食管癌质子和重离子治疗现状与展望

Current status and prospect of esophageal cancer proton and heavy ion therapy

目的综述食管癌质子和重离子治疗的剂量学优势、临床疗效、局限性并展望其发展前景,为提高食管癌的放射治疗疗效提供参考。方法使用PubMed及中国知网数据库检索系统,以“食管癌、放射治疗、质子治疗、重离子治疗、碳离子放射治疗”等为中文关键词,“esophageal cancer,radiotherapy,proton therapy,carbon-ion radiotherapy”为英文关键词进行检索。纳入标准:(1)食管癌的质子治疗;(2)食管癌的重离子治疗;(3)食管癌放射和免疫联合治疗。排除标准:(1)数据陈旧文献;(2)内容相似或重复。最终共纳入38篇文献。结果食管癌质子、重离子治疗具有独特剂量学优势,尤其是对肿瘤部位的局部高剂量辐射与周围正常器官和组织的保护作用,临床疗效也优于光子治疗。然而仍具有局限性,与免疫的联合治疗需进一步临床试验证实。结论质子和重离子治疗是一种有前途的方式,但还需要大量研究结果来进行验证和补充现有的临床和临床前数据,让其发挥更大优势,给患者带来更多生存获益。

Objective To summarize the dosimetric advantages,clinical efficacy,limitations and future prospects of proton and heavy ion therapy in treating esophageal cancer,and to provide new directions and ideas for improving the efficacy of radiation therapy for esophageal cancer.Methods PubMed and the China Knowledge Network database were searched by using the keywords"esophageal cancer,radiotherapy,proton therapy,heavy ion therapy,carbon-ion radiotherapy".Inclusion criteria:(1)proton therapy for esophageal cancer;(2)heavy ion therapy for esophageal cancer;(3)combined radiation and immunotherapy for esophageal cancer.Exclusion criteria:(1)literature with obsolete data;(2)content similarity or duplication.A total of 38papers were finally included.Results This paper illustrates the distinct dosimetric advantages of proton and heavy ion therapy for esophageal cancer,particularly in delivering high-dose radiation locally to the tumor site while safeguarding surrounding normal organs and tissues.Additionally,the clinical efficacy of this treatment surpasses that of photon therapy.Nonetheless,limitations persist,and the potential benefits of combining it with immunotherapy require validation through additional clinical trials.Conclusions Proton and heavy ion therapy is a promising modality,but the results of a large number of studies are needed to validate and supplement the existing clinical and preclinical data,so as to allow it to exert greater advantages and bring more survival benefits to patients.