病控制和高质量生存所必需的。尽管儿科放射肿瘤学的重点是减轻副作用，但在许多疾病或情况下，仍有机会进行剂量升级或生物优化放疗，因为这些疾病或情况下高剂量照射被认为是不可行的。一旦研究和降低了治疗急性症状、生长激素缺乏、骨畸形和继发恶性肿瘤的成本，就应该为儿科患者使用 PBT 提供理由。
