Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Nat Rev Clin Oncol. 2013 Jul;10(7):411-24. doi: 10.1038/nrclinonc.2013.79. Epub 2013 May 21.
The use of charged particle therapy to control tumours non-invasively offers advantages over conventional radiotherapy. Protons and heavy ions deposit energy far more selectively than X-rays, allowing a higher local control of the tumour, a lower probability of damage to healthy tissue, low risk of complications and the chance for a rapid recovery after therapy. Charged particles are also useful for treating tumours located in areas that surround tissues that are radiosensitive and in anatomical sites where surgical access is limited. Current trial outcomes indicate that accelerated ions can potentially replace surgery for radical cancer treatments, which might be beneficial as the success of surgical cancer treatments are largely dependent on the expertise and experience of the surgeon and the location of the tumour. However, to date, only a small number of controlled randomized clinical trials have made comparisons between particle therapy and X-rays. Therefore, although the potential advantages are clear and supported by data, the cost:benefit ratio remains controversial. Research in medical physics and radiobiology is focusing on reducing the costs and increasing the benefits of this treatment.
使用带电粒子治疗来非侵入性地控制肿瘤，优于传统的放射治疗。质子和重离子比 X 射线更有选择性地沉积能量，从而能够更高地控制肿瘤局部，降低对健康组织损伤的概率，并发症风险低，治疗后快速恢复的机会。带电粒子也可用于治疗位于对放射线敏感的组织周围的肿瘤，以及在手术入路有限的解剖部位的肿瘤。目前的试验结果表明，加速离子可能有潜力替代手术治疗根治性癌症，这可能是有益的，因为手术治疗癌症的成功率在很大程度上取决于外科医生的专业知识和经验以及肿瘤的位置。然而，迄今为止，只有少数对照随机临床试验对粒子治疗和 X 射线进行了比较。因此，尽管有明确的数据支持其潜在优势，但成本效益比仍然存在争议。医学物理学和放射生物学的研究重点是降低这种治疗的成本并提高其效益。
