ПРОТОННАЯ ЛУЧЕВАЯ ТЕРАПИЯ: ВОЗМОЖНОСТИ КЛИНИЧЕСКОГО ПРИМЕНЕНИЯ И ПЕРСПЕКТИВЫ ИССЛЕДОВАНИЯ

Работа представлена обзором литературы по вопросу применения метода протонной лучевой терапии в лечении различных онкологических заболеваний. Освещены актуализированные данные о сравнении эффективности данного метода при меланоме глаза. В приведенных данных отражены преимущества протонной терапии по уровню локального контроля и снижению частоты развития радиоиндуцированной катаракты. В наглядном материале коротко освещена технология подготовки и проведения облучения глаза пучком протонов. Полученный за последние несколько десятилетий опыт применения протонной терапии опухолей основания черепа показал хорошие результаты. Физические свойства пучка протонов позволяют добиться максимальной дозовой конформности, снизив тем самым лучевую нагрузку на соседние критически важные анатомические структуры. Представленный материал по онкопедиатрии показывает недостаточные знания ученых по вопросу преимущества пучка протонов над современными методами фотонного излучения. Имеются лишь предварительные клинические результаты, касающиеся в основном лечения краниофарингиом. При лечении рака молочной железы протонная терапия показала лучший локальный контроль послеоперационных рецидивов опухоли, а такжеснижение дозовой нагрузки на контралатеральной стороне. Имеющиеся результаты ретроспективного анализа клинических данных в Университетском медицинском центре Лома Линда протонной терапии локализованного рака предстательной железы. Было показано отсутствие биохимического рецидива и локальной опухолевой прогрессии в течение 5 лет после облучения. Данные, полученные из опыта применения протонной лучевой терапии с пассивно рассеянным пучком для лечения рака предстательной железы на ранней стадии, показали смешанные результаты в сравнении с современными методами лучевой терапии с модулированной интенсивностью. В лечении немелкоклеточного рака легкого преимущества протонной терапии пока не совсем доказаны. Имеются сведения о чрезвычайной токсичности комбинации химиотерапии и фотонного облучения. Предполагается, что физические свойства протонов позволят уменьшить токсичность такой методики, однако клинические исследования по сравнению протонов и лучевой терапии с модулированной интенсивностью (ЛТМИ) еще не завершены. Коротко освещены основные направления развития метода протонной терапии.

протонная терапия, лучевая терапия, онкология, меланома глаза, опухоли основания черепа, эффективность

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