Laryngeal 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 time
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 laryngeal cancer
Laryngeal cancer ranks first in incidence in the category of head and neck tumors, over the years radiotherapy techniques have been perfected, always seeking the well-being of the patient. Recent
studies have shown that hypofractionation (reducing the number of radiotherapies that the patient
receives, with the same effectiveness as traditional RT) in the case of laryngeal cancer helps to
improve the quality of life of patients.
Exist:
- 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 laryngeal cancer in Mexico
According to a study in the Journal of the National Cancer Institute, more than 10,000 patients in the United States have participated in more than ten years of research. The benefit of hyperdivision of stage I and stage II laryngeal cancer is to increase patient survival. In this line, it is estimated that the 5-year survival of patients with stage T2 laryngeal cancer undergoing hyperfractionated radiotherapy has increased by 70.8%, but if conventional radiotherapy is administered it will be reduced to 64.5%.
Currently, Intensity Modulated Radiotherapy (IMRT) is one of the most widely used techniques in laryngeal tumors, since it allows radiation to be very precisely adapted to the shape of the tumor, avoiding damage to nearby healthy organs such as the marrow and the parotid gland; together with Image Guided Radiotherapy (IGRT), with which the radiation dose that reaches the healthy organs surrounding the tumor is reduced to the maximum.
Over the years, combined radiotherapy and chemotherapy have established themselves as an effective alternative option for selected patients, allowing them to maintain speech ability.
Radiation therapy can be used as the main/primary treatment for some early-stage laryngeal and hypopharyngeal cancers. If the cancer is of a considerable size, it can often be destroyed by radiation, as this can help to better preserve voice quality. Also to relieve symptoms of advanced laryngeal and hypopharyngeal cancer, such as pain, bleeding, trouble swallowing, and problems
caused when cancer spreads to the bones.
There are radiotherapy techniques to treat laryngeal cancer:
3D conformal radiation therapy (3D-CRT): 3D-CRT uses the results of imaging studies, such as MRI, and special computers to precisely delineate the location of the tumor. Several beams are configured and directed towards the tumor from different directions. Each beam alone is fairly weak, making it less likely to cause damage to normal tissue it passes through. However, the beams reach the tumor to deliver a higher
dose of radiation there.
Intensity Modulated Radiation Therapy: Intensity Modulated Radiation Therapy (IMRT) is an advanced form of three-dimensional therapy. This technique uses a computer-controlled machine that actually moves around the patient as it delivers radiation. In addition to shaping the beams and directing them at the tumor from various angles, the intensity (strength) of the beams can be adjusted to limit the dose reaching the more sensitive adjacent normal tissues. This may allow the doctor to deliver a higher dose to the tumor. This is the most common way of giving radiation for laryngeal and hypopharyngeal cancer.
According to specialists, hypofractionation of laryngeal cancer treatment is possible when advanced radiotherapy equipment such as VMAT is available. This has been a substantial advantage, both in the procedure and in the quality of life of these patients. At the COC we have advanced techniques in radiotherapy, such as: 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.
Hypofractionated Treatments: It is an external radiotherapy technique that could reduce in selected medical cases the number of radiotherapy sessions that the patient receives with the same effectiveness as a conventional treatment, making it more convenient for the patient to attend fewer days while maintaining the standards of effectiveness and security in the process.