Radiotherapy, also known as radiation oncology or radiotherapy, is an important form of treatment for cancer and some benign diseases.
Radiation is generally a localized form of therapy in which high-energy radiation is concentrated in the tumour wherever possible. As cancer cells react more sensitively to radiation than healthy cells, the cancer cells are damaged to such an extent that they die.
Healthy tissue, on the other hand, is spared by the local application, which minimizes the side effects of radiotherapy.
In most cases, the aim of radiotherapy is to cure the disease (curative radiotherapy). Today, around a third of tumors that have not yet formed metastases can be cured using radiotherapy techniques such as brachytherapy, intraoperative radiotherapy or percutaneous radiotherapy. Ideally, the tumor should be completely removed after cancer radiotherapy.
However, not all tumors respond equally well to radiation treatment. Specialists in radiation therapy (radiation oncology) also differentiate between radiation-sensitive and radiation-resistant tumors.
However, the effect of cancer radiation can be improved by giving the patient additional cytostatic drugs that make the tissue more sensitive to radiation(radiochemotherapy), targeted heating of the tumor tissue (deep hyperthermia or hyperthermia for short), or by distributing the entire intended radiation dose over several treatments (fractionated radiotherapy or fractionation).
The aim of neoadjuvant tumor radiation is to shrink the tumor to such an extent that subsequent surgery or chemotherapy is more promising.
In contrast, tumor cells that remain in the body after surgery (e.g. breast cancer or brain tumors) are to be removed by subsequent radiotherapy, which is referred to as adjuvant tumor radiotherapy.
In palliative radiotherapy, the focus is no longer on healing, but on improving or maintaining quality of life, for example to relieve pain in bone metastases.
Today, over 50 percent of patients with, for example
radiotherapy.
In addition to this tumor irradiation, radiotherapy is also used in pain irradiation. For example, low-dose X-rays (X-ray stimulation radiation) are used to treat
when other procedures have not had the desired effect.
Radiotherapy specialists have a wide range of services at their disposal for the radio-oncological treatment of cancer and pain radiotherapy.
The classic procedure used in radiotherapy clinics is percutaneous radiotherapy, in which the patient or the tissue to be irradiated is placed under an irradiation device similar to an X-ray machine. The high-energy rays penetrate the body from outside the body through the skin (percutaneously).
The patient must not move during radiotherapy so that the rays do not damage healthy tissue. As even breathing can have negative consequences in breast cancer radiotherapy, for example, procedures have been developed in which radiotherapy is adapted to breathing(breath-triggered radiotherapy).
© Thomas Hecker / Fotolia
In contrast, brachytherapy, also known as short-distance radiotherapy, involves the radiation source (so-called seeds, tiny radioactive metal beads) being introduced directly into the tumor tissue or into a body cavity. The main areas of application for brachytherapy are gynecological tumors and carcinomas of the esophagus and prostate.
With intraoperative irradiation, the tumor is irradiated directly during an operation. This means that the organs in the radiation area can be better protected by simply moving them to the side. The principle of brachytherapy is explained in the video:
Intensity-modulated radiotherapy can be used to deliver targeted radiation that is gentle on tissue by changing the direction of radiation several times. This high level of precision is also achieved with tomotherapy. Here, a radiation source rotates from all sides around the area of the patient to be irradiated. The position of the tumor is checked using computer tomography and the radiation is adjusted (image-guided radiotherapy) in order to avoid underdosing the tumor and overdosing the normal tissue.
Another variant of radiotherapy is carried out using a green laser (greenlight laser). The wavelength of the laser is in the green visible color spectrum and is absorbed by the red blood pigment. The laser beams only penetrate the tissue surface and thus destroy the growth of tumors. Greenlight lasers are also used to treat an enlarged prostate. The video shows the green therapy laser being used in the trachea:
In stereotaxy, or more precisely stereotactic radiosurgery, the tumor is "cut out" using high doses of energy. This procedure is used in particular in brain tumor radiotherapy.
A relatively new form of radiation oncology is proton therapy, which is currently only available at a few radiotherapy centers and clinics. The advantage of this radiotherapy is that the main radiation dose can be targeted to the tumor and the tissue above and below it is largely spared.
In addition to these local procedures, there is also whole-body radiotherapy, in which the leukemia or lymphoma cells circulating in the body are killed by irradiating the entire body. It is also used to eradicate the body's own bone marrow before a bone marrow or stem cell transplant.
X-ray stimulation radiation is used in pain irradiation. There are several theories about the effect of X-ray stimulation radiation. It is assumed that low-dose radiation stimulates the metabolism, has an influence on the acid-base environment or inhibits autoimmune processes and blood circulation.
Radiotherapy side effects can occur in healthy tissue depending on the radiation dose, penetration depth, number of irradiations and irradiated tissue. Early reactions to radiotherapy include, for example
- Reddening of the skin
- inflammation of the mucous membranes
- feeling of fullness
- nausea
- diarrhea
- rarely also hair loss.
Late reactions may include vasoconstriction, scarring, skin discoloration or dry mouth and, in the case of breast cancer radiotherapy, coronary heart disease.
The development of a second tumor or germline damage caused by radiotherapy is very rare.
Radiotherapy should be carried out by an experienced specialist in radiotherapy/radiation oncology or radiology. A specialist in radiotherapy has completed five years of further training after studying medicine.
It is not possible to designate a clinic as the "best clinic" or "top clinic" for radiotherapy (radiation oncology). However, there are doctors and clinics that specialize in the radio-oncological treatment of cancer and pain radiotherapy and have a great deal of experience. You can find these experts in radiotherapy (radiation oncology) in the Leading Medicine Guide.
Only selected highly qualified medical experts and specialists are presented in the Leading Medicine Guide. All listed doctors have a high level of professional expertise, have excellent experience in the field of radiotherapy and radiation oncology and fulfill the strict admission criteria of the Leading Medicine Guide.
