Proton radiotherapy has become a bright spot in the field of oncology this year. On December 10, the "2023 Sands International Oncology Forum" was hosted by the Guangdong Provincial Hospital Association and hosted by Jinshazhou Hospital of Guangzhou University of Chinese Medicine. Oncology experts from home and abroad exchanged experience and shared research results with the field of precision medicine, especially for the latest development of precision radiotherapy, especially proton radiotherapy, so as to promote the standardization and individualization of tumor diagnosis and treatment.
At present, there are 80-100 proton radiotherapy centers under construction or under construction across the country, but there are only a dozen proton radiotherapy centers that have been operated. According to the reporter's understanding, on June 29 this year, the National Health Commission issued a notice, clarifying that during the "14th Five-Year Plan" period, the heavy ion proton radiation system, known as the "cancer weapon" and used for malignant tumors, will be deployed in 31 provinces (autonomous regions and municipalities directly under the central government, excluding Hong Kong, Macao and Taiwan) A total of 41 units will be deployed. Beijing, Shanghai, Jiangsu, and Guangdong are configured with 4 units respectivelyShandong, Hubei and Sichuan are equipped with 3 units respectively;1-2 in the remaining provinces.
Radiotherapy is a neglected treatment for cancer**.
According to the latest statistics released by the WHO, there were 4.57 million new cancers in China in 2020, accounting for 23.3 million in the world7%；There are 3 million deaths, accounting for about 30% of the world's deaths. In addition, there is a positive correlation between the incidence and mortality of cancer and age, and the older the age, the higher the probability of cancer.
Surgery, radiotherapy, and drugs are the main means of cancer. But radiation** has not been well known to the general public. It is understood that radiotherapy, as a classic tumor physical means, has a history of more than 100 years, and the most common radiotherapy technology is , radiation and various X-rays. Through radiation irradiation, tumor cells are necrotic, so as to achieve the purpose of **.
At the meeting, Qiu Jie, chief physicist of the Department of Radiotherapy in Beijing, said in an interview with reporters: "There are about 4 million new tumor patients in China, and 1 million patients may receive radiation every year. But in fact, there are many patients who do not receive ** for various reasons. Of course, the popularity of precision radiotherapy is even more insufficient, including the setting of radiotherapy programs, precise implementation, and real-time recording and verification of results, and the true recording of patients' efficacy. ”
Proton radiotherapy has gradually attracted national attention.
On October 7, the National Health Commission issued the "Notice of the General Office of the National Health Commission on Doing a Good Job in the Application for the Configuration License of Class A Large Medical Equipment in 2023", which applies for the license of heavy ion proton radiation system and high-end radiation equipment, and the application time is from October 7 to December 5.
It is reported that the total number of approvals in this round is 69, including 31 heavy ion proton radiation systems (1 in each province, autonomous region and municipality directly under the central government), and 38 high-end radiation equipment (including 2 in Beijing, Liaoning, Shanghai, Zhejiang, Henan and Guangdong, and 1 in other provinces, autonomous regions, municipalities directly under the central government and Xinjiang Production and Construction Corps).
Known as the "important instrument of the country" and used for malignant tumors, the heavy ion proton radiation system has attracted great attention from the medical circles of various provinces. It is understood that proton heavy ion radiotherapy is currently internationally recognized as the cutting-edge radiation technology for tumors, which can protect the normal tissues around the tumor to the greatest extent at the same time, so as to improve the best effect and reduce the toxicity and side effects. It has received a lot of attention due to its precise target dose delivery and good efficacy.
At present, more than 100 proton and heavy ion centers have been built in the world, but most of them are distributed in developed countries and regions such as Europe, the United States and Japan. Professor Wang Luhua of the Cancer Hospital of the Chinese Academy of Medical Sciences introduced: "There are 80-100 that may be discussed or under construction in the country, and there are only a dozen proton radiotherapy centers that have been operated. ”
The era of radiation precision has arrived.
PrecisionFor radiotherapy, it requires not only the accuracy of the preliminary drawing and planning, but also the accurate irradiation of the lesion during the implementation process. Only in this way can the normal tissue be less damaging and the tumor can be killed at the same time.
At present, with the upgrading of radiotherapy equipment, the accuracy of radiotherapy has gradually improved under the guidance of medical images. Taking breast cancer as an example, the 5-year survival rate of breast cancer in China has reached 82%, and that of the United States, Japan and other countries has reached 92%. If the patient can survive for a long time, then we should pay more attention to the protection of healthy tissues and reduce long-term complications. This requires more precision in the radiotherapy process.
However, tumors and normal tissues are often entangled, aggregated, and constantly changing, radiologists should not only hit this target, but also pay attention to the "live target", because people are breathing, moving, and changing every day, today's target is not the same as tomorrow's target target, so precision radiotherapy not only relies on equipment to improve accuracy, but also requires doctors to learn to use these high-end equipment.
Taking proton radiotherapy as an example, it is a positively charged particle that can prevent cancer cells from replicating normally by destroying their DNA, so as to achieve the purpose of precise radiotherapy for tumors. The most significant advantage of proton radiation therapy over photon radiation therapy is the presence of a specific Bragg peak. The proton Bragg peak allows the proton beam to be precisely targeted at the tumor target, after which the dose drops rapidly to zero. This means that protons** concentrate the radiation dose on the tumor, and the normal tissue in front of the tumor receives a smaller dose, and the tissue behind the tumor is basically not irradiated.
Professor Wang Yang, vice president of Jinshazhou Hospital of Guangzhou University of Chinese Medicine, executive director of the Cancer Medical Center and director of the Department of Radiotherapy, told reporters: "Thanks to the continuous upgrading of equipment and the continuous progress of radiotherapy technology, we are getting closer and closer to precision radiotherapy from conventional radiotherapy to three-dimensional conformal radiotherapy, intensity-modulated radiotherapy and the current adaptive radiotherapy Efficiency and safety, the goal is to destroy tumor cells while protecting surrounding normal tissues, thereby improving the quality of life and survival of patients. ”
Text|Reporter Zhang Hua Correspondent Liu Yeming|Visual China.
* |Yangcheng Evening News, Yangcheng faction editor-in-charge|Proofread by Qin Xiaojie |Zhao Dandan.