头颈部恶性肿瘤的质子、重离子治疗实践

Practice of proton and heavy ion radiotherapies for head and neck malignancies

放疗在头颈部肿瘤治疗中占重要地位，但因头颈部集中了人体许多重要功能，放疗可能导致严重后遗症。质子、重离子治疗具有优于常规光子射线放射物理学和生物学特性，有利于肿瘤控制和正常组织保护。质子、重离子技术已在头颈部软组织肿瘤（尤其颅底脊索瘤、软骨肉瘤）、恶性黑色素瘤、腺样囊性癌等常规光子抵抗肿瘤中显出优势，在复发性肿瘤再程放疗中的安全性也得到了验证。

Radiotherapy is an important therapeutic method in the management of head and neck cancer. However, since the head and neck region has many important functions of the human body, radiotherapy may cause serious sequelae. Proton and heavy ion radiotherapies have better radiophysical and biological properties compared with conventional proton beam and are beneficial to tumor control and protection of normal tissue. The advantages of proton and heavy ion radiotherapies have been demonstrated in soft tissue tumors （especially skull base chordoma and chondrosarcoma） , malignant melanoma, and adenoid cystic carcinoma resistant to conventional protons in the head and neck region, and the safety of proton and heavy ion radiotherapies have been confirmed in reirradiation for recurrent tumors.