麻醉在質子治療中的重要性

The Importance of Anesthesia in Proton Beam Therapy

由於質子治療，可以減少對正常組織不必要的損傷。因此，越來越多癌症患者由傳統放射治療，改為接受質子治療，特別是用於兒癌治療效益更高。然而，小兒質子治療與成人質子治療有個重大差異。事實上，質子治療過程不會引起疼痛，不需要麻醉來止痛。但是，要求兒童自己一個人，在放射治療室中躺著約30至90分鐘，是很不容易達成的事。為了讓年幼的兒童進行質子治療，通常需要麻醉或鎮靜，以確保在放射治療期間完全固定患者。小兒質子治療麻醉，需要一群訓練有素的麻醉醫師及麻醉團隊及設備，才能提供病患安全舒適的照顧。從麻醉誘導，到治療結束和麻醉後恢復照護，可使患者安全的完成治療。根據相關文獻，小兒質子治療中，3歲（含）以下兒童幾乎都需要麻醉。而7歲以後的兒童，僅約半數需要麻醉。目前質子治療尚未納入健保給付，小兒質子治療麻醉也必須病患自費，而目前台灣健保財務吃緊，要健保將質子治療及麻醉納入健保給付恐有極大難度。

Proton therapy reduces unnecessary damage to healthy tissues. Therefore, more and more cancer treatments have changed from traditional radiotherapy to proton therapy, especially for pediatric cancer treatment. There is a significant difference between pediatric proton therapy and adult proton therapy. The proton therapy process does not cause pain and does not require anesthesia to relieve pain. However, it is not easy to ask children to lie in the radiotherapy room alone for about 30 to 90 minutes. For young children to undergo proton therapy, anesthesia or sedation is usually required to ensure complete immobilization of the patient during radiation therapy. Proton therapy anesthesia for children involves a group of well-trained anesthesiologists and anesthesia team and equipment to provide safe and comfortable care for patients. From the induction of anesthesia to the end of the treatment and the recovery of care after anesthesia, the patient can safely complete the entire procedure. According to related literature, almost all children under three years of age need anesthesia during proton therapy. Only about half of children after seven years of age require anesthesia. At present, proton therapy does not cover by the health insurance payment, and the patient must pay pediatric proton therapy anesthesia. Currently, Taiwan's health insurance is financially tight. It may be challenging for health insurance to include proton therapy and anesthesia in the health insurance payment.