Medical Radiology and radiation safety Medical Radiology and radiation safety Медицинская радиология и радиационная безопасность 1024-6177 2618-9615 28155 10.12737/article_5ca5a0173e4963.18268254 Протонная терапия Proton therapy Протонная терапия Proton Accelerators for Radiation Therapy Ускорители протонов в лучевой терапии Черняев А. П. Chernyaev A. P.

доктор физико-математических наук;

doctor of physical and mathematical sciences;

 Кленов Г. И. Klenov2 G. I.

доктор технических наук;

doctor of technical sciences;

 Бушманов А. Ю. Bushmanov A. Yu.

доктор медицинских наук;

doctor of medical sciences;

 Пряничников А. А. Pryanichnikov A. A. Белихин М. А. Belikhin M. A. Лыкова Е. Н. Lykova E. N. Московский государственный университет имени М.В. Ломоносова Москва Россия M.V. Lomonosov Moscow State University Moscow Russian Federation Институт теоретической и экспериментальной физики им. А.И. Алиханова Москва Россия Institute for Theoretical and Experimental Physics Moscow Russian Federation Федеральный медицинский биофизический центр им. А.И. Бурназяна ФМБА России Москва Россия A.I. Burnasyan Federal Medical Biophysical Center of FMBA Moscow Russian Federation Физический институт им. П.Н. Лебедева Протвино Россия The Lebedev Physical Institute of the Russian Academy of Sciences Protvino Russian Federation Московский государственный университет имени М.В. Ломоносова Москва Россия M.V. Lomonosov Moscow State University Moscow Russian Federation Физический институт им. П.Н. Лебедева Протвино Россия The Lebedev Physical Institute of the Russian Academy of Sciences Protvino Russian Federation Московский государственный университет имени М.В. Ломоносова Москва Россия M.V. Lomonosov Moscow State University Moscow Russian Federation Московский государственный университет имени М.В. Ломоносова Москва Россия M.V. Lomonosov Moscow State University Moscow Russian Federation 64 2 11 22 https://zh-szf.ru/en/nauka/article/28155/view

Цель: Провести качественный и количественный анализ состояния и развития ускорительной техники для протонной лучевой терапии (ПЛТ) в России и мире, оценить основные тенденции и направления развития этой области лучевой терапии. Материал и методы: В настоящее время протонная терапия в мире быстро развивается. Каждый год строятся новые протонные центры в развитых и развивающихся странах. С каждым годом все большее число коммерческих компаний и научных институтов включается в этот высокотехнологический сектор. Ученые из областей физики и медицины совместно разрабатывают и внедряют новые идеи и технологии, повышающие эффективность и качество протонной терапии, а также делающие ее менее затратной. Данный обзор представляет собой анализ как публикаций в реферируемых изданиях, так и докладов на профильных конференциях и семинарах. Кроме того, приведенные в обзоре данные с указанием источников опираются на открытую или предоставленную для некоммерческого использования информацию компаний-производителей техники для протонной терапии. Результаты: В последние годы основными тенденциями развития протонной лучевой терапии являются: уменьшение размеров и веса протонных установок, повсеместное использование активного сканирования тонким пучком как стандартного метода доставки дозы в опухоль, сокращение времени нахождения пациентов в процедурных комнатах, использование модуляции интенсивности пучка. Осуществляется переход от строительства многокабинных центров ПЛТ с годовым потоком около 1 тыс. пациентов (вследствие их высокой стоимости и проблемы обеспечения полной загрузки пациентами), к созданию малогабаритных однокабинных комплексов с годовым потоком несколько сотен человек. Заключение: Несмотря на активную деятельность в продвижении и популяризации протонной терапии, она все еще остается недоступным методом для большинства пациентов онкологических клиник за исключением США, Японии и Европы. Остро сказывается как недостаток центров ПЛТ, цена за курс лечения, отсутствие специалистов в этой области, так и отношение большинства клиницистов к ПЛТ, как к экспериментальному методу лечения. В России протонная терапия пока не получает должной поддержки со стороны государства, несмотря на огромный потенциал и большой опыт, наколенный за полвека использования метода. Последний открытый протонный центр является частным, а единственный отечественный производитель оборудования для ПЛТ существует только за счет заграничных контрактов. Тем не менее, в нашей стране разработки и исследования в этой области продолжаются и удерживаются на уровне ведущих стран.

Purpose: To make an analysis (including statistical data) of accelerator equipment for proton therapy (PT) in Russia and the world; to identify the main trends and directions of development in this area. Material and methods: Currently, proton therapy is developing rapidly in the world. Every year new proton centers are built. The number of commercial companies and research institutes, that are included in this high-tech sector, grows every year. Physicists and doctors together actively develop and introduce new ideas and technologies that are able to increase the efficiency and quality of proton therapy and also make it less costly. This review is an analysis of both publications in refereed publications, and reports made at relevant conferences and seminars. In addition, the data presented in the review are based on the information from the companies-manufacturers of equipment for proton therapy, which is open or provided for non-commercial use, with an indication of the sources. Results: In recent years, the main trends in the development of accelerators for proton therapy are: reducing the size and weight of machines, using of active pencil scanning as a standard method of dose delivering, reducing the time spent by patients in treatment rooms, using modulated radiation intensity in proton therapy. There is a transition from the construction of multi-cabin PT centers with an annual number of patients about 1000 people (due to their high cost and need to have an infrastructure for such big number of patients), to the creation of small-sized single-cabin complexes with an annual flow of several hundred people. Conclusion: Despite proton therapy has a good promotion and popularization activities, it is still an inaccessible method for most cancer patients with the exception of the United States, Japan and Europe. The lack of PT centers, the price per course of treatment, the lack of specialists in this area, and the attitude of most clinicians to PT as an experimental method of treatment is acute. In Russia, proton therapy does not receive enough support, despite the enormous potential and extensive experience that has been used for half a century of using PT. The last open proton center is private, and the only local manufacturer of equipment for PT exists only thanks to foreign contracts. Nevertheless, research and development continues. Moreover, the development is equal to the level of leading countries.

 протонная терапия ускорители заряженных частиц циклотроны синхротроны кривая Брэгга proton therapy particle accelerators cyclotron synchrotron Bragg curve

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