Novel radiotherapy for cancer

New radiation device for faster and more precise treatment

02/06/2013

At the Hamburg University Hospital Eppendorf (UKE), a new radiation treatment device is intended to help treat cancer patients even faster, more accurately and more individually. The so-called „linear accelerator“, Considered to be one of the most modern devices in the world, it was put into operation on Monday and has a new kind of technology: it revolves around the patient during the treatment and can therefore irradiate the tumor from different positions with variable intensity. With this innovative technology, UKE's medical professionals are now able to work even more effectively, because affected tissue can be focused more precisely than before and then destroyed by X-rays - without affecting healthy tissue.

Radiation treatment is often an essential component of cancer therapies
Radiation therapies are nowadays part of the treatment process for many types of cancer - usually in combination with other medical measures, e.g. Surgery, chemotherapy and hormone therapy for breast cancer. The aim of the irradiation is to damage the cancer cells by ionizing radiation - such as X-rays - so far for each type of cancer that they can no longer spread or be destroyed.

New device should minimize risks of irradiation
But this is exactly where the risk lies, which the procedure entails: After all, irradiation may also destroy surrounding healthy tissue, which is why precise procedures are absolutely essential. Here, the new radiation device in the UKE set a new standard, because unlike the previous devices, the linear accelerator is equipped with two additional X-ray tubes on the ground, which can also shoot diagonal images of the patient and thus allow a more accurate approach: „In the meantime, it is possible to adapt the treatment beam exactly to the size, shape and location of the tumor so that surrounding healthy tissue is largely spared. The quality of treatment has improved considerably. Today, tumors can be irradiated as precisely as never before“, explains Prof. Dr. med. Carsten Bokemeyer, who heads the University Cancer Center Hamburg at UKE.

In addition, the new device has other advantages - because the table on which the patient is lying during the irradiation can now be better corrected and adapted to the patient's movements; moreover, with the new technique, position balls would still be applied to the patient's body provide more security: „The combination of multiple imaging and patient positioning systems provides all the information necessary for optimal therapy. This allows the patient to be positioned with millimeter precision“, says Prof. Cordula Petersen, Director of the Department of Radiotherapy and Radiooncology at UKE.

However, the new device not only works more accurately, but also faster - according to the UKE, the radiation dose can be increased from previously three to five Gray per minute to up to 24 Gray per minute, which shortens the irradiation time from previously 30 minutes to three would mean up to five minutes.

Use especially for tumors in the head and neck area
The new linear accelerator is to be used in particular in the treatment of tumors in the head and neck area, so the message, because „The technique offers new opportunities for the patient: thanks to the great precision, even deeper tumors in the body or brain, which previously were regarded as hardly treatable, can be irradiated in high doses. In such cases the x-rays replace the scalpel. This so-called radiosurgery comes as a treatment from the outside without cut or scars and now often forms a gentle alternative to surgery“, explains Priv.-Doz. Dr. Jan Regelsberger, from the Department of Neurosurgery at UKE.

Therefore, the new radiation technique may in some cases, e.g. In tumors at the base of the skull or the auditory nerve are used as a useful alternative to surgery, because here deep-seated and thus difficult to reach tumors or adjacent vital brain regions would always provide problems. It is conceivable that Dr. Jan Regelsberger also said that in such a problem case the risk would be reduced by removing only part of the tumor by means of surgery and destroying the remainder by irradiation.

Other areas of application for the new linear accelerator are the data from the UKE on childhood brain tumors or benign tumors of the pituitary gland, but also small tumors or metastases in the lungs, which would not be treatable surgically: „With the new system, we lay the technological foundation for a wider range of indications in radiotherapy. In the future, we will be able to precisely treat vascular malformations and tumors in sensitive areas“, so Priv.-Doz. Dr. Andreas Krüll, Head of Radiation Therapy at the Ambulance Center of the UKE.

„Miracle Weapon“ of the UKE has its price
But the commissioning of the new „Miracle Weapon“ of the UKE, which would be similar in this country only in the University Hospital Freiburg and of which so far only a few installed, also brings neat costs: a total of 5.5 million euros, the hospital has invested according to their own information in the linear accelerator and another high-performance irradiation system , From now on, 60 patients could be treated daily with the new technology, whereby the device should be used both on an outpatient and inpatient basis - the costs would be borne by the health insurance companies.

Radiotherapy is becoming increasingly important in the fight against cancer
The aim of the UKE is now to scientifically examine the benefits of the new device for both the individual and the mass of cancer patients. According to Prof. Martin Zeitz, the Medical Director of the UKE, it should be assumed that radiation will receive more and more attention in the future: „In the future, radiation therapy will become even more important due to the enormous technical improvements - not only in cancer therapy“, However, according to the physician, internal coordination is indispensable: „However, the essential component of optimal therapy with state-of-the-art radiotherapy equipment is the close cooperation of experts from different disciplines. The new linear accelerator makes this collaboration possible: The responsible physicians can access CT images and treatment procedures throughout the UK, so that the specialist team can work together anywhere.“

Also Hamburg's science senator Dr. Dorothee Stapelfeldt (SPD) sees the new advanced device as an enrichment for medicine. For example, the linear accelerator is a vivid example of how basic physical research can lead to modern treatment methods, because the device combines the advantages of modern imaging and innovative radiation technology. (Sb)

Picture: Rainer Sturm