Article from Jornal Público, signed by Dr Paulo S. Costa – Clinical Coordinator of the Dr. Júlio Teixeira Radio-Oncology Unit at Instituto CUF Porto.

https://www.publico.pt/2021/08/01/impar/opiniao/cancro-pulmao-inovacao-radioterapia-1972148

“The integration of new advanced modalities of radiotherapy, in which CyberKnife stands out, combined with the appearance of new systemic treatments, allows us to obtain levels of tumor control never before achieved. The treatment of lung cancer has been changing in a radical way in the last decade.The vast knowledge of the biology of these tumors allows us, today, to look at them differently.It is in this context that radiotherapy has been introducing gains in the effectiveness of the treatment of lung cancer.On World Day of Lung Cancer, which marks this Sunday, August 1st, the word is one of hope. Currently, the understanding of the biological phenomena of interaction between radiation and organic tissues has led to therapeutic gains in the treatment of numerous tumors and between they lung cancer. The additional role that radiation can play in triggering immune response cascades against the tumor is now better known. In this way, we can increase the effectiveness of this therapy without increasing adverse effects on the patient. Also in the technological field, remarkable developments have been observed in the treatment of lung cancer. To begin with, the importance of integrating the respiratory movement into the radiotherapy treatment plan proved to be extremely important. This recent technique allows us to increase the dose to be performed on the tumor, with less aggression to the surrounding healthy lung tissue. In this context, technological solutions in radiotherapy that integrate these concepts have been emerging. The visualization of the tumor or the area to be treated, allows to add precision in the treatment in multiple areas and in particular in lung cancer. Can this factor influence the treatment carried out? Since the tumor movement often takes complex trajectories, the adjustment of these movements , in order to ensure that the lesion is always within the irradiation field, requires extreme measures. Such measures include the possibility of the treatment beam continuously following the tumor volume. In this way, we can ensure that the tumor is properly treated during the radiotherapy session. It also allows us to ensure that we include the least amount of healthy lung tissue possible when we carry out the treatment. An example of this type of solution is CyberKnife, a robotic radiosurgery equipment used for the treatment of different types of tumors, which allows us to focus high doses of radiation on the tumor, minimizing damage to adjacent tissues, due to its millimeter precision. The technology it has allows it to follow the tumor continuously throughout the entire treatment. This possibility of continuous visualization reduces to a minimum any possibility of error due to unexpected movements of the tumor. These technological innovations have opened new doors for us in the approach to lung cancer. As a result of the success of the numerous systemic therapies currently in existence — as the name suggests, they act throughout the body — and, consequently, increased survival, the question of whether we can re-treat patients who until now had no indication is increasingly raised. for that.Is this a myth, or increasingly a reality? In this particular, Cyberknife has provided differentiated solutions, making this possibility — of treatments in more advanced stages of the disease — a reality that other technological solutions could not have reached. The fact that it consists of a linear accelerator mounted on a robotic arm, allows it to achieve degrees of freedom through positions only possible with this configuration. With a unique spatial distribution of the treatment beams, it invariably allows us to constitute a valid treatment solution with low toxicity in contrast to other types of solutions. In conclusion, the integration of new advanced radiotherapy modalities, in which CyberKnife stands out, combined with the emergence of new systemic treatments, it allows us to obtain levels of tumor control never before achieved, which are associated with low levels of side effects even in advanced stages of this disease. The message for patients is therefore founded on hope, but we must always bear in mind that we are facing the second most diagnosed type of cancer in the world. Its early detection and treatment remain the fundamental pillars in the fight against this disease.”

 

https://www.publico.pt/2021/08/01/impar/opiniao/cancro-pulmao-inovacao-radioterapia-1972148