Corrales-García Eva María, Aristu-Mendioroz José Javier, Castro-Novais Juan, Matute-Martín Raúl, Learra-Martínez María Concepción, Delgado-López Pedro David
Servicio Oncología Radioterápica, Hospital Universitario de Burgos, Burgos, Spain.
Unidad de Terapia de Protones, Clínica Universitaria de Navarra, Madrid, Spain.
Clin Transl Oncol. 2025 Mar;27(3):858-870. doi: 10.1007/s12094-024-03624-z. Epub 2024 Aug 29.
The unique biophysical properties of proton therapy (PT), regarding the precise dose distribution, a remarkable better sparing of surrounding normal tissues, and the decreasing costs have promoted the spread of this technique worldwide. In Spain, eleven new PT centers, added to the currently two in function, are expected to be available in the near future. Indications for PT are currently evolving. The suitability of PT in central nervous system tumors of the adult population has been extrapolated from the favorable experience in children and adolescents. Given the lack of appropriate randomized trials, controversies remain regarding its use in lower grade tumors, re-irradiation, and other clinical scenarios in which an a priori dose distribution benefit is expected compared to photon-based radiotherapy. PT is a reasonable option in many brain and spinal tumors associating long life expectancy, in which cognitive decline, and the appearance of radiation-induced neoplasms can be minimized.Estado actual de la terapia con protones en los tumores del sistema nervioso central en España: bases físicas, indicaciones, controversias y perspectivas.
质子治疗（PT）独特的生物物理特性，包括精确的剂量分布、对周围正常组织的显著更好的保护以及成本的降低，推动了这项技术在全球范围内的推广。在西班牙，除了目前正在运行的两家质子治疗中心外，预计在不久的将来还会有11家新的质子治疗中心投入使用。目前质子治疗的适应症正在不断发展。成人中枢神经系统肿瘤中质子治疗的适用性是从儿童和青少年的良好经验推断而来的。由于缺乏适当的随机试验，对于其在低级别肿瘤、再照射以及与基于光子的放射治疗相比预期有先验剂量分布优势的其他临床场景中的使用仍存在争议。在许多预期寿命较长的脑和脊髓肿瘤中，质子治疗是一种合理的选择，在这些肿瘤中，认知能力下降和放射性肿瘤的出现可以降至最低。西班牙中枢神经系统肿瘤质子治疗的现状：物理基础、适应症、争议和前景。
