Radioterapija s protonskimi žarki : magistrsko delo

Malinova, Zorica (author), Škrk, Damijan (mentor), Mekiš, Nejc (reviewer)

Uvod: Protonska terapija je napredna oblika radioterapije, pri kateri za zdravljenje tumorjev uporabljamo protone pospešene do 250 MeV. Gre za tehnološko zelo zahteven način zdravljenja, saj je protone poleg pospeševanja treba dostaviti varno in natančno. V primerjavi s konvencionalno radioterapijo ima protonska terapija ugodnejše fizikalne značilnosti, saj protoni v tkivu prodirajo do točno določene globine, imenovane Braggov vrh, ter tam oddajo večino svoje energije. Na svoji poti oddajo zelo malo energije, za Braggovim vrhom pa ta strmo in hitro pade. Posledično je doza na okoliška zdrava tkiva manjša, kar pripomore k manjšim stranskim učinkom terapije. Poleg fizikalnih imajo tudi biološke prednosti, saj lahko z enako dozo povzročijo 10 % višji biološki učinek kot konvencionalna terapija. S protonsko terapijo najpogosteje zdravimo pediatrične bolnike, očesne melanome, možganske tumorje in tumorje baze lobanje. Dodatne klinične raziskave so v teku. Čeprav je izgradnja protonskega centra zelo kompleksna in draga, zaradi vse večje ponudbe na trgu postaja vedno bolj dostopna tudi pri nas. Namen: Namen magistrske naloge je predstaviti protonsko terapijo kot najnaprednejšo obliko radioterapije radiološkim inženirjem in ostalim zdravstvenim delavcem, saj je znanje pri nas omejeno le na manjšo skupino strokovnjakov. Metode dela: Magistrsko delo temelji na deskriptivni metodi s pregledom strokovne in znanstvene literature. Pregled literature je trajal od leta 2019 pa vse do zaključka magistrske naloge. Vključili smo literaturo napisano v angleškem in slovenskem jeziku najdeno v podatkovnih bazah Google Učenjak, DiKUL, ScienceDirect in PubMed. Uporabili smo tudi knjižne in druge relevantne vire. Poleg pregleda literature smo z obiskom dveh nam najbližjih protonskih centrov z opazovanjem in vključenostjo v proces zdravljenja dopolnili naša dognanja iz literature. Razprava in zaključek: Potrebe po onkološkem zdravljenju so vedno večje, saj incidenca raka po vsem svetu narašča. Poleg uspešnega zdravljenja je težnja po zmanjševanju stranskih učinkov in boljši kakovosti življenja vedno večja, zato ima protonska terapija največji potencial na področju radioterapije. V želji po zagotovitvi čim višje ravni zdravljenja onkoloških bolnikov pri nas, se delovna skupina za protonsko terapijo močno zavzema za vzpostavitev takega centra tudi v Sloveniji.

• Language: Slovenian
• Keywords: magistrska dela, radiološka tehnologija, fizikalne lastnosti protonske terapije, primerjava fotonske in protonske terapije, biološka učinkovitost protonske terapije, klinične raziskave protonske terapije, center za protonsko terapijo v Sloveniji
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [Z. Malinova]
• Year: 2023
• Number of pages: 55, [6] str.
• PID: 20.500.12556/RUL-151068
• UDC: 616-07
• COBISS.SI-ID: 167271939
• Publication date in RUL: 28.09.2023

Secondary language

• Language: English
• Title: Proton beam therapy : master thesis

Abstract

Introduction: Proton therapy is an advanced radiotherapy treatment that utilizes accelerated protons up to 250 MeV to target tumours. It is a highly demanding treatment modality that requires precise delivery of protons in a safe and accurate manner. Proton therapy offers favourable physical characteristics compared to conventional radiotherapy, as protons penetrate tissues to a precise depth, called the Bragg peak, where they deposit the majority of their energy. This results in lower doses to surrounding, healthy tissues, reducing toxicity and side effects. Moreover, proton therapy exhibits biological advantages, delivering a 10% higher biological effect than conventional therapy at the same dose. There are ongoing clinical trials. Currently, proton therapy is primarily used to treat paediatric patients, ocular melanomas, brain, and skull base tumours. While constructing a proton centre is complex and expensive, increasing competitiveness in the market is making it more affordable to us. Purpose: This master's thesis aims to introduce proton therapy as an advanced form of radiotherapy to radiographers and other healthcare professionals, as knowledge on this subject in Slovenia is limited to a small group of professionals. Methods: The literature review was conducted from 2019 until the completion of this master's thesis. We focused on English and Slovenian literature, obtained from Google Scholar, DiKUL, ScienceDirect and PubMed databases, as well as books and other relevant sources. Additionally, we complemented our findings by visiting two nearby proton centres, actively observing and engaging with their team. Discussion and conclusion: The demand for oncology treatment is increasing due to the rising incidence of cancer worldwide. Alongside successful treatment outcomes, there is a growing emphasis on reducing side effects and improving patients' quality of life. Proton therapy holds tremendous potential in the field of radiotherapy. Establishing a proton centre in Slovenia would ensure the highest level of cancer treatment for our patients. The Proton Therapy Working Group is deeply committed to this endeavour.

• Keywords: master's theses, radiologic technology, physical properties of proton therapy, photon versus proton therapy, radiobiology of proton therapy, proton therapy clinical research studies, proton therapy centre in Slovenia