质子束治疗（PBT）在原发性脊柱肿瘤的治疗中发挥着重要作用。本共识声明的目的是总结 PBT 对脊柱肿瘤的安全和最佳递送。粒子治疗合作组 (PTCOG) 颅底/中枢神经系统 (CNS)/肉瘤小组委员会由放射肿瘤学家和医学物理学家组成，具有特定的脊柱放射专业知识制定了专家建议，讨论治疗计划考虑因素和当前治疗原发性脊柱肿瘤的方法。CT 模拟：需要重点考虑的因素包括：1) 患者舒适度，2) 设置的可重复性和稳定性，以及 3) 适当的可及性光束角度。如果存在，硬件应放置在远高于/低于原发肿瘤水平的交联处，以减少肿瘤床水平的金属负担。可以减少不确定性的新材料包括聚醚醚酮 (PEEK) 和复合 PEEK-碳纤维植入物。需要选择适当的光束以确保稳健的目标覆盖和 OAR 保护。通常，使用 2-4 个治疗野，通常来自后部和/或后斜方向。建议对所有笔形束扫描计划（首选治疗方式）进行稳健优化，并应考虑设置不确定性（3-7 毫米之间）和范围不确定性（3-3.5%）。在存在金属硬件的情况下，建议使用增加的范围不确定性高达 5%。PTCOG 颅底/中枢神经系统/肉瘤小组委员会已制定建议，使各中心能够安全有效地提供 PBT 来治疗原发性脊柱肿瘤。版权© 2024。由爱思唯尔公司出版。

Proton beam therapy (PBT) plays an important role in the management of primary spine tumors. The purpose of this consensus statement is to summarize safe and optimal delivery of PBT for spinal tumors.The Particle Therapy Co-Operative Group (PTCOG) Skull Base/Central nervous system (CNS)/Sarcoma Subcommittee consisting of radiation oncologists and medical physicists with specific expertise in spinal irradiation developed expert recommendations discussing treatment planning considerations and current approaches in the treatment of primary spinal tumors.CT Simulation: Factors that require significant consideration include: 1) patient comfort, 2) setup reproducibility and stability, and 3) accessibility of appropriate beam angles.If present, hardware should be placed with cross-links well above/below the level of the primary tumor to reduce the metal burden at the level of the tumor bed. New materials that can reduce uncertainties include polyether-ether-ketone (PEEK) and composite PEEK-carbon fiber implants.Appropriate beam selection is required to ensure robust target coverage and OAR sparing. Commonly, 2-4 treatment fields, typically from posterior and/or posterior-oblique directions, are utilized.Robust optimization is recommended for all pencil beam scanning plans (the preferred treatment modality) and should consider setup uncertainty (between 3-7 mm) and range uncertainty (3-3.5%). In the presence of metal hardware, use of an increased range uncertainty up to 5% is recommended.The PTCOG Skull Base/CNS/Sarcoma Subcommittee has developed recommendations to enable centers to deliver PBT safely and effectively for the management of primary spinal tumors.Copyright © 2024. Published by Elsevier Inc.