Stomach cancer
Radiotherapy
The objective of radiotherapy is to deliver a high dose of radiation to a volume of treatment in order to maximize tumor control, keeping the dose in nearby tissues as low as possible to reduce the probability of severity of complications in normal tissues.
Clinical data has shown around 50% of patients would benefit from IMRT (Intensity Modulated Radiotherapy ) treatment, but it must be performed safely, quickly and efficiently from planning to delivery.
Elekta (creators of our radiotherapy equipment, “Versa HD”) developed rotational IMRT, a delivery technique known in Spanish as Modulated Volumetric Arc Therapy (VMAT).
VMAT ( Volumetric Modulated Arc Therapy ) is an advanced radiation therapy technique that delivers high doses of radiation specifically to the target (tumor) while reducing the dose to surrounding tissue and surrounding organs. With the use of single or multiple high-energy rays or particles that move in the form of interrupted arcs around the patient, this technique allows us to drastically reduce treatment times
This gives VMAT of:
- Greater control.
- Greater flexibility.
- Greater dose compliance.
The Elekta VMAT technique allows optimizing the administration of the dose to the needs of each patient, customizing their treatment according to their pathology. In this way, it provides a highly patient-focused procedure, giving us new method opportunities, while offering the freedom to simultaneously vary a number of parameters during the delivery of radiotherapy without having to compromise your treatment plan or its accuracy by time to administer.
Advantages of the VMAT
- Better compliance and dose homogeneity, especially around the spine.
- Lower average doses of OAR (Organs at Risk) vital, such as: heart, thyroid, esophagus, lung, among others.
- Maximum dose reduction in OARs, said dose reduction, could lead to an improvement in late effects and an increased quality of life.
Radiotherapy in gastric cancer
Radiation therapy can be used to treat gastric cancer. It is usually combined with other treatments, such as surgery and/or chemotherapy. Radiation therapy is often used after gastrectomy to target possible subclinical or microscopic disease, or in patients who have had positive nodes on nodal dissection.
Radiation therapy can help relieve some of the painful symptoms and bleeding associated with late-stage gastric cancer.
At the COC we have a radiotherapy team that offers:
Advances in systemic therapy and radiotherapy that have prolonged survival.
Radiotherapy that reduces the risk of locoregional recurrence after surgery by at least 70%.
Radiotherapy that prolongs survival in early and advanced stages after radical surgery.
We have the appropriate technology to apply modern techniques that offer long-term benefit by
controlling late toxicity.
Situation of gastric cancer in Mexico
- In Mexico, in the male population between 30 and 59 years of age who died from malignant tumors, 10% were due to malignant stomach tumors
- This tumor is the fourth cause of cancer worldwide and the third cause of cancer death in Mexico in individuals over 20 years of age.
- Despite the fact that gastric cancer in Mexico is one of the leading causes of death secondary to oncological pathology, and at the time of diagnosis, only less than 5% of patients are in the initial stages, there is no national program for timely detection or prevention of this pathology.
Radiotherapy in the treatment of gastric tumors
Radiotherapy is the use of ionizing radiation for the local or loco-regional treatment of certain tumors that uses high-energy X-rays. Its goal is to destroy tumor cells while causing as little damage as possible to the healthy tissues surrounding the tumor. The association of radiotherapy and chemotherapy after surgery have a key role, since they improve local control after surgery. When the tumor cannot be operated on, chemo-radiotherapy is the first therapeutic option and has a fundamental role in the local control of the disease.
Technological evolution has favored the development of more precise and effective radiotherapy techniques. The most used techniques are:
3D conformal radiotherapy: This technique contemplates homogeneous doses to the target volume of treatment. It uses a 3D simulation Tomography (CT) for its calculation, and protections for treatments with Photons and Electrons. Usually 1 to 6 fields are used. Compared with 2D radiation therapy, 3D conformal radiation therapy delivers radiation to cancer cells more precisely while reducing the amount of radiation to healthy tissue.
Radiotherapy may have a more palliative than curative purpose and is essential in controlling symptoms such as pain, bleeding or intestinal obstruction, improving the quality of life of patients.
Volumetric Modulated Arc Therapy (V-MAT): This technique achieves greater precision than IMRT in less time, which could allow higher doses to the tumor and greater protection to healthy organs. The VMAT delivers a continuous beam of radiation therapy in one or more arcs that move around the treatment area. Automatically changes beam shape and radiation dose as you move. VMAT treatment sessions are generally shorter than IMRT, around 10 minutes.
In radiotherapy in gastric cancer, the VMAT significantly reduces the treatment time of a patient with dose limitation to the liver and kidneys, according to different comparative studies between other planning systems.