ATreP (Provincial Agency for Proton Therapy), Trento, Italy.
Int J Radiat Oncol Biol Phys. 2012 Mar 1;82(3):1142-8. doi: 10.1016/j.ijrobp.2011.03.038. Epub 2011 Aug 18.
Proton radiotherapy (PT) has been prescribed similarly to photon radiotherapy to achieve comparable disease control rates at comparable doses. The chief advantage of protons in this setting is to reduce acute and late toxicities by decreasing the amount of normal tissue irradiated. We report the preliminary clinical outcomes including late effects on our pediatric Ewing's sarcoma patients treated with PT at the Francis H. Burr Proton Therapy Center at Massachusetts General Hospital (Boston, MA).
This was a retrospective review of the medical records of 30 children with Ewing's sarcoma who were treated with PT between April 2003 and April 2009.
A total of 14 male and 16 female patients with tumors in several anatomic sites were treated with PT at a median age of 10 years. The median dose was 54 Gy (relative biological effectiveness) with a median follow-up of 38.4 months. The 3-year actuarial rates of event-free survival, local control, and overall survival were 60%, 86%, and 89%, respectively. PT was acutely well tolerated, with mostly mild-to-moderate skin reactions. At the time of writing, the only serious late effects have been four hematologic malignancies, which are known risks of topoisomerase and anthracyline exposure.
Proton radiotherapy was well tolerated, with few adverse events. Longer follow-up is needed to more fully assess tumor control and late effects, but the preliminary results are encouraging.
质子放疗 (PT) 的应用方式与光子放疗类似，旨在以相当的剂量实现可比的疾病控制率。在这种情况下，质子的主要优势是通过减少照射的正常组织量来降低急性和迟发性毒性。我们报告了初步的临床结果，包括在马萨诸塞州总医院弗朗西斯 H.伯尔质子治疗中心接受 PT 治疗的儿童尤文肉瘤患者的晚期影响。
这是对 2003 年 4 月至 2009 年 4 月期间接受 PT 治疗的 30 名尤文肉瘤儿童的病历进行的回顾性分析。
共有 14 名男性和 16 名女性患者，肿瘤位于多个解剖部位，中位年龄为 10 岁。中位剂量为 54 Gy（相对生物学效应），中位随访时间为 38.4 个月。3 年无事件生存率、局部控制率和总生存率的估计值分别为 60%、86%和 89%。PT 急性耐受性良好，皮肤反应大多为轻至中度。截至撰写本文时，唯一的严重晚期影响是 4 例血液恶性肿瘤，这是拓扑异构酶和蒽环类药物暴露的已知风险。
质子放疗耐受性良好，不良事件较少。需要更长时间的随访才能更全面地评估肿瘤控制和晚期影响，但初步结果令人鼓舞。
