ПЕРСПЕКТИВЫ РАЗВИТИЯ ПРОТОННОЙ ТЕРАПИИ В РОССИИ

Abstract

It is generally accepted that a proton therapy is one of the most effective method of external beam radiotherapy. Proton therapy has the highest conformal factor even compared with the most modern facilities for radiotherapy which use electron beam or gamma rays. Accuracy of combination of the 90–95 % isodose surface with PTV is better and dose gradients outside PTV is steeper, also integral dose of radiation from proton therapy for a healthy tissue is less than two times that for gamma irradiation. We can clearly see it comparing a HDV of treatment plan for gamma irradiation and proton therapy for the same clinical cases. In last years a lifespan of patient after radiotherapy treatment is a quit extended, so a question for quality of life for them is more significant. Decreasing of integral dose for a healthy tissue reduces a chance of negative effects from radiotherapy that would mostly appear after a lot years after treatment, so named late side effects. Quality of life is even more important in the case of pediatric oncology, when we not only expect a long healthy life for them, but also have aim to exclude side effects from their development. There was a long term clinical investigation in 1954–1990 years in ten experimental centers (among them clinical data: 50% in USA, 30% in USSR/Russia) that had confirmed the described advantages of proton therapy. These clinical results formed a foundation of quick development proton therapy clinical centers in developed countries in 1990s. These centers are based on oncology and multidisciplinary hospitals and treat 1000 and more patients per year. There are 96 working and 38 constructing PTCs in the world for today. Although we have a lot of experience in proton therapy in Russia, we didn’t take part in this new stage. In fact a patient treatment was over in all of three experimental PTCs (Moscow, Dubna, St. Petersburg) up to 2014. Thus we have a delay in a development of proton therapy for 30 years from a world level. Government of the Russian Federation Decree № 287 of 16th March 2020 establishes Program, which has to overcome this delay in development. Main science executer of the Program is National Research Center «Kurchatov Institute», which has an experience, scientific potential and competence for it. The main aims, stages and objects of the Program are presented.