腺样囊性癌的碳离子治疗

Carbon Ion Radiotherapies for Adenoid Cystic Carcinoma

腺样囊性癌(adenoid cystic carcinoma,ACC)发病率较低,常见于头颈部唾液腺恶性肿瘤中,可手术的患者手术治疗加术后放疗效果尚可,对于无法手术的患者单纯光子线放疗效果不理想。碳离子具有优于常规光子线的放射物理学和生物学特性,有利于对肿瘤的控制和正常组织的保护。目前全世界范围内可以开展碳离子治疗的单位不多,主要集中在德国、日本、美国以及中国上海,治疗的方式主要包括碳离子单独应用治疗ACC、碳离子与调强放射治疗(IMRT)联合治疗ACC、碳离子治疗复发的ACC、碳离子治疗年幼的ACC患者以及正在研究的碳离子放疗与靶向药物及化疗的联合,此类研究可以证实碳离子在临床应用的有效性及安全性。

Adenoid cystic carcinoma （ACC） is a rare tumor accounting for approximately 1% of all malignant tumors in the salivary gland tissue of head and neck. The main clinical treatment of ACC was depended on surgical operation in the past. Those patients with operable ACC have better clinical outcomes after surgery. However, as ACC cannot be completely excised by surgery, the residual of tumor cells is the independent risk factor for the recurrence of ACC. Therefore, radiotherapy was usually used after the operation. However, ACC is a disease resistant to radiation. Comparing to conventional proton beam, carbon ion radiotherapies have better radiophysical features, biological properties and beneficial for tumor control and protection of normal tissues. There are many carbon ion therapy centers worldwide, mainly in Japan, German, America and Shanghai of China. The treatment methods include carbon ion radiotherapy only, combined carbon ion radiotherapy with intensity-modulated radiotherapy （IMRT）, carbon ion radiotherapy for recurrent ACC, pediatric patients and young adults with ACC. In addition, combined carbon ion radiotherapy with targeted drug remains ongoing. The effectiveness and safety of carbon ion have been confirmed in those researches.