文章：

超高能电子治疗迈向临床应用

Very High-Energy Electron Therapy Toward Clinical Implementation

原文发布日期：8 January 2025

DOI: 10.3390/cancers17020181

类型: Article

开放获取: 是

英文摘要：

The use of very high energy electron (VHEE) beams, with energies between 50 and 400 MeV, has drawn considerable interest in radiotherapy due to their deep tissue penetration, sharp beam edges, and low sensitivity to tissue density. VHEE beams can be precisely steered with magnetic components, positioning VHEE therapy as a cost-effective option between photon and proton therapies. However, the clinical implementation of VHEE therapy (VHEET) requires advances in several areas: developing compact, stable, and efficient accelerators; creating sophisticated treatment planning software; and establishing clinically validated protocols. In addition, the perspective of VHEE to access ultra-high dose–rate regime presents a promising avenue for the practical integration of FLASH radiotherapy of deep tumors and metastases with VHEET (FLASH-VHEET), enhancing normal tissue sparing while maintaining the inherent dosimetric advantages of VHEET. However, FLASH-VHEET systems require validation of time-dependent dose parameters, thus introducing additional technological challenges. Here, we discuss recent progress in VHEET research, focusing on both conventional and FLASH modalities, and covering key aspects including dosimetric properties, radioprotection, accelerator technology, beam focusing, radiobiological effects, and clinical outcomes. Furthermore, we comprehensively analyze initial VHEET in silico studies on coverage across various tumor sites.

摘要翻译： 

能量介于50至400 MeV的极高能电子束因其深部组织穿透能力、锐利的束流边缘以及对组织密度的低敏感性，在放射治疗领域引起了广泛关注。通过磁学元件可实现VHEE束流的精确引导，使其成为介于光子治疗与质子治疗之间具有成本效益的治疗选择。然而，VHEE治疗的临床应用需要在多个领域取得进展：开发紧凑、稳定、高效的加速器；创建精密的治疗计划软件；建立经临床验证的治疗方案。此外，VHEE技术实现超高剂量率照射的特性，为深部肿瘤及转移灶的FLASH放疗与VHEET的实践融合开辟了新途径，在保持VHEET固有剂量学优势的同时，可增强对正常组织的保护效应。但FLASH-VHEET系统需验证时间依赖性剂量参数，这带来了额外的技术挑战。本文系统综述了VHEET研究的最新进展，涵盖常规与FLASH两种模式，重点探讨剂量学特性、辐射防护、加速器技术、束流聚焦、放射生物学效应及临床结果等关键问题，并对不同肿瘤部位覆盖度的初期VHEET计算机模拟研究进行了全面分析。

原文链接：

Very High-Energy Electron Therapy Toward Clinical Implementation