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Fortschritte in der Radioonkologie

Von der Präzisionsstrahlentherapie mit Photonen zur Ionentherapie mit Protonen und Kohlenstoffionen

Advances in Radio-oncology

From precision radiotherapy with photons to ion therapy with protons and carbon ions

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Zusammenfassung

Mit modernen strahlentherapeutischen Techniken wie der fraktionierten stereotaktischen Radiotherapie (FSRT), der stereotaktischen Radiochirurgie (SRS) und der intensitätsmodulierten Radiotherapie (IMRT) ist es heute möglich, hohe Strahlendosen auf ein definiertes Bestrahlungsvolumen zu applizieren, während das umliegende gesunde Gewebe geschont werden kann. Dabei können hohe lokale Tumorkontrollraten erzielt werden, während das Risiko für therapieassoziierte Nebenwirkungen reduziert werden kann. Das innovative Hi-Art-Tomotherapie-System bietet eine weitere Alternative, bei der ein 6-MV-Photononbeschleuniger mit einem CT-Scanner kombiniert ist. Mit Ionenstrahlen wie Protonen und Kohlenstoffionen konnten bei einer Reihe von Tumorerkrankungen sehr gute therapeutische Ergebnisse erreicht werden. Beide zeichnen sich durch die physikalische Charakteristik des sog. invertierten Dosisprofils aus, das zu der vorteilhaften Dosiskonformierung beiträgt. Kohlenstoffionen weisen des Weiteren eine erhöhte relative biologische Wirksamkeit auf. Für eine Reihe von Tumoren konnte bereits ein signifikanter Therapievorteil in Bezug auf lokale Tumorkontrolle und Gesamtüberleben mit der Kohlenstoffionentherapie gezeigt werden.

Abstract

Modern techniques in radiation oncology, such as fractionated stereotactic radiotherapy (FSRT), stereotactic radiosurgery (SRS) or intensity modulated radiotherapy (IMRT) allow the application of high local doses to defined treatment volumes, while normal structures in close vicinity can be spared; high local control rates can be achieved, while treatment-related toxicity can be minimized. Innovative Hi-Art tomotherapy systems offer an alternative, combining a 6 MV photon accelerator with a CT scanner. Ion beams, such as protons and carbon ions, have been shown to be beneficial for distinct tumor entities. Both offer a characteristic physical dose distribution with an inverse dose profile contributing to beneficial dose conformality. Carbon ions also offer the advantage of increased relative biological effectiveness. For certain tumor types, a significant increase in local control and survival rates could be obtained with carbon ions.

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Authors and Affiliations

  1. Klinik für Radioonkologie und Strahlentherapie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120 , Heidelberg, Deutschland

    S. E. Combs, D. Schulz-Ertner, K. K. Herfarth, R. Krempien & J. Debus

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  1. S. E. Combs
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  2. D. Schulz-Ertner
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  3. K. K. Herfarth
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  4. R. Krempien
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  5. J. Debus
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Correspondence to S. E. Combs.

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Combs, S.E., Schulz-Ertner, D., Herfarth, K.K. et al. Fortschritte in der Radioonkologie. Chirurg 77, 1126–1132 (2006). https://doi.org/10.1007/s00104-006-1268-2

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  • DOI: https://doi.org/10.1007/s00104-006-1268-2

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