Radiotherapy is an essential tool in the treatment of many tumours. Radiotherapists are also involved in every multidisciplinary group at the Cliniques Universitaires Saint-Luc Cancer Centre.

They therefore play an active part in treatment of cancer, working alongside surgeons and oncologists specialising in chemotherapy. They can accurately define the benefit of irradiation techniques in each case discussed at the multidisciplinary meetings.

Radiotherapy, either alone or in combination with other treatment methods, can cure many tumours. In other cases, it can control various other symptoms, such as pain, and thus improve quality of life.

Appareil Hi-art de Thomotherapy installé dans notre centre

WHAT IS RADIOTHERAPY?

Radiotherapy involves treatment of cancer cells with X-rays. These cells, which have already mutated in several ways because of their malignant nature, do not readily survive exposure to radiation. Radiotherapy provides treatment in the form of small daily doses that are harmless to normal cells but progressively destroy cancer cells. This administering of small doses of rays has considerably reduced both frequency and intensity of side effects. More specifically, radiotherapy is better tolerated; it is now usually given in the outpatients’ department and no longer requires admission to hospital.

There are two distinct radiotherapy techniques:

• Curie treatment, or interstitial radiotherapy

In some cases, especially when small tumours are being treated, a specific irradiation technique is used. It is known as brachytherapy or curie treatment, after Marie Curie, who discovered radium in the late 19th century.
Depending on the zone to be treated, small radioactive grains or thin radioactive plates are injected or inserted and left in contact with the tumour, slowly irradiating it. The application (the term used in brachytherapy) is carried out under general anaesthesia and, if necessary, using a sophisticated ultrasound procedure that views the organ in three dimensions. The dose is calculated during implantation (a process known as dosimetry), thus allowing any necessary changes to be made at any time.
At our centre, brachytherapy is administered in four fields: eye melanoma (and some other tumours), breast cancer, skin cancer and prostate cancer. One other field is the treatment of persistent keloids (abnormal scars) but this is outside the scope of oncology.

• Classical or external radiotherapy

This is the technique most frequently used in the treatment of cancer by radiotherapy, involving treatment of the tumour with linear accelerators.

Our radiotherapy department has three linear accelerators, including the Tomotherapy Hi-Art, recently acquired by our centre and one of the first of its kind in Europe. It allows inaccessible tumours to be irradiated while preserving healthy neighbouring tissue. To find out more about tomotherapy, click here (link to article “tomotherapy from newsletter1»).

To find out more about radiotherapy, click here.

Vue du "pilote" de l'appareil Hi-art

INNOVATION ET EXPERTISE

Irradiation techniques have made huge steps forward in recent years. Computers now allow the tumour to be located and its nature determined with great accuracy. Cancers therefore be irradiated massively while preserving the adjoining healthy structures. And the computer revolution is far from over; no doubt it will lead to further progress in the use of rays.

Our centre’s experience in defining the position of the tumour within the body and its characteristics (shape, extent, location in relation to neighbouring vessels etc) is now internationally recognised (for example: Grégoire V, Scalliet P, Ang KK (publishers). Clinical Target Volume in Conformal and Intensity Modulated Radiation Therapy. Springer-Verlag Berlin Heidelberg New York. 2004). Progress in imaging has been used to maximum benefit to optimise the way in which radiotherapy is administered, thanks to combined efforts from specialists in imaging, radiotherapy and anatomy. The radiotherapy department’s research unit dedicates much of its activity to imaging techniques applied in radiotherapy.

Irradiation of cancer is becoming more and more accurate. Massive doses are fired into the tumour, while adjoining healthy structures are preserved. Our Tomotherapy Hi-Art machine allows these results to be achieved even with tumours difficult to access. Progress in imaging allows the targeting of the rays to be optimised.

In total, about 40 people work in the radiotherapy department.
This number includes medical technicians, almost as numerous as the doctors.
Their role is to monitor the performance of modern equipment constantly, ensure that measuring instruments are properly calibrated, and so on.
This shows the great attention paid to monitoring quality of care: irradiation techniques are becoming more and more complex and require ever more sophisticated equipment.
Irradiation is conducted according to a very rigorous procedure. Initially, it is simulated on screen. Subsequent checks ensure that irradiation of patients is consistent in every way with data calculated during the preparation phase. These very strict verification procedures prevent accidents.

The quality control skills of the Cancer Centre’s radiotherapy specialists are internationally recognised. It is evident in the development and publication of quality control programmes, which are used as references.

Séance de simulation avec masque