Association for Nuclear Technology in Medicine, Nikkei Bldg., 7-16 Nihombashi-Kodemmacho, Chuo-ku, Tokyo, Tokyo, 103-0001, Japan.
Radiol Phys Technol. 2022 Dec;15(4):271-290. doi: 10.1007/s12194-022-00681-3. Epub 2022 Nov 8.
Radiation therapy for cancer using the Bragg peak of an ion beam has been making steady progress after being proposed by Robert Wilson in 1946. At the end of 2020, 12 dedicated treatment devices existed in operation worldwide, and approximately 40,000 patients have been treated with ion beams (mostly carbon ions). To date, ion beam therapy is superior to other treatments for rare cancers in the head and neck as well as bone and soft tissues; however, most recently, evidence submitted in Japan for the 2022 revision of public health insurance shows that ion beam therapy outperforms photon therapy for intractable common cancers such as pancreatic cancer and liver cancer. This may greatly expand its indications. Lawrence Berkeley Laboratory in the United States started research of ion beam therapy, National Institute of Radiological Sciences in Japan built the first dedicated device Heavy Ion Accelerator in Chiba and started systematic clinical research, and GSI in Germany developed the scanning irradiation method and rotating gantry for the first time. This paper presents the history and future challenges of ion beam therapy in three fields: accelerator and beam delivery system, physical/biological model and treatment planning system, and clinical research. This study is divided into three parts describing the achievements and roles of the three laboratories. In Part 1, accelerator and beam delivery system are described.
自 1946 年罗伯特·威尔逊(Robert Wilson)提出利用离子束的布拉格峰进行癌症放射治疗以来,该技术一直在稳步发展。截至 2020 年底,全球已有 12 台专用治疗设备投入运行,约有 4 万名患者接受了离子束治疗(主要是碳离子)。迄今为止,离子束疗法在治疗头颈部、骨骼和软组织等罕见癌症方面优于其他疗法;然而,最近在日本提交的 2022 年公共医疗保险修订证据表明,离子束疗法在治疗胰腺癌和肝癌等难治性常见癌症方面优于光子疗法。这可能会大大扩大其适应证。美国劳伦斯伯克利国家实验室开始了离子束治疗的研究,日本放射线医学综合研究所(National Institute of Radiological Sciences)在千叶建造了第一台专用重离子加速器并开始了系统的临床研究,德国的 GSI 首次开发了扫描照射方法和旋转机架。本文从加速器和束流传输系统、物理/生物模型和治疗计划系统以及临床研究三个领域介绍了离子束治疗的历史和未来挑战。本研究分为三部分,分别描述了三个实验室的成就和作用。第 1 部分描述了加速器和束流传输系统。