質子治療在兒童癌症的角色

The Role of Proton Therapy in Pediatric Cancer

質子放射治療因具備獨特的「布拉格峰」劑量分佈，能將輻射能量精準集中於治療靶區，顯著減少對周圍正常組織的損害，成為癌症治療的重要突破。相較於傳統光子治療，質子治療可降低70-90%的長期副作用及二次癌症風險，特別適合存活率高且預期壽命長的兒童癌症病人，對提升康復者生活品質，具有重大意義。隨著醫療進步，兒童癌症整體存活率已逾80%，但長期副作用如生長遲緩、內分泌異常、認知功能下降等問題仍不容忽視。國際共識指出，藉由質子治療的高精準度，能有效改善這些慢性健康風險，特別適用於中樞神經系統腫瘤、顱底脊索瘤、視網膜母細胞瘤等重要組織密集度高的癌別部位。另外，對於鄰近心臟、肺部、腸胃道等重要器官的腫瘤，質子治療也能顯著降低後遺症風險，提升病人長期健康。臺北醫學大學醫療體系積極推動質子治療應用，北醫質子中心自2022年8月啟用以來，致力發展兒童癌症質子治療，搭配兒童麻醉、藝術與音樂治療等友善措施，降低病童治療焦慮。北醫體系也率先設立兒癌康復者長期追蹤門診，整合跨領域資源，提供完整的康復照護，協助病童順利回歸日常生活。總結而言，質子治療以其卓越的物理特性與臨床優勢，正逐步成為兒童癌症治療的新標準。未來隨著醫學實證累積，質子有望成為兒癌放射治療的新標準，開創兒童癌症照護的新局。

Proton therapy, with its unique Bragg peak dose distribution, allows for the precise delivery of radiation energy to the tumor while sparing surrounding healthy tissues. This distinct characteristic marks a major advancement in cancer treatment. Compared to conventional photon radiotherapy, proton therapy can reduce long-term side effects and the risk of secondary malignancies by 70–90%, making it especially suitable for pediatric cancer patients, who typically have higher survival rates and longer life expectancies. As a result, proton therapy plays a vital role in enhancing the long-term quality of life for childhood cancer survivors. With the advances of medical care, the overall survival rate for childhood cancers has now surpassed 80%. However, long-term treatment-related side effects—such as growth impairment, endocrine disorders, and cognitive decline—remain significant concerns. International guidelines underscore this particular value of proton therapy in treating tumors located in sensitive areas, including central nervous system tumors, skull base chordomas, and retinoblastomas. It is also especially beneficial for tumors situated near critical organs, such as the heart, lungs, and gastrointestinal tract, by substantially reducing the risk of late-onset complications and improving long-term health outcomes. Taipei Medical University System has been at the forefront of advancing the clinical application of proton therapy. Since the launch of the TMU Proton Center in August 2022, the focus has been on developing specialized pediatric programs, incorporating child-centered services such as pediatric anesthesia, art and music therapy to reduce the treatment-related anxiety of child patients. TMU was also among the first in the region to establish a dedicated long-term follow-up clinic for childhood cancer survivors, integrating multidisciplinary resources to deliver comprehensive rehabilitative care and support children's reintegration into everyday life. In summary, with its superior physical and clinical advantages, proton therapy is increasingly becoming the new standard in pediatric cancer treatment. As clinical evidence continues to grow, proton therapy is poised to reshape radiotherapeutic care in pediatric oncology and usher in a new era of survivorship care.