RESUMO
Charted-particle therapy (CPT) benefits cancer patients by localizing doses in the tumor volume while minimizing the doses delivered to normal tissue through its unique physical and biological characteristics. The world's first CPT applied on humans was proton beam therapy (PBT), which was performed in the mid-1950s. Among heavy ions, carbon ions showed the most favorable biological characteristics for the treatment of cancer patients. Carbon ions show coincidence between the Bragg peak and maximum value of relative biological effectiveness. In addition, they show low oxygen enhancement ratios. Therefore, carbon-ion radiotherapy (CIRT) has become mainstream in the treatment of cancer patients using heavy ions. CIRT was first performed in 1977 at the Lawrence Berkeley Laboratory. The CPT technology has advanced in the intervening decades, enabling the use of rotating gantry, beam delivery with fast pencil-beam scanning, image-guided particle therapy, and intensity-modulated particle therapy. As a result, as of 2019, a total of 222,425 and 34,138 patients with cancer had been treated globally with PBT and CIRT, respectively. For more effective and efficient CPT, many groups are currently conducting further studies worldwide. This review summarizes recent technological advances that facilitate clinical use of CPT.
Assuntos
Tecnologia Biomédica/tendências , Radioterapia com Íons Pesados/métodos , Neoplasias/radioterapia , Tecnologia Biomédica/estatística & dados numéricos , Radioterapia com Íons Pesados/instrumentação , Radioterapia com Íons Pesados/estatística & dados numéricos , Radioterapia com Íons Pesados/tendências , HumanosAssuntos
Difusão de Inovações , Neoplasias/terapia , Radioterapia (Especialidade)/tendências , Radioterapia/tendências , Sobreviventes de Câncer , Terapia Combinada , Radioterapia com Íons Pesados/métodos , Radioterapia com Íons Pesados/tendências , Humanos , Imunoterapia , Imageamento por Ressonância Magnética , Neoplasias/diagnóstico por imagem , Terapia com Prótons , Lesões por Radiação/prevenção & controle , Radioterapia (Especialidade)/métodos , RadiocirurgiaRESUMO
Charged particle therapy is the most advanced radiotherapy method in oncology. The favorable depth-dose distribution and the biological properties of charged particles have potentially a great benefit for reducing toxicity and increasing the local control. While the number of proton centers is exponentially growing worldwide, the therapy remains controversial due to the high cost and lack of level-I evidence of superior effectiveness compared to conventional X-rays. Here we will discuss the advantages and the challenges in both physics and biology to fully exploit the potential of ion therapy in medicine. The challenges include reducing the footprint and costs of accelerators, reducing range uncertainty, exploitation of the biological advantages such as the high effectiveness against hypoxic tumors, and to select patients with biology-driven personalized approaches. International collaboration in the field is likely to bring definite answers to these ongoing problems.
Assuntos
Radioterapia com Íons Pesados/métodos , Oncologia/métodos , Neoplasias/radioterapia , Terapia com Prótons/métodos , Radioterapia com Íons Pesados/tendências , Humanos , Oncologia/tendências , Fenômenos Físicos , Terapia com Prótons/tendências , Radiobiologia/tendências , Raios XRESUMO
Actuality was dense in 2017 for oncology and hematology. The editorial board of the Bulletin du Cancer proposes a selection of key data distinguishing four trends: precision medicine, immunotherapy, focus on early stages and global management of metastatic disease. A summary of results which have been published or presented in congresses is proposed and the impact on daily practices is discussed.
