文／放射腫瘤部 醫師 林亭君
頭頸部腫瘤類型多樣，包括鼻咽癌、口咽與下咽癌、口腔癌、顱底與鼻竇癌等，各有不同預後與潛在副作用。放射治療原則是有效控制腫瘤，同時盡可能保護頭頸部健康器官，如口腔與吞嚥肌肉、聽神經、腦幹、唾液腺及甲狀腺等。
傳統光子治療（Photon Therapy）在穿透人體時，能量會持續釋放到腫瘤後方的正常腦組織與重要結構 (圖一)，可能損害神經、肌肉組織與腺體，增加放射性壞死、長期神經副作用、口乾、吞嚥困難或聽力下降等風險。
質子治療（Proton Therapy）利用質子束的「布拉格尖峰」特性，在腫瘤處釋放最高能量，並幾乎不再向後延伸，讓高劑量精準集中於腫瘤，大幅降低周圍部分正常組織的照射劑量(圖二)。
質子治療因此能減緩部分急性與慢性副作用嚴重程度（如口腔炎、味覺喪失、疲勞或肩頸僵硬），保護神經、顱底、聽神經、口黏膜、咽喉肌肉與味覺功能，降低神經與肌肉損傷及次發性腫瘤風險。對於頭頸癌患者，這項技術有助於兼顧治療效果與減少治療帶來的相關不適，進而有利於生活品質，是值得考慮的放射治療選擇。
照射劑量分佈圖 (以鼻咽癌為例)
.PNG)
文獻佐證
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- Vasudevan, S. S., Deeb, H., Katta, A., et al. (2024). Efficacy and safety of proton therapy versus intensity-modulated radiation therapy in the treatment of head and neck tumors: A systematic review and meta-analysis. Head & Neck, 46(10), 2616–2631.
- Uezono, H., Indelicato, D. J., Rotondo, R. L., et al. (2019). Proton therapy following induction chemotherapy for pediatric and adolescent nasopharyngeal carcinoma. Pediatric Blood & Cancer, 66(12), e27990.
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