Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.
OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.
Radiother Oncol. 2018 Jul;128(1):56-67. doi: 10.1016/j.radonc.2018.05.018. Epub 2018 Jun 1.
The physical properties of proton beams offer the potential to reduce toxicity in tumor-adjacent normal tissues. Toward this end, the number of proton radiotherapy facilities has steeply increased over the last 10-15 years to currently around 70 operational centers worldwide. However, taking full advantage of the opportunities offered by proton radiation for clinical radiotherapy requires a better understanding of the radiobiological effects of protons alone or combined with drugs or immunotherapy on normal tissues and tumors. This report summarizes the main results of the international expert workshop "Radiobiology of Proton Therapy" that was held in November 2016 in Dresden. It addresses the major topics (1) relative biological effectiveness (RBE) in proton beam therapy, (2) interaction of proton radiobiology with radiation physics in current treatment planning, (3) biological effects in proton therapy combined with systemic treatments, and (4) testing biological effects of protons in clinical trials. Finally, important research avenues for improvement of proton radiotherapy based on radiobiological knowledge are identified. The clinical distribution of radiobiological effectiveness of protons alone or in combination with systemic chemo- or immunotherapies as well as patient stratification based on biomarker expressions are key to reach the full potential of proton beam therapy. Dedicated preclinical experiments, innovative clinical trial designs, and large high-quality data repositories will be most important to achieve this goal.
质子束的物理特性提供了降低肿瘤邻近正常组织毒性的潜力。为此，在过去 10-15 年中，质子放射治疗设施的数量急剧增加，目前全球约有 70 个运营中心。然而，要充分利用质子辐射为临床放射治疗提供的机会，就需要更好地了解质子单独或与药物或免疫疗法联合应用于正常组织和肿瘤的放射生物学效应。本报告总结了 2016 年 11 月在德累斯顿举行的“质子治疗放射生物学”国际专家研讨会的主要结果。它涉及主要议题：（1）质子束治疗中的相对生物学效应（RBE）；（2）质子放射生物学与当前治疗计划中的放射物理学的相互作用；（3）质子治疗与全身治疗相结合的生物学效应；（4）临床试验中质子生物学效应的检测。最后，确定了基于放射生物学知识改善质子放射治疗的重要研究途径。单独使用质子或与全身化疗或免疫疗法联合使用的放射生物学效应的临床分布，以及基于生物标志物表达的患者分层，是充分发挥质子束治疗潜力的关键。专门的临床前实验、创新的临床试验设计和高质量的大型数据存储库将是实现这一目标的最重要因素。
