Better technicality makes it possible to better control radiotherapy, a treatment against cancer based on radiation. “Patient safety is at the center of the debate. The major breakthrough lies in the increase in requirements in terms of radiotherapy, naturally with better comfort for patients, ”explains Dr Daniel Serin, radiotherapist at the Institut Sainte-Catherine, in Avignon.
Deliver the right dose of rays to the right place
The latest recommendations ensure that the right dose of radiation has been delivered to the right place. Thus, dosimetry in vivo assesses the dose received directly on the breast of the patients. And an imaging system checks the accuracy of the irradiating beam (once a week during treatment).
“There is currently at European level a consensual harmonization of the standard irradiation doses to be delivered, they are therefore no longer in doubt on the national territory”, adds Dr Daniel Serin. In addition, the radiotherapist must see his patient once a week during treatment, then at least once a year for five years.
Conformational radiotherapy, a powerful technique against cancer
Before any treatment, conformational radiotherapy, real computer progress, is used to take anatomical measurements with absolute precision, thanks to a 3D dosimetry scanner. The goal is to reconstruct, under the guidance of a physicist, the target volume of the mammary gland or tumor to be treated, while avoiding critical areas (lungs and heart). The treatment then consists of irradiating these volumes at the rate of five sessions per week for five to six weeks.
For better results, in the event of lumpectomy after irradiation of the mammary gland, an additional dose of rays can be delivered to the operating area. This technique, known as the “boost”, is performed after the surgeon has placed small clips to better identify this area.
Ongoing study on the number of radiotherapy sessions required
Will women with breast cancer soon be able to benefit from shorter radiation therapy? Research work carried out in France, Europe and the United States concerns 4,000 women over the age of 50. The goal, in the event of removal of a tumor at low risk of recurrence, is to quickly and strongly irradiate the operated area. In other words, two sessions of radiation at a higher dose twice a day for five days replace the classic five-week regimen.
“If the result is equivalent with more comfort for the patients, this type of irradiation could be the standard treatment for some women, in particular the elderly”, explains Dr Christophe Hennequin, radiotherapist at Saint-Louis hospital in Paris.