Frisch S, Timmermann B
West German Proton Therapy Center Essen, Essen, Germany.
West German Proton Therapy Center Essen, Essen, Germany; Clinic for Particle Therapy, Essen University Hospital, Essen, Germany; West German Cancer Centre, Essen University Hospital, Essen, Germany.
Clin Oncol (R Coll Radiol). 2017 Aug;29(8):500-506. doi: 10.1016/j.clon.2017.04.034. Epub 2017 May 12.
As an alternative to conventional photon-based radiotherapy, radiation with protons is recognised to offer considerable advantages. Today, central nervous system tumours, various sarcomatous tumours, childhood cancer and head and neck tumours are commonly treated with proton therapy. This review evaluates current data from clinical and dosimetric trials on the treatment of selected sarcomatous tumours like rhabdomyosarcoma, osteosarcoma, chordoma, chondrosarcoma and Ewing sarcoma. Special considerations for paediatric tumours and future prospects of proton therapy are outlined. Proton therapy is already an internal part in the multidisciplinary management of childhood sarcomas in contiguity to sensitive structures, especially at the base of skull, spine and pelvis. It offers special advantages for tumours requiring high-precision radiotherapy, particularly when total resection seems not feasible. Previous and ongoing research is generating evidence for the benefit of protons in sarcoma patients. Up to now, proton therapy has been safely applied with encouraging results. For future research, prospective, multi-institutional, large registries are required to answer open questions. Modern radiotherapy techniques, such as pencil beam scanning and intensity modulation are increasingly established in proton therapy. More research is needed to understand protons' limitations and potential.
作为传统光子放疗的替代方法，质子辐射被认为具有诸多显著优势。如今，中枢神经系统肿瘤、各类肉瘤性肿瘤、儿童癌症以及头颈部肿瘤通常采用质子治疗。本综述评估了关于横纹肌肉瘤、骨肉瘤、脊索瘤、软骨肉瘤和尤因肉瘤等特定肉瘤性肿瘤治疗的临床和剂量学试验的现有数据。概述了儿童肿瘤的特殊考量因素以及质子治疗的未来前景。质子治疗已然是儿童肉瘤多学科管理中不可或缺的一部分，尤其适用于临近敏感结构的肿瘤，特别是在颅底、脊柱和骨盆部位。对于需要高精度放疗的肿瘤，尤其是在全切似乎不可行的情况下，质子治疗具有特殊优势。既往和正在进行的研究正在为质子治疗对肉瘤患者的益处提供证据。到目前为止，质子治疗已安全应用且效果令人鼓舞。对于未来研究，需要前瞻性、多机构的大型登记研究来解答尚未解决的问题。现代放疗技术，如笔形束扫描和调强放疗，在质子治疗中越来越多地得到应用。需要更多研究来了解质子治疗的局限性和潜力。