Assuntos
Imunoterapia/tendências , Oncologia/tendências , Metástase Neoplásica/terapia , Neoplasias/terapia , Medicina de Precisão/tendências , Radioterapia com Íons Pesados/tendências , Humanos , Neoplasias/patologia , Inibidores de Poli(ADP-Ribose) Polimerases , Terapia com Prótons/tendênciasAssuntos
Radioterapia com Íons Pesados/tendências , Neoplasias/radioterapia , Terapia com Prótons/tendências , Institutos de Câncer/organização & administração , Ensaios Clínicos Fase IV como Assunto , Países em Desenvolvimento , Medicina Baseada em Evidências/normas , Radioterapia com Íons Pesados/economia , Humanos , Movimento , Órgãos em Risco/efeitos da radiação , Terapia com Prótons/economia , Editoração/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Eficiência Biológica RelativaAssuntos
Irradiação Craniana/métodos , Radioterapia com Íons Pesados/métodos , Radiocirurgia/métodos , Adenoma/radioterapia , Fatores Etários , Neoplasias Encefálicas/radioterapia , Irradiação Craniana/tendências , Radioterapia com Íons Pesados/tendências , Humanos , Malformações Arteriovenosas Intracranianas/radioterapia , Neoplasias Meníngeas/radioterapia , Meningioma/radioterapia , Neuroma Acústico/radioterapia , Órgãos em Risco/efeitos da radiação , Neoplasias Hipofisárias/radioterapia , Terapia com Prótons , Radiocirurgia/instrumentação , Radiocirurgia/tendências , Radioterapia Conformacional , Eficiência Biológica RelativaAssuntos
Institutos de Câncer/organização & administração , Radioterapia com Íons Pesados/métodos , Neoplasias/radioterapia , Radioterapia (Especialidade)/tendências , Bicarbonatos/uso terapêutico , Previsões , Radioterapia com Íons Pesados/tendências , Humanos , Terapia com Prótons , Radioterapia (Especialidade)/normas , Estados UnidosAssuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Radioterapia com Íons Pesados , Terapia com Prótons , Carcinoma Adenoide Cístico/radioterapia , Carcinoma de Células Escamosas/radioterapia , Terapia Combinada , Radioterapia com Íons Pesados/métodos , Radioterapia com Íons Pesados/tendências , Humanos , Melanoma/radioterapia , Neoplasias Nasofaríngeas/radioterapia , Terapia com Prótons/métodos , Terapia com Prótons/tendências , Dosagem Radioterapêutica , Eficiência Biológica Relativa , Neoplasias da Língua/radioterapiaAssuntos
Radioterapia com Íons Pesados/tendências , Neoplasias/radioterapia , Aceleradores de Partículas , Radioterapia de Alta Energia/instrumentação , Radioterapia de Alta Energia/tendências , Idoso , Idoso de 80 Anos ou mais , Carbono , Radioterapia com Íons Pesados/instrumentação , Radioterapia com Íons Pesados/métodos , Radioterapia com Íons Pesados/estatística & dados numéricos , Íons Pesados , Humanos , Japão/epidemiologia , Neoplasias/epidemiologia , Nêutrons , Fótons , Radioterapia de Alta Energia/métodos , Radioterapia de Alta Energia/estatística & dados numéricosRESUMO
Recent advance in the field of radiation oncology, especially in medical physics for radiation therapy (RT), has considerably improved treatment outcomes of various cancers including prostate cancer with regard to both of tumor control and morbidity. Three-dimensionally conformal RT with image-guided radiotherapeutic modalities for accurate tumor localization, such as brachytherapy, intensity-modulated radiation therapy (IMRT), and charged particle beam RT can thereby deliver a large dose to the tumor and allow the sparing of surrounding normal tissues. It is thought that prostate cancer is one of representative cancers which have been treated with RT as a curative intent and benefited from novel conformal RT techniques. Because the number of prostate cancer patients has been increasing year by year in Japan as results from wide spread of PSA screening and rapid change in life style, RT has been recently playing much more important roles in the curative treatment for patients with prostate cancer. Hence, we will review the outcomes of RT for prostate cancer and introduce the benefit of modern RT modalities from clinical aspect. In addition, our future prospect to further yield better disease control with minimum morbidity compared with present RT will be also mentioned in the report.