Meyer Juergen, Eley John, Schmid Thomas E, Combs Stephanie E, Dendale Remi, Prezado Yolanda
1 Department of Radiation Oncology, University of Washington , Seattle, WA , USA.
2 Department of Radiation Oncology, School of Medicine, University of Maryland , Baltimore, MD , USA.
Br J Radiol. 2019 Mar;92(1095):20180466. doi: 10.1259/bjr.20180466. Epub 2018 Nov 7.
Extraordinary normal tissue response to highly spatially fractionated X-ray beams has been explored for over 25 years. More recently, alternative radiation sources have been developed and utilized with the aim to evoke comparable effects. These include protons, which lend themselves well for this endeavour due to their physical depth dose characteristics as well as corresponding variable biological effectiveness. This paper addresses the motivation for using protons to generate spatially fractionated beams and reviews the technological implementations and experimental results to date. This includes simulation and feasibility studies, collimation and beam characteristics, dosimetry and biological considerations as well as the results of in vivo and in vitro studies. Experimental results are emerging indicating an extraordinary normal tissue sparing effect analogous to what has been observed for synchrotron generated X-ray microbeams. The potential for translational research and feasibility of spatially modulated proton beams in clinical settings is discussed.
25多年来，人们一直在探索正常组织对高度空间分割的X射线束的非凡反应。最近，人们开发并利用了替代辐射源，目的是产生类似的效果。这些辐射源包括质子，由于其物理深度剂量特性以及相应的可变生物效应，质子非常适合用于此目的。本文阐述了使用质子产生空间分割束的动机，并回顾了迄今为止的技术实施情况和实验结果。这包括模拟和可行性研究、准直和束流特性、剂量学和生物学考量以及体内和体外研究的结果。实验结果表明，正常组织具有非凡的保护效应，类似于同步加速器产生的X射线微束所观察到的效果。本文还讨论了转化研究的潜力以及空间调制质子束在临床环境中的可行性。
