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碳离子放疗在肝细胞癌治疗中的应用。

Carbon Ion Radiotherapy in the Treatment of Hepatocellular Carcinoma.

机构信息

Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.

Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Clin Mol Hepatol. 2023 Oct;29(4):945-957. doi: 10.3350/cmh.2023.0217. Epub 2023 Aug 14.

Abstract

Hepatocellular carcinoma (HCC) is a highly lethal cancer with limited treatment options and poor prognosis. Carbon ion radiotherapy (CIRT) has emerged as a promising treatment modality for HCC due to its unique physical and biological properties. CIRT uses carbon ions to target and destroy cancer cells with a high precision and efficacy. The Bragg Peak phenomenon allows precise dose delivery to the tumor while minimizing damage to healthy tissues. In addition, the high relative biological effectiveness of carbon ions can be shown against radioresistant and hypoxic tumor areas. CIRT also offers a shorter treatment schedule than conventional radiotherapy, which increases patient convenience and compliance. The clinical outcomes of CIRT for HCC have shown excellent local control rates with minimal side effects. Considering its physical and biological properties, CIRT may be a viable option for complex clinical scenarios such as patients with poor liver function, large tumors, re-irradiation cases, and tumors close to critical organs. Further research and larger studies are needed to establish definitive indications for CIRT and to compare its efficacy with that of other treatment modalities. Nevertheless, CIRT offers a potential breakthrough in HCC management, providing hope for improved therapeutic outcomes and reduced treatment-related toxicities.

摘要

肝细胞癌 (HCC) 是一种高度致命的癌症,治疗选择有限,预后较差。由于其独特的物理和生物学特性,碳离子放疗 (CIRT) 已成为 HCC 的一种有前途的治疗方式。CIRT 使用碳离子以高精度和高效靶向和破坏癌细胞。布拉格峰现象允许精确地将剂量输送到肿瘤,同时最大限度地减少对健康组织的损害。此外,碳离子的相对生物学效应较高,可以抵抗放射抗性和缺氧肿瘤区域。CIRT 还提供比传统放疗更短的治疗方案,增加了患者的便利性和依从性。CIRT 治疗 HCC 的临床结果显示出极好的局部控制率,副作用极小。考虑到其物理和生物学特性,CIRT 可能是复杂临床情况的可行选择,例如肝功能不佳、肿瘤较大、再放疗病例和靠近关键器官的肿瘤患者。需要进一步的研究和更大的研究来确定 CIRT 的明确适应证,并比较其与其他治疗方式的疗效。然而,CIRT 为 HCC 治疗提供了一个潜在的突破,为改善治疗结果和减少治疗相关毒性带来了希望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d04/10577350/fe9365f51090/cmh-2023-0217f1.jpg

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