PDF(Pubmed)
Abstract：
The skull base is an anatomically and functionally critical area surrounded by vital structures such as the brainstem, the spinal cord, blood vessels, and cranial nerves. Due to this complexity, management of skull base tumors requires a multidisciplinary approach involving a team of specialists such as neurosurgeons, otorhinolaryngologists, radiation oncologists, endocrinologists, and medical oncologists. In the case of pediatric patients, cancer management should be performed by a team of pediatric-trained specialists. Radiation therapy may be used alone or in combination with surgery to treat skull base tumors. There are two main types of radiation therapy: photon therapy and particle therapy. Particle radiotherapy uses charged particles (protons or carbon ions) that, due to their peculiar physical properties, permit precise targeting of the tumor with minimal healthy tissue exposure. These characteristics allow for minimizing the potential long-term effects of radiation exposure in terms of neurocognitive impairments, preserving quality of life, and reducing the risk of radio-induced cancer. For these reasons, in children, adolescents, and young adults, proton therapy should be an elective option when available. In radioresistant tumors such as chordomas and sarcomas and previously irradiated recurrent tumors, particle therapy permits the delivery of high biologically effective doses with low, or however acceptable, toxicity. Carbon ion therapy has peculiar and favorable radiobiological characteristics to overcome radioresistance features. In low-grade tumors, proton therapy should be considered in challenging cases due to tumor volume and involvement of critical neural structures. However, particle radiotherapy is still relatively new, and more research is needed to fully understand its effects. Additionally, the availability of particle therapy is limited as it requires specialized equipment and expertise. The purpose of this manuscript is to review the available literature regarding the role of particle radiotherapy in the treatment of skull base tumors.
摘要：
颅底是解剖学和功能上的关键区域，被脑干等重要结构包围，脊髓，血管,和颅神经。由于这种复杂性,颅底肿瘤的管理需要一个多学科的方法，涉及一组专家，如神经外科医生，耳鼻喉科医师,放射肿瘤学家，内分泌学家,和医学肿瘤学家。在儿科患者的情况下，癌症治疗应由一组经过儿科培训的专家进行.放射疗法可单独使用或与手术联合使用以治疗颅底肿瘤。有两种主要类型的放射疗法:光子疗法和粒子疗法。粒子放射治疗使用带电粒子（质子或碳离子），由于它们特殊的物理性质，允许以最小的健康组织暴露精确靶向肿瘤。这些特征可以最大程度地减少辐射暴露对神经认知障碍的潜在长期影响，保持生活质量，并降低放射诱发癌症的风险。由于这些原因,在儿童中，青少年,和年轻人，质子治疗应该是一种可选选择。在放射抗性肿瘤如脊索瘤和肉瘤以及先前照射的复发性肿瘤中，粒子疗法允许递送高生物有效剂量，或者无论多么可接受，毒性。碳离子疗法具有独特且有利的放射生物学特性，可以克服抗辐射特性。在低度肿瘤中，由于肿瘤体积和关键神经结构的受累，在具有挑战性的病例中应考虑质子治疗。然而,粒子放射治疗还是比较新的,需要更多的研究来充分了解其影响。此外,粒子疗法的可用性是有限的，因为它需要专门的设备和专业知识。本手稿的目的是回顾有关粒子放射疗法在颅底肿瘤治疗中的作用的现有文献。
