Tumors, here are which ones can be cured with radiotherapy

The scalpel is needed: with surgery the tumor is removed and, if in the initial stage, once the mass has been removed the patient can recover permanently. A very clear concept known to all, while the news that the same objective can often be achieved only with radiotherapy is still not widespread. Many patients “use” it, but too few are well informed and know, for example, that It is thanks to radiotherapy that over 40% of patients are able to recover – points out Marco Krengli, president of the Italian Association of Radiotherapy and Clinical Oncology (Airo) —. And the numbers also demonstrate the importance of this strategy: today, in fact, a radiotherapy treatment is prescribed to approximately 70% of cancer patients, alone or associated with other treatments (surgery, chemotherapy, hormone therapy, immunotherapy).

The first choice

Today there are many different techniques and machines for dispensing radiation that is increasingly targeted and effective, less toxic and tailored to the individual patient. So much so that it is estimated that the healing of tumors (both solid and haematological) is due to surgery in 46.5% of cases, radiotherapy in 42% and chemotherapy in 11.5%. Thus, the cases in which radiation treatment is the first choice of specialists to treat and heal a patient are increasing.

Prostate cancer

Not an example The most common cancer in men is prostate cancer: Five sessions of radiotherapy can be enough to definitively recover from early-stage prostate cancer — he explains Rolando D'Angelillo, professor of Radiotherapy at the University of Rome Tor Vergata —. a possibility that has been known for several years and we know that it has the same success rates as surgery, but now clinical and technological advancement allows us to achieve the goal in just a few sessions, with a very precise treatment. The advantages for patients, compared to surgery, are that disorders related to invasiveness and urinary incontinence are avoided. Not to mention that in a few minutes, lying on a bed and feeling nothing, the treatment was done.

Lung

There are 44 thousand new diagnoses of lung cancer every year in our country, the third most widespread. Despite notable progress in therapies, this neoplasm remains difficult to fight because more than 70% of patients are diagnosed late, when the disease is already in an advanced stage and the chances of recovery are unfortunately reduced. To increase early diagnoses, however, a screening program has been launched dedicated to those most at risk of getting ill (i.e. heavy smokers). First stage patients treated with stereotactic radiotherapy they get excellent results,” he says Sara Ramella, full professor of diagnostic imaging and radiotherapy at the Fondazione Policlinico Universitario Campus Bio-Medico in Rome and director of oncology radiotherapy —. This is already the standard today, in the patient with problems that make surgery risky we achieve results that were unhoped for until a few years ago. Furthermore, recent research clearly indicates that this strategy is very valid even in those who, despite being a candidate for the operation, refuse it to avoid exposing themselves to complications, risks or changes in their quality of life. For third stage patients (i.e. with a more advanced neoplasm in the thorax, but confined to this area and not localized in distant organs), the best results are obtained integrating radiotherapy with immunotherapy and chemotherapy: thus one in two patients survives beyond five years. A remarkable achievement if compared with historical data which unfortunately stopped at just a few months of life.

Head and neck

Radiotherapy is also a fundamental weapon for head and neck tumors, which affect visible and very delicate areas: oral cavity, pharynx, larynx, paranasal sinuses and salivary glands. The consequences of these tumors interfere with normal daily activitiessuch as eating and speaking, and end up having a significant impact on patients' socio-family relationships – he recalls Pierluigi Bonomo, medical director at Careggi Radiotherapy in Florence and coordinator of the Airo scientific committee —. In approximately 35% of cases the disease is in the initial stage at diagnosis and, in these circumstances, Radiotherapy can be adopted as the only curative treatment, as an alternative to surgery, for example in tumors of the vocal cords or tonsil. In 60% of cases the tumor is discovered in a locally advanced stage: radiotherapy is therefore adopted, alone or in association with chemotherapy, after surgery or as a curative weapon of organ preservationwith excellent results on tumor control and quality of life.

Anal canal

Anal carcinoma is a rare disease that affects a crucial area, also for the daily quality of life of patients. The combination of radiotherapy and chemotherapy allows for complete regression of the tumor which in the vast majority of cases (over 80%) is stable over time and leads to complete recovery – he clarifies Krengli, director of Radiotherapy at the Veneto Oncology Institute IRCCS in Padua —. The treatment is usually well tolerated with limited side effects and, with appropriate precautions, it can also be carried out at an advanced age. Radiotherapy, in combination with chemotherapy, has now supplanted surgery which involved a demolitive resection and a permanent colostomy (i.e. with a bag for collecting feces).

Few metastases

Finally, the use of radiotherapy for oligometastatic patients is a recent innovation, very important and still little known by patients and their families: with a limited number of targeted radiotherapy sessions, in fact, it is possible to achieve recovery. As he indicates Marta Scorsetti, director of Radiotherapy and Radiosurgery at the Humanitas Clinical Institute in Milan: “oligometastatic disease” describes that intermediate phase between localized tumor and diffusely metastatic tumor, characterized by few metastases in which local treatment can be particularly effective. Recent research has shown that Radiotherapy, if delivered with precision and with curative dosages, can lead to recovery from oligometastatic lesions. There Stereotactic Body Radiation Therapy (SBRT), an advanced radiotherapy technique, allows treatment with a reduced number of sessions (generally from one to six) obtaining a synergy with modern systemic therapies, such as immunotherapy and targeted therapy, without requiring prolonged interruptions of pharmacological treatment. Being a non-invasive therapy, Radiotherapy is well tolerated and can also be used for frail or elderly patients. SBRT can be used in different parts of the body, including the lung, liver, lymph nodes and bones.

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