The new linear accelerators used in external radiation-therapy improve the treatments significantly: they can define more precisely and efficiently the area affected by the tumour which has to be irradiated and reduce the risk to damage healthy tissue. This allows a reduction of the side effects that radiation may cause.

These are some of the conclusions which were presented during the ‘Up-dating Day’ in new technology for radiation-therapy, which have taken place at ICO in Hospitalet. The meeting, which gathered around 80 experts in radiation therapy and medical physics oncology from sanitary centres all over Spain, presented the newest technologic advances in radiation-therapy.

More accuracy: more benefits for the patients

One of the main challenges in radiation therapy is to avoid changes in the patients’ positions which may mean that radiation is not applied exactly on the area to be treated. This is specially relevant when working with high dose but very small tumours or the latter are very near vital organs, such as prostate or head or neck ones near to marrow, among others. The new generation of linear accelerators wants to avoid these variations in the patients’ positions and have more accuracy:

Intensity Modulated Radiation Therapy (IMRT). Its aim is to obtain the best results by means of computer technology tools for the radiation beams, in order to make the dose more adequate for each patient’s needs. The treatment is more accurate and focused, since it increases the action on the tumour and healthy tissues are not affected. It is used in tumours located very near vital organs, like marrow or optic nerves. “Until now, radiation therapy on head or neck tumours, for example, might imply unwanted side effects, such as a permanent dry-mouth sensation because radiation affected the parotid glands, responsible for the production of saliva. Thanks to the IMRT we can reduce the dose which goes to these glands so side-effects are avoided” explains Ferran Guedea, head of Radiation Therapy Oncology of ICO Hospitalet.

Image Guided Radiation Therapy (IGRT): The linear acelerator has an X-ray-image integrated equipment and a scanner, which enable us to check the patient’s position and the location of the tumour to improve accuracy. It is mostly applied on prostate tumours.

Radiation therapy synchronized with breathing: in this case, the breathing movements of the patient are synchronized with the radiation beams, and it monitors and compensates the movements of the tumour during radiation. This is specially important for small lung tumours which require highly accurate treatment, and the digestive system, which will move during the treatment because the patient is breathing.

Estereotaxic extra-cranial radiation therapy: it is a very precise technique which allows the application of high doses of radiation in very specific areas. It is used against lung, liver and bone cancer.

ICO, reference centre

ICO is a reference centre in the field of radiation-therapy oncology. Since May 2007 it has been treating patients with IMRT and IGRT and it is working on the protocols to apply breath-synchronized and estereotaxic extra-cranial radiation therapies. Moreover, it is the Spanish centre which treats most patients: in 2006, 4,315 treatments took place (1,981 in Hospitalet, 984 in Girona and 1,350 in Badalona). It owns more devices: it counts on the biggest concentration of linear accelerators in Spain (5 at ICO in Hospitalet, 2 at ICO in Girona and 3 at ICO in Badalona. Their latest acquisition is a linear accelerator, among the very few now at work in Spain, which is capable of carrying out radiation surgery, IMRT, IGRT and breath-synchronized radiation therapy.

11 of March 2008

The Catalan Institute of Oncology is a public institution, monographic about cancer, with an integral approach to this illness, which includes prevention, assistance, research and specialized training. ICO* is made up of three main assistance centres located in l’Hospitalet, Girona and Badalona, which work jointly with university hospitals of the ICS (the Hospital in Bellvitge, the Hospital Dr. Josep Trueta and the Hospital Germans Trias i Pujol). Moreover, it has stablished a network of regional 15 hospitals. This means that ICO has become the reference centre about cancer for more than 2.5 milion people (39% of the adult population in Catalonia).