ПРОТОННАЯ ЛУЧЕВАЯ ТЕРАПИЯ: ВОЗМОЖНОСТИ КЛИНИЧЕСКОГО ПРИМЕНЕНИЯ И ПЕРСПЕКТИВЫ ИССЛЕДОВАНИЯ

М. В. Забелин, В. А. Климанов, Ж. Ж. Галяутдинова, Александр Сергеевич Самойлов, А. О. Лебедев, Е. В. Шелухина
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引用次数: 6

Abstract

This article is the review of literature concerning use of proton beam therapy in treatment of oncology. The staticized data on comparison of effi ciency of this method at an eye melanoma are lit. Advantages of proton therapy on the level of local control and depression of frequency of development of the radio induced cataract are refl ected in the provided data. In evident material the technology of preparation and carrying out radiation of an eye is shortly covered with a fascicle of protons. The experience of use of proton therapy of tumors of a skull base got for the last several decades, showed good results. Physical properties of a fascicle of protons allow to achieve the maximum dose conformality, having lowered, thereby, a radial load on the next crucial anatomical structures. The presented material on an oncopediatrics shows insuffi cient knowledge of scientists concerning advantage of a fascicle of protons over modern methods of photon radiation. There are only preliminary clinical results concerning generally of treatment of cranyopharyngiomas. At cancer therapy of a mammary gland, proton therapy showed the best local control of postoperative recurrent tumors, and also depression of a dose load on the contralateral party. The available results of the retrospective analysis of clinical data in the University medical center of Lome Linda, testify to advantages of proton therapy of the localized prostate cancer. The lack of a biochemical recurrence and a local tumoral progression within 5 years after radiation was shown. The data obtained from experience of use of proton radiation therapy with passively scattered fascicle for cancer therapy of a prostate at an early stage showed the admixed results in comparison with modern methods of radiation therapy with the modulated intensity. In treatment of non-small cell cancer of mild advantage of proton therapy aren’t absolutely proved yet. There are data on extreme toxicity of a combination of a chemotherapy and photon radiation. It is supposed that physical properties of protons will allow to reduce toxicity of such technique, however clinical trials in comparison of protons and RTMI aren’t fi nished yet. The main directions of development of a method of proton therapy are shortly lit.
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本文对质子束治疗在肿瘤治疗中的应用作一综述。本文列举了该方法在眼部黑色素瘤中的有效性比较的统计数据。所提供的数据反映了质子治疗在局部控制水平和降低放射性白内障发展频率方面的优势。在明显的材料中,制备和实施眼睛辐射的技术很快就被质子束覆盖。质子治疗颅底肿瘤已有几十年的经验,取得了良好的效果。质子束的物理特性允许达到最大剂量一致性,从而降低了下一个关键解剖结构的径向负荷。所提出的关于肿瘤医学的材料表明,科学家对质子束优于现代光子辐射方法的认识不足。关于颅咽管瘤的一般治疗方法,目前只有初步的临床结果。在乳腺肿瘤治疗中,质子治疗对术后复发肿瘤的局部控制效果最好,对侧剂量负荷也较低。通过对洛美林达大学医学中心临床资料的回顾性分析,证实了质子治疗局限性前列腺癌的优势。放射治疗后5年内无生化复发和局部肿瘤进展。从被动分散束质子放射治疗早期前列腺癌的经验中获得的数据显示,与现代调制强度放射治疗方法相比,结果好坏参半。在治疗非小细胞癌中,质子治疗的轻微优势尚未得到绝对证实。有数据表明,化疗和光子辐射的结合会产生极大的毒性。据推测,质子的物理性质可以降低该技术的毒性,但质子与RTMI的临床试验尚未完成。简述了质子治疗方法发展的主要方向。
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