Radiotherapy innovations in 2023

Sofie Heylen*, Geneviève Van Ooteghem, Xavier Geets, Eléonore Longton**, Dario Di Perri**, Ad Vandermeulen Published in the journal : February 2024 Category : Radiothérapie

The recent introduction of the artificial intelligence-powered linear accelerator Ethos® in our department now allows us to offer patients continuous and real-time adaptation of their radiation therapy treatment based on the patients’ daily anatomy.

In 2023, this adaptive radiotherapy was performed for the first time in the world in “breath-hold” to treat gastric lymphomas. This approach allows for a reduction of the irradiation margins while preserving adjacent organs.

Another area of innovation is stereotactic radiotherapy (SBRT) for liver tumors with mechanical ventilation assistance, which is an alternative to surgery for selected cases. Since 2018, non-invasive ventilation assistance, called MANIV, has been adopted, reducing irradiation margins and improving treatment quality. In October 2023, the Cliniques universitaires Saint-Luc became the first center to integrate MANIV into their routine clinical practice for treating liver tumors.

Stereotactic radiotherapy can also be offered for localized prostate cancer. It represents a faster and more precise alternative compared to traditional radiotherapy. Studies show comparable success rates with fewer side effects, highlighting the potential of SBRT for the treatment of prostate cancer.

Finally, an increasing number of patients are being treated with radiotherapy for bladder cancer. This conservative treatment is a new therapeutic alternative that can be offered under certain conditions. The application of adaptive radiotherapy in this indication is of maximum benefit due to the rapid and frequent variation in bladder volume during treatment. This makes it possible to avoid cystectomy and offer patients a better quality of life.

All these developments in radiotherapy align with our department's commitment to progress and improve patient care regarding oncological outcomes and quality of life.

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2021 technological innovations in radiotherapy

Xavier Geets, Antoine Delor, Emmanuel Bonnarens, Françoise Vanneste, Loic Vander Veken Published in the journal : February 2022 Category : Radiothérapie

Though often misunderstood, radiation therapy is a local cancer treatment that Is offered to nearly half of all patients on their cancer journey.

To be safe and effective, radiation therapy requires extreme precision in delivering the dose to destroy the tumor, while minimizing exposure to radiation of nearby organs and potential treatment toxicities. In its relentless quest for precision, the radiotherapy department of the Cliniques universitaires Saint-Luc benefited in 2021 from major technological innovations that have revolutionized the care of our patients.

To illustrate, our department was equipped with the Ethos® LINAC, which was a first in Belgium, offering an adaptive radiotherapy solution based on artificial intelligence. This new therapy renders it possible to automatically and rapidly adapt the radiation ballistics to the patient's anatomical changes, at each radiotherapy session.

Besides the anatomical changes that occur from session to session, breathing is another source of ballistic inaccuracy. Indeed, breathing induces a cyclic and often irregular movement of tumors and organs within the thorax and upper abdomen. In order to avoid such movements, our department has set up a technique of irradiation synchronized to breathing, or more precisely, which is delivered during repeated apneas of the patient induced by mechanical ventilation.

Finally, a 3D printer was also made available in the department. It allows for the creation of individualized objects for patients, thus improving the quality of treatment and protection of the patient during irradiation. When technological evolution rhymes with clinical revolution, both caregivers and patients can only look forward to the radiotherapy of tomorrow, which will be increasingly personalized, effective, and safe.

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