St James Sara, Grassberger Clemens, Lu Hsiao-Ming
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Transl Lung Cancer Res. 2018 Apr;7(2):210-215. doi: 10.21037/tlcr.2018.04.01.
Lung cancer, due to its poor clinical outcomes and significant toxicity associated with standard photon-based radiation, is a disease site that has the potential to greatly benefit from accurate treatment with proton radiation therapy. The potential of proton therapy is the ability to increase the radiation dose to the tumor while simultaneously decreasing the radiation dose to surrounding healthy tissues. For lung cancer treatment, this could mean significant sparing of the uninvolved healthy lung, which is difficult to achieve with external photon beam therapy, or decreasing the heart dose. In treating lung cancer with proton therapy, some additional considerations need to be made compared to treating patients with external photon beam radiation therapy. These include accounting for the finite range of protons in the patient, understanding temporal effects, potential dose discrepancies and choosing an appropriate treatment planning system for the task. One final consideration is differences between the different available proton therapy delivery systems-passive scattered proton therapy (PSPT) and active scanning proton therapy.
肺癌由于其临床预后不佳以及与基于光子的标准放疗相关的显著毒性，是一个极有可能从质子放射治疗的精准治疗中大幅获益的疾病部位。质子治疗的潜力在于能够增加肿瘤的辐射剂量，同时降低周围健康组织的辐射剂量。对于肺癌治疗而言，这可能意味着显著减少未受影响的健康肺组织所接受的辐射，而这用外部光子束疗法很难实现，或者降低心脏所接受的剂量。在用质子治疗肺癌时，与用外部光子束放射疗法治疗患者相比，还需要考虑一些其他因素。这些因素包括考虑质子在患者体内的有限射程、理解时间效应、潜在的剂量差异以及为该任务选择合适的治疗计划系统。最后一个需要考虑的是不同可用质子治疗输送系统——被动散射质子治疗（PSPT）和主动扫描质子治疗之间的差异。
