Radiochemotherapy: Specialists & Information

Radiochemotherapy is a non-surgical treatment for certain types of cancer. It combines radiation therapy and chemotherapy.

The principle behind radiation therapy (radiotherapy) is to direct high-energy radiation specifically at a tumor. Cancer cells are more sensitive to this radiation than healthy cells. The radiation damages the tumor tissue, which then dies off. This can cause the tumor to shrink.

Chemotherapy involves the use of drugs (known as cytostatics). These drugs prevent rapidly dividing tumor cells throughout the body from dividing further. As a result, the tumor cells die.

Some tumors are suitable for a combined application of both methods. It has been found that chemoradiotherapy is more effective for these tumors than the separate use of these two treatment approaches.

Although both radiation therapy and chemotherapy are frequently used to treat a tumor, they are not administered simultaneously but rather at separate times, one after the other—that is, sequentially.

In simultaneous chemoradiotherapy, the patient is treated with coordinated radiation and chemotherapy at the same time. Patients often seek out a clinic specializing in chemoradiotherapy for this purpose.

Tumor cells that may be resistant to chemotherapy can be destroyed by radiation—and vice versa. There are also chemotherapy drugs that make cancer cells more sensitive to radiation.

All of these effects significantly increase the chances of cure for certain tumors. At the same time, they reduce the risk of metastases forming in other organs and of recurrence. Recurrences are the reappearance of tumors that have already been treated.

Radiochemotherapy is suitable for types of cancer that are sensitive to radiation and chemotherapy drugs. These include, for example,

• anal and rectal carcinomas (colorectal cancer),
• cancers of the mouth and throat (head and neck tumors and esophageal cancer),
• bladder cancer,
• cervical cancer,
• breast cancer,
• lung cancer, and
• brain tumors.

Radiochemotherapy can increase the chances of a cure or at least prolong life.

Another advantage of concurrent chemoradiation therapy is that treatment is completed after six to eight weeks. With sequential chemoradiation therapy, treatment can take up to half a year.

This means less strain on the patient, both in terms of time and physical exertion.

Specialists in chemoradiotherapy are typically medical specialists in radiation oncology. They work in an interdisciplinary manner with experts from other fields (e.g., oncology) at specialized clinics for chemoradiotherapy (radiation oncology clinics).

Instead of a radiation clinic, treatment can also be carried out at a chemotherapy clinic under the supervision of a specialist in chemoradiotherapy or radiation oncology.

Simultaneous chemoradiotherapy follows a specific schedule. It can vary depending on the tumor and the severity of the disease. One possible treatment plan involves radiation therapy five days a week for six weeks. During the first and fifth weeks, the patient may also receive chemotherapy on all five days of radiation therapy.

Radiochemotherapy is often used as a preoperative or postoperative treatment for surgery. In such cases, it is intended to either

• reduce the size of the tumor before surgery (neoadjuvant chemoradiotherapy), or
• kill any remaining cancer cells after surgical removal and reduce the likelihood of recurrence (adjuvant chemoradiotherapy).

Less commonly, chemoradiotherapy is used on its own, i.e., without surgery before or after. This is referred to as definitive chemoradiotherapy.

Possible side effects are the same as those that occur with chemotherapy or radiation therapy alone. They vary from person to person and depend on

• radiation dose,
• depth of penetration,
• the number of radiation sessions and the tissue being treated, as well as
• the type and duration of the chemotherapy drug.

Chemotherapy can cause, among other things,

• fatigue,
• anemia,
• nausea,
• diarrhea,
• mucosal inflammation, and
• hair loss

. Radiation therapy relatively often leads to scarring (radiation fibrosis).