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[EsoTODAY 050 - Proton therapy for esophageal cancer. 양성자치료] - End of document

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성균관의대 학술잡지 Precision and Future Medicine에 Proton therapy에 대한 멋진 리뷰가 실렸습니다 (PFM 2019).

Proton therapy는 X-ray를 이용한 photon therapy와는 사뭇 다른 물리적 특성이 있습니다. Proton의 에너지는 특정 깊이에 모입니다 (Bragg peak). 따라서 target 이외의 조직에 미치는 영향이 매우 적습니다.

The width of the Bragg peak is narrow; thus, it needs to be spread out to cover the tumor volume longitudinally ("spread-out Bragg peak").

[식도암에서의 성적]

Investigators at the MD Anderson Cancer Center reported that in patients treated with neoadjuvant chemotheradiation followed by surgery, there was a significant increase in pulmonary complications for 3D-CRT (three dimensional conformal radiation therapy) and a trend for IMRT (intensity-modulated radiation therapy) compared with that for proton therapy.

In a recent study, the treatment outcomes of proton therapy for locally advanced esophageal cancer were better than those of IMRT. A total of 343 patients who received definitive chemoradiation with either proton therapy (n=132) or IMRT (n=211) were analyzed retrospectively. Proton therapy resulted in significantly better OS (P=0.01), PFS (P=0.0001), and locoregional failure-free survival (P=0.041) in multivariate analysis. In stage III disease, 5-year OS (34.6% vs. 25.0%, P=0.038) and PFS (33.5% vs. 13.2%, P=0.005) rates were higher in the proton therapy group, while there were no significant differences in survival for Stage I/II patients.

© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (since 1999-8-23)