Levy R P, Fabrikant J I, Frankel K A, Phillips M H, Lyman J T
University of California, San Francisco.
Neurosurg Clin N Am. 1990 Oct;1(4):955-90.
Charged-particle beams (e.g., protons and helium, carbon and neon ions) manifest unique physical properties which offer advantages for neurosurgery and neuroscience research. The beams have Bragg ionization peaks at depth in tissues, and finite range and are readily collimated to any desired cross-sectional size and shape by metal apertures. Since 1954 nearly 6000 neurosurgical patients worldwide have been treated with stereotactic charged-particle radiosurgery of the brain for various localized and systemic malignant and nonmalignant disorders. Experimental studies with charged-particle beams have been carried out in laboratory animals to characterize anatomic and physiologic correlates of various behavioral and functional properties in the brain. Highly focused charged-particle beams have been used to induce sharply delineated laminar lesions or discrete focal ablation of deep-seated brain structures for the study of the functional anatomy of selected intracranial sites. Charged-particle beam irradiation for stereotactic radiosurgery and radiation oncology of intracranial disorders has achieved increasing importance internationally. More than 30 biomedical accelerator facilities on four continents are currently fully operational, under construction, or in an active planning stage; this last group consists primarily of dedicated biomedical hospital-based facilities. Therapeutic efficacy has been demonstrated clearly for the treatment of selected intracranial sites, e.g., pituitary adenomas and intracranial arteriovenous malformations. Heavier charged particles (e.g., carbon and neon ions) have been found to manifest a number of valuable radiobiologic properties and appear to be of potential advantage in the radiosurgical treatment of those primary or metastatic brain tumors that are radioresistant. The optimal dose and choice of charged-particle species must be determined for the treatment of the different intracranial disorders to improve the cure rate and to minimize potential adverse sequelae of the reaction of the brain to radiation injury.
带电粒子束（例如质子、氦离子、碳离子和氖离子）具有独特的物理特性，这为神经外科手术和神经科学研究带来了优势。这些粒子束在组织深处具有布拉格电离峰，射程有限，并且可以通过金属孔径轻松准直到任何所需的横截面尺寸和形状。自1954年以来，全球已有近6000名神经外科患者接受了立体定向脑带电粒子放射外科治疗，用于治疗各种局部和全身性恶性及非恶性疾病。在实验动物身上进行了带电粒子束的实验研究，以表征大脑中各种行为和功能特性的解剖学和生理学相关性。高度聚焦的带电粒子束已被用于诱导清晰划定的层状病变或对深部脑结构进行离散的局灶性消融，以研究选定颅内部位的功能解剖。颅内疾病的立体定向放射外科和放射肿瘤学的带电粒子束照射在国际上的重要性日益增加。四大洲有30多个生物医学加速器设施目前已全面投入运营、正在建设或处于积极规划阶段；最后一组主要由专门的医院生物医学设施组成。对于选定的颅内部位，如垂体腺瘤和颅内动静脉畸形的治疗，已清楚地证明了治疗效果。已发现较重的带电粒子（例如碳离子和氖离子）具有许多有价值的放射生物学特性，并且在放射外科治疗那些对放射有抗性的原发性或转移性脑肿瘤方面似乎具有潜在优势。必须确定治疗不同颅内疾病的最佳剂量和带电粒子种类的选择，以提高治愈率并尽量减少大脑对辐射损伤反应的潜在不良后遗症。
