Today the treatment can be carried out with great precision and be effective, going to hospital fewer times and having limited side effects
My brother, 67, was told he will have to have radiotherapy for prostate cancer. I would like to understand what the difference is between the different machines and what are the side effects we should expect. How many sessions are usually done and for how long?
He answers Vittorio Donato, director of the Radiotherapy Division at San Camillo Forlanini in Rome and president of the Italian Association of Radiotherapy and Clinical Oncology (Airo)
Today, thanks to the technological advances in recent years, radiotherapy has an efficacy and tolerability profile that allows it to be offered as an alternative treatment of equal efficacy to surgery in various neoplastic pathologies and constitutes one of the three fundamental pillars (together with surgery and drugs ) on which cancer treatment is based. So that it is prescribed to 6 out of 10 cancer patients, for solid tumors or for haematological ones, depending on the case before or after the operation, alone or in combination with different drugs, including immunotherapeutic ones. Each radiotherapy session usually lasts a few minutes, is carried out with machinery of different technical complexity (linear accelerators, tomotherapy equipment, cyberknife, gammaknife, etc.) that the specialist chooses according to the indications.
Fewer sessions with more concentrated dosages
An important element of innovation in modern oncological radiotherapy is that of hypofractionation, which means do shorter, more concentrated treatments, where the radiant dose for each single session is higher than the standard which consisted of small doses and very long cycles. Thanks to imaging, which allows us to recognize very small tumors and thanks to sophisticated technology, it is now possible to perform selective hypofractionated treatments, which allow to optimize care, decrease side effects and reduce the number of times the patient has to come to the hospital. Prostate cancers are one of those pathologies for which radiotherapy has given the best results: it can be curative and cure the disease, like surgery. In this regard, of course, we must see at what stage of the disease we go for the radiotherapy treatment: depending on the stage of the neoplasm, different techniques and different types of fractionation can be used.
Temporary side effects
In other words, if the goal is to cure a low-grade carcinoma of malignancy, will use a treatment with a highly sophisticated technology, such as stereotaxis, and will be able to perform it in a few fractions (for example 5 fractions of high doses concentrated in 5 days). If, on the other hand, the disease is a little more extensive and not in the initial phase he will always have to do a treatment with curative intent, but it will last a little longer, two or three weeks. And this also happens for other types of cancer: the technique, and therefore the machinery, are established according to many variables, first of all the characteristics of the specific tumor, but also those of the individual patient (age, previous treatments, conditions general). As for side effects, they are always related to volume (how big the tumor and therefore how much radiation it takes to destroy it) and to the affected site. Indeed, radiotherapy causes an inflammatory reaction, limited to the irradiated area. So, for your brother, we may have inflammation of the areas surrounding the prostate, such as the rectum and bladder, such as cystitis or proctitis. It’s always about temporary effects, normally easily controlled by the radiotherapist with appropriate treatments and which are resolved in a short time.
November 28, 2021 (change November 28, 2021 | 21:49)
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