Radiotherapy

Radiotherapy is a type of cancer treatment – like surgery or a systemic treatment, such as chemotherapy, hormone therapy and immunotherapy – that involves exposing a small area of the body to a high dose of radiation targeted directly to the tumour. Cancer cells are sensitive to radiotherapy, as a result, the radiation destroys the cells, which prevents them from dividing and therefore stops or slows the growth of the tumour. Radiotherapy uses a particle accelerator. This device delivers targeted doses of rays or ionising radiation to the tumour volume. These doses damage the DNA of cancer cells, killing them or stopping their growth while protecting the surrounding healthy tissue.

Cancers treated by radiotherapy

• Gynaecological cancers (breast, uterine and cervical cancer)
• Urological cancers (prostate, bladder, kidney and testicular cancer)
• Gastrointestinal cancers (stomach, oesophageal, anal canal and rectal cancer)
• Head and neck cancers
• Lung cancers
• Central nervous system cancers
• Skin cancers
• Other cancers (lymphomas, soft tissue tumours, metastases, brain, lung, bone, liver, lymph node, etc.)

Radiotherapy involves multidisciplinary care: it requires the expertise of a wide range of specialists, including radiologists, nuclear medicine specialists, pathologists, radiotherapists, oncologists and surgeons, who discuss and review each patient case during weekly team meetings, known as Tumour Boards, in order to determine the best possible treatment option together. Supportive care is provided alongside treatment and focuses on coordinating support to manage challenges related to the disease.

Different radiotherapy techniques

Intensity modulated radiotherapy (IMRT)

Intensity modulated radiotherapy is a form of high-precision external radiotherapy. Instead of a uniform dose of radiation, the beams deliver three-dimensional conformal radiation for a higher and more targeted dose to the tumour while minimising radiation to the surrounding healthy tissue. There are fewer side effects and it reduces treatment toxicity. It is particularly indicated for treating cancers in the following parts of the body:

• Breast
• Prostate
• Lung
• Gastrointestinal tract
• Head and neck
• Central nervous system

Hypofractionated radiotherapy

Hypofractionated radiotherapy is a treatment technique that consists of intensifying the dose of radiation delivered during each radiotherapy session, therefore reducing the number of sessions and total treatment time. It is suitable for specific cancers in the following parts of the body:

• Prostate
• Breast

Stereotactic body radiotherapy (SBRT)

Stereotactic body radiotherapy (SBRT) is a high-precision radiotherapy technique that delivers a dose of radiation to kill the tumour while protecting the surrounding healthy tissue. It is indicated for the non-invasive treatment of primary and metastatic cancer, particularly in the following parts of the body:

• Lung
• Liver
• Brain
• Lymph nodes
• Bone

Radiosurgery

Radiosurgery is a high-dose, non-invasive radiotherapy technique that destroys tumours in a single session in the following parts of the body (so that patients do not have to undergo surgery):

• Brain
• Bone
• Liver
• Lung

Superficial radiotherapy

Superficial radiotherapy is used to treat tumours on or close to the skin’s surface, for example skin cancer, and delivers low-energy radiation that penetrates only a few millimetres into tissue.

Intraoperative radiotherapy (IORT)

Intraoperative radiotherapy is used to treat certain types of breast cancer and involves a single session of radiation, which takes place during surgery and immediately after the tumour resection. This intraoperative technique may shorten the course of standard postoperative radiotherapy and, in some cases, there may be no need for radiotherapy after surgery at all.

Rectal cancer radiotherapy

Specialised rectal cancer radiotherapy is used to treat rectal tumours in some patients without the need for surgery.