RADIOTHERAPY

It is estimated that over three quarters of all oncological Patients will require radiotherapy at some stage of treatment.

Radiotherapy, alongside surgery and chemotherapy, is one of the main methods of cancer treatment. Ionizing radiation is used for treatment, which can be applied from outside and inside the patient's body. Due to the radiation source, radiotherapy is divided into teletherapy and brachytherapy. In teletherapy, the radiation source is at a certain distance from the patient, while in brachytherapy, the radiation source is in direct contact with the patient.

In radical treatment, radiotherapy is used as an independent method of treatment or as part of a multi-stage process combined with surgical and systemic treatment, i.e., chemotherapy, hormone therapy, and immunotherapy. Depending on the treatment goal, there is radical radiotherapy, aimed at completely curing the lesion, and palliative radiotherapy, aimed at improving the quality of life and treating cancer pain in an advanced stage of the disease.

In specific clinical situations, stereotactic radiotherapy (SBRT) and radiosurgery (SRS) are also used. These are highly specialized treatment techniques that allow for very precise delivery of radiation to the target area.

Moreover, radiotherapy occurs as a method of independent cancer treatment, but it can also be used in combination with other methods. Therefore, the following types are distinguished:

Combined radiotherapy – combining treatment methods, e.g., with chemotherapy; Adjuvant radiotherapy – used after surgical treatment, to irradiate the tumor bed, where clinically invisible cancer cells may be present; Preoperative radiotherapy – used before surgery, to reduce the cancerous lesion. Radiotherapy is often combined with chemotherapy. The patient simultaneously undergoes radiotherapy and chemotherapy treatment, i.e., the so-called radiochemotherapy.

Currently, we are observing rapid technological progress in the field of radiotherapy. New equipment and introduced highly specialized irradiation techniques clearly indicate an increase in treatment effectiveness while sparing healthy tissues. This progress means that radiotherapy has an increasingly wider application as a method of independent cancer treatment.

In our centers, we treat patients with tumors of various systems and organs, and the most common indications for radiotherapy include:

Cancer diseases:

Breast cancer Head and neck tumors Brain and nervous system tumors Lung and chest tumors Digestive system tumors Genitourinary system tumors Bone and soft tissue tumors Metastases to bones, brain, lungs, abdominal organs In addition to malignant tumors, we also irradiate non-cancerous diseases, i.e.:

Graves' disease – exophthalmos (orbitopathy) Painful shoulder syndrome (PHS – periarthritis humeroscapularis) Aggressive fibromatosis – surgery + adjuvant radiotherapy Tennis elbow (EPH – epicondylopathia humeri) Golfer's elbow Palmar fascia contracture, known as Dupuytren's disease, characterized by scarring of the palmar fascia with subsequent flexion contracture of the fingers Heel spurs Keratoacanthoma Achilles tendon inflammation Heterotopic ossification – immediately before or after surgery Painful vertebral hemangiomas Ledderhose's disease - nodular fibromatosis of the plantar fascia Detailed information: Non-oncological treatment

Tumor Board

The Patient's treatment process begins with a tumor board, where decisions are made about the form of therapy, methods, and its individual stages. The tumor board consists of specialists in surgery, pathomorphology, radiology, clinical oncology, and radiotherapy, as well as DILO coordinators. In case of a complicated clinical situation of the Patient, doctors of other specializations participate in the tumor board.

Course of Radiotherapy

The radiotherapy process begins with treatment planning. Radiotherapy takes place in fractionated sessions, usually lasting several or a dozen minutes. The number of fractions depends on the type and advancement of the disease as well as the treatment applied. The therapy itself can last several or a dozen weeks.

Equipment

The centers are equipped with linear accelerators, brachytherapy devices, and the most modern planning, management, and dosimetric verification systems. The radiotherapy planning itself takes place using computed tomography, magnetic resonance imaging, and a PET/CT machine. Services are provided in the field of 3D radiotherapy (IGRT) (3D-IMRT) (3D-SIMRT) (3D-RotlMRT), 4D radiotherapy (4D-IGRT) and IMRT, stereotactic radiotherapy, and brachytherapy.

Linear accelerators have been equipped with Image-Guided RadioTherapy and VisionRT systems, which enable irradiation of the tumor with high precision. Additionally, in some clinical situations, such as prostate cancer, pancreatic cancer, radiotherapy is conducted using markers placed under USG control, in the area directly adjacent to the tumor.

In case of the need to account for the respiratory mobility of the irradiated area, respiratory gating techniques and Deep Inspiration Breath Hold Radiotherapy are used during treatment, which are applied in stereotactic radiotherapy of lung or liver tumors and during irradiation of patients with left-sided breast cancer, which reduces the dose to the heart.

Radiotherapy is conducted in all Affidea NU-MED Group centers:

• Centrum Radioterapii i Onkologii - Elbląg  (Center for Radiotherapy and Oncology - Elbląg)
• Centrum Diagnostyki i Terapii Onkologicznej - Katowice (Center for Oncological Diagnosis and Therapy - Katowice) 
• Specjalistyczny Szpital Onkologiczny - Tomaszów Mazowiecki (Specialised Oncology Hospital - Tomaszów Mazowiecki)
• Centrum Diagnostyki i Terapii Onkologicznej - Zamość (Center for Oncological Diagnosis and Therapy - Zamość)

Information for patients