Протонная терапия в лечении опухолей области головы и шеи: состояние проблемы и перспективы развития (обзор)

Протонная терапия (ПТ) ввиду дозиметрических особенностей (образование пика Брэгга, резкий спад дозы) является на сегодняшний день одним из наиболее высокотехнологичных методов лучевого лечения, превосходящим стандартные фотонные методики.

Традиционно на протяжении десятилетий ПТ применялась в первую очередь при опухолях области головы и шеи (ОГШ), в том числе локализованных в области основания черепа. И несмотря на то, что в последние годы области применения ПТ заметно расширились, опухоли ОГШ по-прежнему остаются ведущим показанием к облучению протонами, поскольку именно при данных нозологиях физико-дозиметрические и радиобиологические преимущества ПТ позволяют достичь наилучших результатов лечения.

Настоящий обзор посвящен применению ПТ опухолей ОГШ в мировой и российской медицине и перспективам ее дальнейшего развития, оценке радиобиологических особенностей ПТ, физико-дозиметрическому сравнению распределения протонов и фотонов. Показаны возможности ПТ при лечении опухолей основания черепа, ОГШ (полости носа, параназальных синусов, носо-, рото- и гортаноглотки и т.д.), опухолей глаза и слюнной железы. Проанализированы исследования по повторному облучению. Приведены последние экспериментальные данные, отражающие благоприятный профиль облучения протонами в сравнении с традиционными видами лучевого лечения.

Обзор позволяет сделать вывод о том, что ПТ на сегодняшний день — это динамично развивающийся метод облучения, открывающий новые возможности для повышения качества лечения онкологических больных, в особенности при локализациях новообразований в ОГШ.

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