粒子弧放射治疗(PAT):技术进展与临床应用前景

      Particle Arc Therapy (PAT): Technical Advances and Clinical Application Prospects

      • 摘要: 粒子弧放射治疗(Particle arc therapy, PAT)是放射治疗领域的前沿创新技术,主要包括质子弧治疗(Spot-scanning proton arc therapy, SPArc)与重离子弧治疗(Spot-scanning heavy ion arc therapy, SHArc)两种模式。该技术通过弧形轨迹实现多角度连续照射,在复杂靶区的剂量学适形性与危及器官剂量削减方面表现出显著优势。现有研究表明,与传统强度调制质子治疗(IMPT)相比,SPArc可平均降低危及器官剂量约 10%~20%(P<0.05),同时在计划鲁棒性与递送效率方面亦具有潜在改进。SHArc结合高线性能量传递(LET)特性,在放射抗性肿瘤的治疗中具有更高的理论优势。该文系统综述了PAT的物理与技术原理、计划优化策略及最新研究进展,分析了其在鲁棒性验证、运动管理及经济性评估中的关键挑战与发展方向。总体而言,PAT尤其是SPArc,正展现出良好的临床转化潜力,有望成为下一代精准放射治疗的重要发展方向。

         

        Abstract: Particle Arc Therapy (PAT) represents a cutting-edge innovation in modern radiation therapy, encompassing two principal modalities: Spot-Scanning Proton Arc Therapy (SPArc) and Spot-Scanning Heavy Ion Arc Therapy (SHArc). By delivering beams continuously along an arc trajectory, PAT enables highly conformal dose distributions and improved sparing of organs at risk (OARs), particularly in complex anatomical sites. Existing studies have demonstrated that, compared with conventional Intensity-Modulated Proton Therapy (IMPT), SPArc can reduce the mean OAR dose by approximately 10–20% (p < 0.05), while achieving enhanced plan robustness and delivery efficiency. SHArc, benefiting from the high Linear Energy Transfer (LET) characteristics of heavy ions, is theoretically advantageous for the treatment of radioresistant tumors. This review provides a comprehensive overview of the physical and technical foundations of PAT, its planning optimization strategies, and recent clinical and preclinical developments. Challenges related to robustness verification, motion management, and cost-effectiveness are also discussed. Overall, PAT—particularly SPArc—exhibits promising translational potential and is poised to become an important direction in the future of precision radiotherapy.

         

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