肿瘤医生:儿童癌症 为何要选择质子治疗?

2019-08-06 汉鼎好医友 健康号

儿童的身体还在成长发育中,传统放射疗法可能给儿童癌症患者带来难以估量的伤害。儿童对常规放疗的副作用特别敏感。

儿童的身体还在成长发育中,传统放射疗法可能给儿童癌症患者带来难以估量的伤害。儿童对常规放疗的副作用特别敏感。

对一些儿童癌症患者来说,质子疗法是很好的选择,它可以在治疗肿瘤的同时,将副作用降到最低。

放射治疗对缩小或消除肿瘤非常有效,但医生有时会避免对癌症儿童使用放疗。因为传统的X射线放射治疗对儿童有潜在的长期副作用,他们正在发育的身体对辐射非常敏感。例如幼儿的脑部在0至3岁间发展成熟最为迅速,年纪越小接受放疗,5年内智商下降幅度越大。由于儿癌病童存活率上升,放射疗法更长期的副作用,也可能陆续在儿童成长的过程中出现,比方心血管系统的冠状动脉疾病、及中风几率上升等。甚至能在数年或数十年后增加儿童患第二原发癌症的风险。

质子疗法是一种强大、安全的替代疗法,它可以使更多的儿童受益于放射治疗。这种复杂的疗法使用一种叫做质子的带电粒子,将高剂量的辐射直接传送到肿瘤上。质子治疗可以减少辐射对周围组织的影响,减少副作用相关风险。

质子独特的物理特性(布拉格峰)使它们能够在体内特定的深度释放出辐射剂量,而X射线在击中目标前后都会释放能量。所以和传统的放疗不同,质子治疗可以在质子在到达肿瘤时释放所有能量,从而达到“精准聚焦”的效果。

纪念斯隆凯特琳癌症中心(MSK)儿童放射肿瘤学家Suzanne Wolden用这种技术治疗了越来越多患有脑瘤、肉瘤和其他癌症的儿童。仅在2018年,她就用质子疗法治疗了大约100名儿童。

“对很多人来说,质子治疗真的改变了游戏规则。现在我们能够为病人提供最好的护理。我们能更有效的治疗儿童癌症,并且减少对他们的成长和发展的副作用。”Wolden博士说。

充分发挥质子治疗优势的一个显着例子是儿童脑癌和脊柱肿瘤。治疗这类癌症,辐射必须覆盖整个大脑和脊柱。

“我们从头部和身体后部为这些癌症提供放射治疗。在常规辐射下,X射线会在穿过肿瘤后仍会继续前进,其他组织也会受到不必要的照射。但质子可以完全停止在肿瘤所在的位置。你的喉咙、心脏、或其他器官不会受到任何辐射。”

作为一名儿科肿瘤放射治疗专家,Wolden博士对质子疗法的潜力充满热情。她说:“从医学院和住院医生开始,我最喜欢的事情就是照顾孩子。我爱我的工作。没有什么比帮助他们走出可怕的处境,继续他们的生活更有意义的了。”

近年来,全球质子治疗中心数量大约翻了一番,共有约80家质子治疗中心,美国约占40%,其质子治疗技术全球领先。根据美国国家质子治疗协会数据显示,2018年的美国接受质子治疗的患者总数在15000左右。早在1990年,洛马林达大学(Loma Linda)医学中心便率先开展质子治疗,每天约有近200名患者在该质子中心接受治疗。儿童癌症也是该中心收治的常见病种,主要是脑肿瘤,最小的患者只有2岁。

而目前中国质子治疗还处于起步阶段,在技术、经验、适应症方面都与美国存在较大差距。由于国内肿瘤患者太多,仅有的几家质子治疗中心供不应求,且缺乏有经验的放疗医师。因此在经济条件允许的情况下,赴美就医成为许多患者的更好的选择。

不过,汉鼎好医友提醒:不应将质子治疗神化,是否接受质子治疗需要充分考虑利弊和潜在的获益。质子治疗并非万能,也有一定的适应症。对于非实体肿瘤(如淋巴瘤白血病血液肿瘤)、已有多发远处转移且转移灶在3个以上的肿瘤、同一部位1年内接受过放射或放射性粒子植入治疗等患者,质子治疗并不一定适合.

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    2019-11-22 wxl882001

    了解一下

    0

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    2019-10-04 wxl882001

    了解一下

    0

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    2019-09-13 0348

    我身边的一个大四女孩,就是在上海采用质子技术治疗脑瘤,现在博士已经毕业

    0

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    2019-08-20 wxl882001

    了解一下

    0

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  7. [GetPortalCommentsPageByObjectIdResponse(id=1926459, encodeId=044719264598f, content=<a href='/topic/show?id=553582853d1' target=_blank style='color:#2F92EE;'>#肿瘤医生#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82853, encryptionId=553582853d1, topicName=肿瘤医生)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Sun Jan 19 20:22:00 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=375661, encodeId=c7763e566121, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Fri Nov 22 19:32:58 CST 2019, time=2019-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373519, encodeId=65703e3519f9, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Fri Oct 04 18:02:14 CST 2019, time=2019-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=372654, encodeId=23c23e2654f1, content=我身边的一个大四女孩,就是在上海采用质子技术治疗脑瘤,现在博士已经毕业, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/04/04/355c07748bd28246a802dedc6fdf7421.jpg, createdBy=4cfd1732073, createdName=0348, createdTime=Fri Sep 13 06:21:24 CST 2019, time=2019-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371570, encodeId=198c3e15705b, content=了解一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Tue Aug 20 22:39:04 CST 2019, time=2019-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428915, encodeId=aa3a14289154b, content=<a href='/topic/show?id=4b409235552' target=_blank style='color:#2F92EE;'>#质子治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92355, encryptionId=4b409235552, topicName=质子治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=165c4147630, createdName=mxj1971613, createdTime=Thu Aug 08 13:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511133, encodeId=f62d151113372, content=<a href='/topic/show?id=e1372836021' target=_blank style='color:#2F92EE;'>#儿童癌症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28360, encryptionId=e1372836021, topicName=儿童癌症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a3910291816, createdName=guozhenyu, createdTime=Thu Aug 08 13:22:00 CST 2019, time=2019-08-08, status=1, ipAttribution=)]

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