Blog

Modern Radiotherapy has adopted a wide range of advanced technological applications aimed at high precision and effectiveness of treatment, as well as reducing side effects.

The innovative techniques and advanced systems used aim at precise patient positioning, optimized radiation delivery and minimizing unnecessary irradiation of healthy tissues, contributing to the growing demands for personalized oncology treatment.

In recent years, the use of techniques such as stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT – SABR), deep inhalation radiotherapy (DIBH) and surface-guided radiotherapy (SGRT), serves precisely this need: increased probability of cure while ensuring the quality of life of our patients.

Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT – SABR)

They are advanced radiotherapy techniques, in which a very high dose of radiation is administered to small tumors, with absolute precision and in a small number of sessions (one to five). SRS concerns tumors of the brain and central nervous system, while SBRT tumors in the rest of the body. With the large dose administered, they enable us to destroy tumors, while with their precision they ensure the protection of surrounding healthy tissues.

They could be described as surgery without a scalpel and in many cases they replace surgical removal. When the patient’s general condition does not allow surgery, the tumor is not accessible to the surgeon or surgery is judged to be oncologically burdensome for the patient or will delay other treatments, these two radiotherapy techniques provide us with the solution.

Stereotactic radiosurgery (SRS) is applied to:

• Primary or secondary malignant brain tumors.
• Benign tumors, such as acoustic neuroma, meningioma and pituitary adenoma.
• Other diseases, such as arteriovenous malformations, trigeminal neuralgia, etc.

Respectively, stereotactic body radiotherapy (SBRT – SABR) is applied to: Primary or secondary tumors of the lung, pancreas, liver, adrenal glands, bone metastases in bones of the spine, in early stages of prostate cancer etc.

Deep Inspiration Breath Hold (DIBH) radiotherapy is a modern radiotherapy technique that helps us in cases where we want to avoid movement due to breathing. One of its most widespread uses is in patients with left breast cancer, as through deep inspiration, the heart is removed from the irradiation field, thus eliminating the radiation burden on the heart muscle. This technique contributes substantially to cardioprotection, while maintaining high accuracy and homogeneity of the therapeutic dose to the breast. The patient simply needs to take a deep breath and hold it for 20 seconds. The radiotherapy will be performed only during this phase.

Surface-guided radiotherapy (SGRT)
It is a significant innovation in the positioning and control of the patient’s position during treatment. It is applied in combination with all modern radiotherapy techniques. Through continuous three-dimensional visual recording of the body surface, extremely precise positioning and monitoring of the patient in real time is achieved, without the use of additional ionizing radiation. This technology is particularly important in treatments that require absolute precision or synchronization with breathing, such as stereotactic therapies and DIBH.

The use of ultrasound in the radiotherapy process

My team at the Department of Radiation Oncology and Stereotactic Radiosurgery, at the International Oncology Center, uses a portable ultrasound device that allows for direct, non-invasive measurement of the size of the bladder in patients with pelvic tumors, before each session. This capability ensures consistent bladder filling every day, and consequently, repeatability of the anatomical position of healthy organs and the target tumor. At the same time, it is applicable to patients with prostate cancer, gynecological tumors and other tumors in the area. This practice enhances the accuracy of the treatment and, as it is performed with ultrasound, is in the same climate of minimizing the unnecessary use of ionizing radiation.

This specific practice is applied in many major centers abroad and we are the first team in Greece to implement it in our daily clinical practice.

In conclusion
Modern radiotherapy has incorporated many high-tech applications, which we have at our disposal at the International Oncology Center at the Inter-Balkan Medical Center of Thessaloniki, in order to achieve the triptych: Accuracy, Safety and Effectiveness. And all this with a focus on the patient and the individualization of his treatment.