概述
质子疗法是一种使用高功率能量来治疗癌症和某些非癌性肿瘤的放射疗法。长期以来，上述状况的治疗一直使用 X 线放射疗法。质子疗法则是一种采用正电荷粒子能量（质子）的新型放射疗法，
在治疗多种癌症方面具有良好的应用前景。研究表明，由于医生能够更好地控制质子束输送能量的位置，质子疗法的副作用可能少于传统的放疗。但是少有研究比较质子放疗和 X 线放疗，因此尚不清楚质子疗法能否更有效地延长生命。
虽然美国及其他国家/地区正在建立新的质子疗法中心，但质子疗法尚未普及。
Proton therapy vs. traditional radiation therapy
Proton therapy and traditional radiation therapy both use powerful energy beams to treat cancer and noncancerous tumors. But each treatment uses a different kind of energy.
- Traditional radiation therapy also is called photon therapy. Photon therapy uses high-energy X-rays to target and destroy cancer cells. The photons work like a beam of light. They enter the body from one side, travel through the area being treated, and then exit from the other side.
- Proton therapy uses the energy from positively charged particles called protons. Unlike photons, which pass all the way through the body, protons enter the body, release most of their energy right where the cancer is, and then they stop. This means proton therapy may help lower the amount of radiation that healthy tissues and organs receive.
Proton therapy may allow healthcare teams to give larger doses of radiation, especially to cancers and tumors that are near important structures.
目的
质子疗法用于治疗癌症和一些非癌性肿瘤。质子疗法可以用作唯一治疗方法。也可以结合其他治疗方法使用，例如手术和化疗。
如果癌症在传统 X 线照射后仍然存在或复发，也可以利用质子疗法。
质子疗法有时用于治疗：
- 脑肿瘤
- 乳腺癌
- 儿童癌症
- 眼黑色素瘤
- 食管癌
- 头颈癌
- 肝癌
- 肺癌
- 淋巴瘤
- 胰腺癌
- 垂体腺瘤
- 前列腺癌
- 肉瘤
- 脊柱肿瘤
- 颅底肿瘤
临床试验正在研究质子疗法作为其他几种类型癌症的治疗方法。
风险
当癌细胞死亡或来自质子束的能量损伤肿瘤附近的健康组织时，质子疗法会引起副作用。
质子疗法可以让医生更好地控制释放最强能量的部位，因此与传统放射疗法相比，对健康组织的影响更小，副作用也更少。但质子疗法仍会向健康组织释放一部分能量。
所出现的副作用取决于治疗部位以及接受的质子疗法的辐射量。
一般来说，质子疗法的常见副作用包括：
- 疲劳
- 治疗部位周围脱发
- 正在接受治疗的患处周围可能出现皮肤发红
- 治疗部位周围出现疼痛
如何进行准备
在接受质子疗法之前，您需要在医疗团队的指导下完成治疗计划制订，以确保质子束精准投射到需要治疗的身体部位。
治疗计划通常包括：
Find a proton therapy center
Proton therapy isn't widely available in the United States. To find a hospital that offers proton therapy, use online resources such as the National Association for Proton Therapy, which lists the locations of proton therapy centers in the United States. Ask your healthcare team if proton therapy is available in your area. Getting proton therapy may require traveling far from home, so consider this when deciding whether to have this treatment.
考虑费用
部分保险并不承保质子疗法。考虑治疗方案时，应咨询健康保险公司，了解保险可报销哪些费用，以及您需要支付哪些费用。
Have treatment planning
Before you are treated with proton therapy, your healthcare team guides you through a planning process to ensure that the proton beam reaches the right spot in your body.
Planning typically includes:
-
Determining the best position for you during treatment. During a simulation of your radiation treatment, your radiation therapy team works to find a comfortable position for you during treatment. It's important that you lie still during treatment, so finding a comfortable position is vital.
You'll be positioned on a table that will be used during your treatment. Cushions and body molds are used to place you in the correct position and to help you keep still. Your radiation therapy team will mark the area of your body that will receive the radiation. You may receive a temporary marker or permanent tattoos.
- Planning the path of the protons with imaging tests. You may have MRI or CT scans to find the area of your body that needs treatment and figure out how best to reach it with the proton beams.
可能出现的情况
质子疗法期间
您通常每周五天接受质子疗法，并持续数周。但在某些情况下，您可能仅接受一种或几种治疗，具体取决于您的医疗状况。质子疗法的实际治疗时间可能仅有几分钟，但每次治疗前需要 30 到 45 分钟做准备。
您还可能每周进行一次 CT 扫描，以确认是否需要根据体重或肿瘤大小和形状的变化重新计算所接受的剂量。
为做好治疗准备，您将躺在检查台上。将使用垫子和约束装置使您的身体保持静止。然后，您将进行影像学检查，例如 X 射线或 CT 扫描，以确保每次治疗前您的身体处于完全相同的位置。
然后，您的放射疗法团队将离开房间，进入可以监测您的区域。他们仍然可以看到您，并且可以听到您的声音。
质子疗法使用一种称为机架的机器进行，该机器将质子束引导至您身体上的精确点位。机器打开并提供质子疗法辐照时，您会听到机器发出的声音。但是，您在治疗期间不会感觉到辐射。
Before proton therapy
Before the proton therapy treatment, you may have imaging tests and blood tests to see if the dose you receive needs to be recalculated based on changes in weight, or tumor size and shape.
To prepare for treatment, you'll be positioned on a table. Cushions and body molds will be used to hold your body still. Then you'll have an imaging test, such as a CT scan, to make sure your body is in the same position before each treatment.
Your radiation therapy team then will leave the room and go to an area where team members can monitor you. They still can see and hear you.
During proton therapy
During proton therapy, a machine directs proton beams at precise points on your body. You'll hear the machine when it's turned on and delivering the dose of proton therapy. However, you won't be able to feel the radiation during your treatment.
A proton therapy machine is a complex system designed to deliver radiation precisely. It starts with a particle accelerator that generates high-energy protons. These protons are then guided through a beamline, which brings the proton beam to a machine in the treatment room. This machine is called a gantry. The gantry can move around the treatment table, aiming the proton beam at your body from many different angles.
There are different kinds of proton therapy machines that shape and direct the proton beams in different ways. They all direct proton beams precisely with the goal of hurting cancer and tumors, while sparing the nearby healthy tissue as much as possible.
质子治疗后
一旦疗程结束，您就可以开始新生活了。您不具有放射性，也不会发出辐射。
质子疗法的副作用通常会随着时间的推移而进展。开始时您可能并不会感受到副作用。但经过几次治疗后，您可能会感到疲劳，这会让您觉得进行平时的活动需要更多的精力，或者您几乎没有精力做日常任务。您也可能在质子束照射的部位注意到类似晒伤的皮肤发红。
结果
医生可能会建议您在质子疗法期间和之后定期进行影像学检查，以确定治疗是否对癌症有效。
临床试验
探索 Mayo Clinic 的研究 测试新的治疗、干预与检查方法，旨在预防、检测、治疗或控制这种疾病。