Jethwa Krishan R, Haddock Michael G, Tryggestad Erik J, Hallemeier Christopher L
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA.
Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
J Gastrointest Oncol. 2020 Feb;11(1):144-156. doi: 10.21037/jgo.2019.11.04.
Chemoradiotherapy (CRT) plays an essential role in the treatment of esophageal cancer as either curative or neoadjuvant therapy. When delivered with conventional photon-based techniques, multiple adjacent organs at risk including the heart, lungs, kidneys, liver, stomach, and bowel, receive considerable radiation dose which may contribute to acute and late adverse events (AEs). Proton beam therapy (PBT) offers a reduction in radiation exposure to these organs and potentially an improvement in the therapeutic ratio. Herein we discuss the emerging role of PBT for esophageal cancer, including rationale, treatment planning, early dosimetric and clinical comparisons of PBT with photon-based techniques, ongoing prospective trials, and potential areas of opportunity for the incorporation of PBT with the goal of improving outcomes for patients with esophageal cancer.
放化疗（CRT）作为食管癌的根治性或新辅助治疗发挥着重要作用。当采用传统的基于光子的技术进行治疗时，多个临近的危及器官，包括心脏、肺、肾脏、肝脏、胃和肠道，会接受相当大的辐射剂量，这可能会导致急性和晚期不良事件（AE）。质子束治疗（PBT）可减少这些器官的辐射暴露，并有可能提高治疗比。在此，我们讨论PBT在食管癌治疗中的新兴作用，包括基本原理、治疗计划、PBT与基于光子的技术的早期剂量学和临床比较、正在进行的前瞻性试验，以及将PBT纳入治疗以改善食管癌患者预后的潜在机会领域。
