为什么并非所有儿童癌症患者都使用质子治疗? 瑞典2016-2023年人口报告
Anna Asklid1, Ingrid Kristensen2, Ulla Martinsson3
1Department of Oncology, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden. anna.asklid@ki.se.
Acta oncologica (Stockholm, Sweden)
|September 3, 2025
概括
尽管有好处,但对儿科患者并不总是选择质子疗法. 临床,后勤和技术因素往往导致选择替代性放射疗法 (RT) 进行最佳治疗.
科学领域:
- 儿童瘤学
- 辐射瘤学
- 医学物理
背景情况:
- 瑞典的质子疗法 (PT) 设施于2015年建立,以改善儿科的准入.
- 尽管有剂量优势和完全补贴,但PT并不是儿童癌症治疗的普遍选择.
- 这项研究探讨了为什么在儿童中选择替代性放射治疗 (RT) 而不是PT.
研究的目的:
- 研究影响儿科患者选择放射治疗技术的因素.
- 了解为什么质子疗法并不总是适合儿童的选择.
主要方法:
- 在2016年至2023年期间接受RT的18岁或更年轻患者的病历回顾.
- 从国家注册表中识别RT课程.
- 分析没有选择质子疗法的原因.
主要成果:
- 只有34%的儿科RT课程使用PT;66%使用光子RT.
- 选择光子RT的主要原因包括非治愈的意图 (35%),可比或优异的结果 (23%),全身辐射 (15%) 和技术不确定性 (15%).
- 8%的光子计划是基于剂量测量选择的;后勤/社会/技术因素占了4%.
结论:
- 临床,后勤和技术考虑往往需要替代RT方式,即使PT为儿科患者提供剂量优势.
- 通过平衡医疗,技术和实际因素来优化治疗, 个性化RT规划和多学科合作至关重要.
- 确保每个孩子的最佳治疗方法需要仔细考虑超出质子疗法的理论益处.
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