That radiation alone, or combined with drugs and surgery, is enough to completely eliminate a neoplasm is not a new thing, but still little known. Less toxic treatments than in the past
Many use it, but still too few are well informed and know, for example, that thanks to radiotherapy that over 4o% of cancers succeed in healing. And to demonstrate the importance of this strategy are also the numbers: today, in fact, a radiotherapy treatment is prescribed around 60% of cancer patients, alone or in combination with other treatments (surgery, chemotherapy, hormone therapy, immunotherapy). According to the indications necessary for each person, radiation can be curative (or for radical purposes), administered with or without anticancer drugs (such as, for example, in neoplasms of prostate, head-neck, lung); or adjuvants and subsequent to other treatments (as happens, post-surgery, for carcinoma of the breast); o neo-adjuvant, i.e. prior to the resolutive treatment (for example before surgery on the straight). Or, again, they can have a palliative endto control disease or to relieve pain, often caused by bone metastases.
Healings
The number of people who will need cancer radiotherapy is constantly growing – he explains Cinzia Iotti, president of the Italian association of radiotherapy and clinical oncology (Airo) and director of radiotherapy at the AUSL-IRCCS of Reggio Emilia -. Healing of tumors (both solid and hematological) is estimated to be in 46.5% of cases due to surgery, 42% to radiotherapy and 11.5% to chemotherapy. And what is the situation of the fleet in Italy? We have a national average of about three radiotherapy centers for every million inhabitants, therefore a center for 330 thousand citizens – replies the president Airo -. The average is lowest in the south (2.7) and highest in the center (3.7). There are about six “machines” (linear accelerator) per million inhabitants, but their distribution on the territory varies considerably from Region to Region: evident a territorial inhomogeneity with some Regions reaching, sometimes exceeding them, the European standards (which provide from 7 to 8 high-energy machines per million inhabitants) and others that are far below.
How it works
Radiotherapy mostly uses high-energy radiation, produced by specific equipment called linear accelerators or, less frequently, lower energy radiation emitted by radioactive substances inserted (usually temporarily) inside the body. Ionizing radiation is capable of lethally affect cancer cells or to damage them irreparably by acting on their DNA chain. Unlike cancer cells, healthy cells are able to better repair the insults caused by radiation so that, even if irradiated, they can more easily survive and resume their normal functions. Curative radiotherapy represents 70-80% of treatments – clarifies Marco Krengli, director of oncological radiotherapy at the Maggiore University Hospital of Carit in Novara and elected president of Airo -. Today, radiation is increasingly effective, less toxic and tailored to the individual patient: modern radiotherapy has made great progress thanks to the increasing ability to identify tumor lesions by imaging techniques, to the most precise dose deposition. on the volume of the neoplasm and the optimization of combinations with innovative drugs. Thus we have the ability to achieve healing in a relevant percentage of patientspreserving more and more the anatomy and function of vital organs, with a consequent improvement in the quality of life of the patients treated.
How it is administered
In external radiotherapy the source of the rays positioned outside the body; while internal radiotherapy administered directly inside the body. The rigorously personalized radiotherapy treatment for each patient depending on the type of tumor, its size, location and general health conditions of the patient. In addition to the most suitable type of radiotherapy, the duration and dose of the treatment is established, in how many fractions should be administered, how often and, obviously, with what type of machinery (from the latest census conducted by Airo it emerges that in Italy part of the obsolete machine park: over 40% of the devices have at least 10 years of life). Just as drug therapy is prescribed and managed by the medical oncologist, radiotherapy must be dosed and established, tailoring it to the patient’s needs, from the radiotherapist. With the advances in technology and the fundamental role of specialists, the development of innovative techniques in radiotherapy has made it possible today to arrive at more effective treatments, in less time, with fewer side effects. The new devices, more powerful and precise, are also faster and this allows to reduce the therapy cycles up to halve the number of sessions or decrease them by a third – he says. Stefano Pergolizzidirector of Radiotherapy at the University Hospital Gaetano Martino di Messina -: the “shorter therapeutic time”Not only a decrease in the“ cure time ”, but must offer better or identical results compared to the classical times. Today, thanks to technological evolution, side effects, feared by patients, are limited.
The oncology radiotherapy team
The radiotherapy team made up of radiotherapist oncologist, medical physicist, radiotherapy technician, specialized nurse. The radiotherapist oncologist is then an integral part of the multidisciplinary group that establishes, together with themedical oncologist and surgeon, the path of care for each patient. The approach to the cancer patient is extremely complex, so much so that no single specialist can define and offer, on his own, all the useful options for an optimal management of his specific clinical situation – he concludes Renzo MazzarottoDirector of Radiotherapy at the Integrated University Hospital of Verona -. The decisions on the diagnostic-therapeutic path have proved to be better if taken after discussion among the various specialists. Even communications to the patient of a diagnosis and a sometimes long and complex diagnostic-therapeutic process, which often cause anxiety and strong concern in the person concerned and in the family, are better accepted if carried out by a group of specialists who, in agreement, believe that that is the best path for your clinical situation. The work of multidisciplinary teams is facilitated and made more homogeneous if it is carried out following the Pdta (diagnostic-therapeutic-assistance paths) previously agreed.
August 18, 2022 (change August 19, 2022 | 13:44)
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