广州泰和肿瘤医院专家解读：质子治疗在前列腺癌治疗中的应用

Core Viewpoint - Prostate cancer is gaining public attention, with advanced radiation therapy, particularly proton therapy, showing significant potential as a treatment option for elderly patients like Biden [1] Group 1: Treatment Landscape - Prostate cancer treatment in the U.S. is primarily radiation-based (70%) with surgery as a secondary option (30%), leading to a nearly 98% five-year survival rate [1] - Advanced radiation techniques, including proton therapy, have significantly reduced side effects such as erectile dysfunction and urinary incontinence compared to traditional methods [1] Group 2: Advantages of Proton Therapy - Proton therapy offers precise targeting of tumors, minimizing damage to surrounding healthy tissues through the Bragg peak effect, unlike traditional photon therapy which can harm adjacent organs [3] - The ability to deliver higher doses (82-87 GyRBE) to tumors without damaging surrounding tissues enhances local control rates [3] - Proton therapy significantly reduces long-term side effects, improving patients' quality of life post-treatment [3] Group 3: Patient Selection for Proton Therapy - Patients with localized prostate cancer (T1-T2) can achieve over 95% five-year biochemical recurrence-free survival with proton therapy [5] - Low-risk patients can achieve a 94%-99% five-year survival rate with minimal rectal toxicity [6] - Intermediate-risk patients benefit from combined proton therapy and short-term hormone therapy, achieving 91%-94% five-year biochemical recurrence-free survival [6] - Elderly patients or those with comorbidities experience lower rates of severe side effects with proton therapy compared to surgical options [7] Group 4: Global Application and Development - The U.S., Europe, Japan, and China are leading in the application of proton therapy for prostate cancer, with the U.S. integrating it into treatment guidelines [9] - China is rapidly developing its proton therapy capabilities, with centers like the Shanghai Proton and Heavy Ion Center reporting a 100% five-year specific survival rate for localized prostate cancer patients [10] - Clinical cases in China demonstrate the effectiveness of proton therapy in controlling tumors while minimizing side effects, enhancing patient quality of life [10]