By Vidhi Prasad K.V.
Advancements in radiation therapy have made this treatment a fundamental component of cancer care. An estimated 60% of people with cancer will receive treatment with radiation therapy either as their sole care option or along with surgery, chemotherapy or immunotherapy.
While radiation therapy has been in use for more than 100 years, innovations including linear accelerators, imaging, artificial intelligence (AI), and cutting-edge hardware and software have made this treatment exceptionally targeted and highly effective. Today, radiation beams can change in size, shape, direction and strength, enabling personalisation of care based on patient needs. Following are four key developments:
- Stereotactic Body Radiation Therapy (SBRT) is an advanced external beam radiation treatment technique used to deliver (ultra) hypofractionated radiation therapy. This form of care involves delivery of a higher dose per session or fraction across fewer total sessions, usually five or less. In comparison, conventionally fractionated treatments involve the delivery of a lower dose of radiation per session, often up to 35 visits across several weeks.
- With Robotic Radiation Delivery, a linear accelerator is mounted on a robot, enabling (ultra) hypofractionated radiation therapy treatments with sub-millimetre accuracy and precision. The system’s design facilitates the delivery of radiation from potentially thousands of unique angles, significantly expanding the possible positions from which radiation beams can be delivered. This enables physicians to maximise the radiation dose delivered to the tumour and minimise dose to surrounding healthy tissues.
- Intensity-Modulated Radiation Therapy (IMRT) modulates the radiation beam intensity. While most IMRT solutions use a single beam of radiation, some advanced IMRT solutions divide the beam into many smaller, narrow “beamlets”. Every beamlet is individually optimised to a specific intensity of radiation targeted at the tumour, enabling customised and precise treatment delivery. Thousands of beamlets combine in the tumour to contribute to the total radiation dose uniquely prescribed to each patient. Image-guidance enhances IMRT by incorporating imaging techniques to improve the precision and accuracy of radiation-dose delivery. This is called Image-Guided Radiation Therapy (IGRT).
- Helical Radiation Delivery integrates the linear accelerator and CT technology to deliver IMRT or IGRT from multiple 360-degree rotations around the patient during treatment delivery. The fully integrated, daily imaging guides the treatment each day, giving the treatment team the ability to clearly see the shape and location of the patient’s tumour in real time before each treatment session, and providing greater precision of the radiation dose so it conforms precisely to the tumour.
The future will see continued evolution. The use of AI is anticipated to significantly reduce treatment planning time and improve plan quality by automating tasks such as organ segmentation and dose optimisation, which in turn may lead to more precise treatment plans. The combination of Surface Guided Radiation Therapy (SGRT) and Deep Inspiration Breath Hold (DIBH) in left-breast cancer patients has enabled the precise delivery of radiation while significantly minimising dose to the heart and left anterior descending artery. This is important as it helps to reduce the risk of coronary events, and may enable patients to maintain a better quality of life. Emerging technologies such as FLASH therapy, which uses ultra-high dose rate delivery in less than a tenth of a second, and biology-guided radiotherapy are showing promise across a range of cancer cases.
Advanced radiation therapy has transformed the landscape of cancer treatment worldwide, offering hope to millions of patients. Through the amalgamation of precise targeting, sophisticated imaging and innovative delivery systems, modern treatment techniques are making the impossible possible in cancer care. The future has never looked as promising, as industry and clinicians continue to partner to expand the curative power of radiation therapy.
The writer is Managing Director — India and Subcontinent, Accuray.
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.
The opinions, beliefs, and views expressed by the various authors and forum participants on this website are personal and do not reflect the opinions, beliefs, and views of ABP Network Pvt. Ltd.]
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