质子放疗在头颈部恶性肿瘤治疗中的研究进展  

Research progress on proton therapy in the treatment of head and neck tumors

作　　者：刘玮 丁行晨 张扬 陈云昊 王勇 胡漫 LIU Wei;DING Xingchen;ZHANG Yang;CHEN Yunhao;WANG Yong;HU Man(Department of Radiation Oncology,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan,Shandong250117,China;Department of Radiation Oncology,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan,Shandong 250117,China;Department of Radiation Oncology,960th Hospital of the PLA Joint Logistic Support Force,Jinan,Shandong 250031,China;Department of Radiation Oncology,Affiliated Cancer Hospital of Nanjing Medical University&Jiangsu Cancer Hospital,Nanjing,Jiangsu210019,China)

机构地区：[1]山东第一医科大学(山东省医学科学院)放射肿瘤学系,山东济南250117 [2]山东省肿瘤防治研究院(山东省肿瘤医院)放疗科,山东第一医科大学(山东省医学科学院),山东济南250117 [3]中国人民解放军联勤保障部队第九六〇医院放疗科,山东济南250031 [4]南京医科大学附属肿瘤医院(江苏省肿瘤医院)放疗科,江苏南京210019

出　　处：《中华肿瘤防治杂志》2024年第23期1468-1474,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省自然科学基金生物医药联合基金(ZR2021LSW002);济南市科技计划(202225019)。

摘　　要：目的总结质子放疗在头颈部恶性肿瘤(HNC)治疗中的优势及其临床应用现状,并探讨其面临的挑战和发展方向,以期为HNC患者的临床治疗提供参考。方法以“头颈部恶性肿瘤、质子放疗”为中文关键词,以“radiotherapy for head and neck cancer、proton therapy”为英文关键词,检索PubMed数据库与中国知网的相关文献,检索时间为2014年8月-2024年6月。纳入标准:(1)质子治疗物理基础及应用相关文献;(2)HNC中质子与光子放疗疗效比较相关文献;(3)HNC质子治疗与光子放疗毒副作用比较相关文献;(4)质子治疗目前面临的挑战相关文献。排除标准:(1)内容重复的文献;(2)评论及会议纪要等文献。共纳入符合条件的文献45篇。结果质子放疗是目前国际上最先进的放疗方式之一,可以进一步优化放疗剂量分布,从而减少放疗相关毒副作用,具有独特的物理剂量学优势。质子治疗尤其是笔形束的应用,降低了对包括鼻咽癌、口咽癌、鼻腔与鼻窦肿瘤及眶周肿瘤在内的HNC靶区以外正常组织的放疗辐射,为减少HNC患者的急慢性放射反应提供了一种更为理想的治疗方案。同时,质子治疗在提高局部控制率和总生存率上也有显著效果。结论与光子放疗相比,质子放疗在提高HNC肿瘤控制率和减轻放疗毒副作用方面表现出显著优势。随着自适应放疗、MR直线加速器等先进技术的应用,质子放疗有望克服现有局限,为HNC患者带来更好的治疗效果和生存质量。Objective To summarize the advantages and current clinical applications'of proton therapy in the treatment of head and neck cancer(HNC),and to explore its challenges and development directions,in order to provide a reference for the clinical treatment of HNC patients.Methods Using keywords of"radiotherapy for head and neck cancer,proton therapy",relevant literature was retrieved in the PubMed and China National Knowledge Infrastructure(CNKI)databases from August 2014 to June 2024.The inclusion criteria were:(1)Literature related to the physical basis and application of proton therapy;(2)Literature comparing the efficacy of proton and photon radiotherapy in HNC;(3)Literature comparing the toxic side effects of proton therapy and photon radiotherapy in HNC;(4)Literature on the current challenges faced by proton therapy.Exclusion criteria were:(1)Duplicate content literature;(2)Comments,meeting summaries,and similar types of literature.A total of 45 articles met the inclusion criteria.Results Proton therapy is currently one of the most advanced radiotherapy methods internationally,capable of further optimizing the distribution of radiation dosage to reduce radiotherapy-related toxic side effects,possessing unique physical dosimetry advantages.The application of proton therapy,especially the use of pencil beam scanning,reduces the radiation exposure to normal tissues outside the target area in HNC,including nasopharyngeal carcinoma,oropharyngeal carcinoma,nasal and paranasal tumors,and periorbital tumors,providing a more ideal treatment option for reducing acute and chronic radiation reactions in HNC patients.At the same time,proton therapy has also shown significant effects in improving local control rates and overall survival rates.Conclusions Compared with photon radiotherapy,proton therapy has shown significant advantages in improving tumor control rates and reducing the toxic side effects of radiotherapy in HNC.With the application of advanced technologies such as adaptive radiotherapy and MR linear accelerators

关 键 词：头颈部恶性肿瘤 质子放疗 放疗毒性 自适应放疗 综述文献 

分 类 号：R739.1[医药卫生—肿瘤]