Koosha Fereshteh, Ahmadikamalabadi Mahdieh, Mohammadi Mohadesseh
Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Adv Radiat Oncol. 2024 Feb 8;9(5):101465. doi: 10.1016/j.adro.2024.101465. eCollection 2024 May.
This article provides an overview of the physical and biologic properties of carbon ions, followed by an examination of the latest clinical outcomes in patients with glioma who have received carbon ion radiation therapy.
According to thee articles that have been reviewed, glioma represents the predominant form of neoplastic growth in the brain, accounting for approximately 51% of all malignancies affecting the nervous system. Currently, high-grade glioma, specifically glioblastoma, comprises 15% of cases and is associated with a high mortality rate. The development of novel drugs for the treatment of high-grade tumors has been impeded by various factors, such as the blood-brain barrier and tumor heterogeneity, despite numerous endeavors. According to the definition of tumor grade established by the World Health Organization, the conventional treatment involves surgical resection followed by adjuvant radiation and chemotherapy. Despite numerous attempts in photon radiation therapy to apply the highest possible dose to the tumor site while minimizing damage to healthy tissue, there has been no success in increasing patient survival. The primary cause of resistance to conventional radiation therapy methods, namely x-ray and gamma-ray, is attributed to the survival of radio-resistant glioma stem cells, which have the potential to trigger a recurrence of tumors. Particle beams, such as protons and carbon ions, can deposit the highest dose to a confined region, thus offering a more accurate dose distribution compared with photon beams.
Carbon ions exhibit higher linear energy transfer and relative biologic effectiveness compared with photons, potentially enabling them to overcome radio-resistant tumor cells.
Therefore, it can be hypothesized that carbon ion radiation therapy may show superior efficacy in destroying neoplastic cells with reduced negative outcomes compared with x-ray radiation therapy.
本文概述了碳离子的物理和生物学特性，随后考察了接受碳离子放射治疗的胶质瘤患者的最新临床结果。
根据已审阅的文章，胶质瘤是脑肿瘤生长的主要形式，约占影响神经系统的所有恶性肿瘤的51%。目前，高级别胶质瘤，特别是胶质母细胞瘤，占病例的15%，且死亡率高。尽管进行了大量努力，但血脑屏障和肿瘤异质性等各种因素阻碍了用于治疗高级别肿瘤的新型药物的开发。根据世界卫生组织制定的肿瘤分级定义，传统治疗包括手术切除，随后进行辅助放疗和化疗。尽管在光子放射治疗中多次尝试在尽量减少对健康组织损害的同时向肿瘤部位施加尽可能高的剂量，但在提高患者生存率方面并未取得成功。对传统放射治疗方法（即X射线和γ射线）产生抗性的主要原因归因于抗辐射胶质瘤干细胞的存活，这些干细胞有可能引发肿瘤复发。粒子束，如质子和碳离子，可以将最高剂量沉积在一个受限区域，因此与光子束相比，能提供更精确的剂量分布。
与光子相比，碳离子具有更高的线性能量传递和相对生物学效应，这可能使它们能够克服抗辐射肿瘤细胞。
因此，可以假设与X射线放射治疗相比，碳离子放射治疗在破坏肿瘤细胞方面可能显示出更高的疗效，且负面结果更少。
