The objective of modern oncological treatment is to ensure patients the maximum chance of recovery while minimising adverse effects related to the treatment. Today, this goal can be achieved with proton therapy.
Proton radiotherapy is a gentle method of cancer treatment with minimal side effects. It allows for accurate targeting of the proton beam to the target area (to the place of the original tumour), and thus minimises exposure of surrounding tissues and organs to radiation. Proton therapy is used to treat tumours of the oesophagus, pancreas, bile ducts, and anus.
The anatomic placement of the oesophagus – between the two lungs and close to the heart – requires delivery of radiation to a geometrically complex area in the midst of organs to which irradiation needs to be minimised. That is why proton radiotherapy is used.
Radiotherapy of oesophageal tumours is rather complex and requires the irradiation of a large volume of tissue, including the oesophageal area affected by the tumour, adjacent parts of the oesophagus, as well as extensive areas of sentinel lymph nodes. This is why the irradiation of this area is difficult and can benefit from the use of proton radiotherapy. The radiotherapy is modified according to the procedure planned by the surgeon.
From a technical and biological standpoint, irradiation of the pancreas and bile ducts is extremely difficult. This is because the pancreas and bile ducts are surrounded by a number of organs which may be damaged by irradiation (liver, duodenum, kidneys, stomach, etc.). The only radiotherapy option in which a sufficiently high dose of radiation is delivered to the target volume to destroy the tumour is proton beam irradiation.
Pancreatic tumour irradiation does not replace chemotherapy, but is rather used as a supplementary treatment.
Radiotherapy of primary liver tumours is a relatively new method which has thus far not been used frequently. Due to the location and extent of the involvement, it is often not possible to apply an effective dose of radiation in the case of hepatocellular carcinoma other than by proton irradiation. Proton therapy considerably reduces exposure of the tumour surroundings to radiation; therefore, it gives patients a greater chance of recovery.
Radiotherapy of anal tumours is very difficult. For this reason proton radiotherapy techniques have been developed to limit the adverse effects on the skin and mucous membranes of the sphincter and the surrounding tissue – typically allowing for the application of irradiation without needing to perform a temporary (relief) colostomy.
