2023-10-19 09:32:24
In it World Breast Cancer Dayon October 19, we delved into proton therapy in breast cancer with the specialists of the Cancer Center of the University of Navarra in Madrid, which since April 2020 has had this Proton Therapy Unit in which more than 700 patients with different cancers have been treated.
The greater precision and lower toxicity make proton therapy especially indicated for children and elderly adults with tumors that affect areas that are particularly sensitive to irradiation, such as the brain, spinal cord or eyes, mucous membranes and cells. germ cells, among others.
Public health is in the process of implementing ten proton therapy teams, financed by the Amancio Ortega Gaona Foundation, in seven autonomous communities: the Basque Country, Catalonia, Galicia, Andalusia, Valencia, the Canary Islands and Madrid.
Video: EFE/MIRIAM FELIPE/BERTA PINILLOS Resources provided by the Clínica Universidad de Navarra
Protons against tumors
Proton therapy in breast cancer is taking its first steps and currently accounts for around 15% of all patients treated, in general, in proton therapy units in other countries.
Expectations are promising, as scientific evidence shows, given this proton therapy which allows applying a “very selective” treatment, avoiding unnecessary radiation in healthy tissue” with respect to the conventional radiotherapy, with photons.
This is how the doctor explains it to EFEsalud Mauricio Cambeiro, specialist in radiation oncology at the Cancer Center of the Clínica Universidad de Navarra in Madrid.
“It’s like sculpting, it’s a treatment that adapts very carefully to the volume that you really want to treat and that protects everything that doesn’t want to be damaged,” he says.
“The breast – he points out – is an organ that is in a region that is close to functionally important structures, such as the heart and lungs, and everything that involves protecting healthy tissue, everything that involves avoiding unnecessary radiation, that is what They represent protons.
Mauricio Cambeiro, specialist in radiation oncology Cancer Center at the Clínica Universidad de Navarra in Madrid. EFE/BERTA PINILLOS
Less toxic effects
This greater precision and better dosage of proton therapy therefore means fewer toxic effects.
“Proton therapy in patients with breast cancer will greatly reduce toxicities in healthy organs, which do not need to be irradiated,” he insists. Jaime Espiños, medical oncologist at the Cancer Center of the Clínica Universidad de Navarra in Madrid.
Dr. Espiños is confident that a large percentage of patients will achieve “long and prolonged survival and many will be cured,” since these are long-term health effects, especially by reducing chronic toxicity in functional structures such as the heart. or the lungs.
“And this benefit – he adds – can be seen in all subtypes of breast cancer, we still do not know if some more than others.”
In the opinion of radiation oncologist Mauricio Cambeiro, more aggressive breast cancers may have a greater probability of lymph node involvement and, therefore, require volume radiation treatments beyond the breast, so proton therapy could be recommended in these cancer scenarios. high risk.
But the effects of this radiation on the tissue are similar to both conventional radiotherapy and proton therapy and can cause inflammatory lesions and fibrosis.
Combine with different treatments
Proton therapy can be combined with different breast cancer treatments, such as surgery, chemotherapy, targeted therapies and also with conventional radiotherapy.
“Everything adds up to the good, but we can also add to the complication and toxicity and that is why proton therapy is a cleaner form of treatment because we avoid a form of complication in the healthy,” points out Dr. Mauricio Cambeiro.
Still in the development phase is the combination of proton therapy with immunotherapy drugs which, in the case of breast cancer, are currently indicated for the triple negative subtype.
“The conventional radiotherapy, with photons, in breast cancer it can be combined with immunotherapy, but not simultaneously. That is, you can give immunotherapy before radiotherapy or give radiotherapy and then immunotherapy,” explains medical oncologist Jaime Espídos.
And this is because, with photons, there may be greater toxicity in the lung that immunotherapy could enhance, he points out.
“But, theoretically, the protons By limiting irradiation of the healthy lung, they could allow immunotherapy not to be suspended during irradiation treatment. But it is a fact that still has to be studied,” he points out.
Jaime Espiños, specialist in medical oncology Cancer Center at the Clínica Universidad de Navarra in Madrid. EFE/BERTA PINILLOS
The reirradiation is another therapeutic scenario: when a patient needs to receive radiation again, proton therapy may be the indicated technique.
On the other hand, in cases of breast removal or mastectomy proton therapy is also positioned.
“A mastectomy represents a devitalized tissue where the entire component close to the healthy tissue is, anatomically, much more related to the target volume to be treated and proton therapy allows us to offer a treatment that is as delicate as possible” and safe, concludes the Dr. Cambeiro.
This is how proton therapy works
The Proton Therapy Unit of the Cancer Center Clínica Universidad de Navarra It occupies an area of 3,600 square meters on the Madrid campus.
While conventional radiotherapy is based on a high-energy beam of .
The technology used is the Hitachi synchrotron, “the most modern currently available,” according to the University of Navarra Clinic.
It is considered a “clean” particle accelerator since it allows the proton beam to be accelerated to just the energy required to reach the tumor of each patient individually.
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