Mohamad Osama, Sishc Brock J, Saha Janapriya, Pompos Arnold, Rahimi Asal, Story Michael D, Davis Anthony J, Kim D W Nathan
Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Cancers (Basel). 2017 Jun 9;9(6):66. doi: 10.3390/cancers9060066.
Compared to conventional photon-based external beam radiation (PhXRT), carbon ion radiotherapy (CIRT) has superior dose distribution, higher linear energy transfer (LET), and a higher relative biological effectiveness (RBE). This enhanced RBE is driven by a unique DNA damage signature characterized by clustered lesions that overwhelm the DNA repair capacity of malignant cells. These physical and radiobiological characteristics imbue heavy ions with potent tumoricidal capacity, while having the potential for simultaneously maximally sparing normal tissues. Thus, CIRT could potentially be used to treat some of the most difficult to treat tumors, including those that are hypoxic, radio-resistant, or deep-seated. Clinical data, mostly from Japan and Germany, are promising, with favorable oncologic outcomes and acceptable toxicity. In this manuscript, we review the physical and biological rationales for CIRT, with an emphasis on DNA damage and repair, as well as providing a comprehensive overview of the translational and clinical data using CIRT.
与传统的基于光子的外照射放疗（PhXRT）相比，碳离子放疗（CIRT）具有更优的剂量分布、更高的传能线密度（LET）和更高的相对生物效应（RBE）。这种增强的RBE由独特的DNA损伤特征驱动，其特点是簇状损伤超过了恶性细胞的DNA修复能力。这些物理和放射生物学特性赋予重离子强大的杀瘤能力，同时有可能最大限度地保护正常组织。因此，CIRT有可能用于治疗一些最难治疗的肿瘤，包括那些缺氧、抗辐射或深部的肿瘤。主要来自日本和德国的临床数据很有前景，肿瘤学结果良好且毒性可接受。在本手稿中，我们回顾了CIRT的物理和生物学原理，重点是DNA损伤和修复，并全面概述了使用CIRT的转化和临床数据。
