Madrid, January 16, 2023 - Advances in radiotherapy have made it possible to shorten the treatments of some patients to only five sessions in breast and prostate tumors, two of the most prevalent in Spain1, explains Dr. Natalia Carballo, head of the Radiotherapy Service at MD Anderson Cancer Center Madrid. “Traditionally, the patient has had to come in for treatment over many sessions. However, now the trend is to reduce the number of radiotherapy sessions. This is possible thanks to the fact that the technology we use is much more precise and administers the treatments in an equally effective, safer way.” These new, shorter treatments are currently applied to breast and prostate cancer, but their use in other cancers is also being studied.
Specifically, in the case of prostate cancer, in certain groups of patients, we have gone from administering 35 sessions (2.5 months of treatment) to just 5. And in the case of breast cancer, we have been able to reduce the number of sessions to 15 and nowadays, we are beginning to break that number down to 5 or 6 sessions.
The main benefit for patients is that the number of trips they have to make to the hospital is reduced – journeys that can be very inconvenient when the patients does not live near a specialized radiotherapy unit.
On the other hand, in addition to tried and tested effectiveness and safety, experience has shown medical professionals that in addition to shortening radiation times, there is no increased toxicity in these protocols. “We achieve the same results without increasing toxicity, thus greatly improving patients’ quality of life”, states Dr. Carballo. She goes on to explain that, for example, “in breast cancer, the main side effect is that the skin turns a little red, which is called epithelitis. Even if we make the treatment more intense, in fewer sessions, this epithelitis will not get worse or more serious.”
Respiratory gating in the delivery of radiation therapy
Among the latest innovations incorporated into radiotherapy, respiratory gating in the delivery of radiation therapy, or Deep Inspiratory Breath Hold (DIBH), stands out. This technique is applied to women with breast cancer in the left breast to protect the heart from the effects of radiation. “It is based on administering radiation in time with the patient’s respiratory cycle, when the heart is further away from the chest wall and, therefore, is less exposed to the effects of radiation. So, women’s breathing cycles are studied so the radiation can be applied at just the right time”, explains Carballo.
Various studies have observed that patients who received radiotherapy in the past could be at greater risk of heart attacks, sudden death from heart disease or valve stenosis. These are all disorders associated with exposure to radiation needed to eliminate the cancer. "The application of these new DIBH protocols makes it possible to ensure that these patients will be healthy in 15 or 20 years and will not have complications as a result of these treatments," adds Dr.Carballo.
New studies to refine and personalize treatments
In parallel, studies have been published that explore the possibility of replacing treatments now applied in a standard way, like chemotherapy or surgery, with other more innovative methods with radiation playing a greater role. Above all, at this time when the biology of cancer is beginning to be better understood.
In the words of the specialist, "one of the studies underway at MD Anderson in Houston aims to find out whether surgery can be avoided in patients with more aggressive breast tumors like triple negative, and in those who normally receive chemotherapy prior to surgery. The new aspect to which this research is committed is that after chemotherapy, doctors assess whether the tumor has gone and, if it has not, to apply radiotherapy instead of operating.” What we are trying to do is assess the suitability of the different treatments in order to personalize them as far as possible to the individual patients and to be able to predict what their response will be.
1 Sociedad Española de Oncología Médica (SEOM). Las Cifras del Cáncer en España 2022. Acceso en: https://seom.org/images/LAS_CIFRAS_DEL_CANCER_EN_ESPANA_2022.pdf