Re-treatment of tumours

Re-irradiation or the treatment of already irradiated tumours, is usually more complex than treatment of an onset disease.

The intervention that offers a greater possibility to control the disease in the event of a relapse is still surgery. However, there are few patients who have the characteristics to be able to have it be performed effectively and without negative consequences. Alternatively, only chemotherapy is used, with a lower possibility of long-term survival and disease control compared to surgery.

In radiation therapy, the irradiation of a previously irradiated part of the body requires a complex analysis that is not completely coded with various clinical, radiobiological, and technical variables (time since the previous radiation treatment, type of tissue irradiated, technique used, fraction used, dose delivered, comorbidities, performance status, intent of the treatment, etc.). Recently, various studies have highlighted the role of re-irradiation as a possible and valid therapeutic alternative for certain types of patients.

The advantages of proton therapy in retreating tumours

Due to the intrinsic properties of the proton beam, proton therapy guarantees a greater therapeutic ratio compared to conventional radiation therapy for the possibility of delivering high doses to the target and reduce irradiation of the surrounding healthy tissue, producing a better ratio of local control to expected toxicity. For re-irradiation, the purpose of using proton therapy is to improve the therapeutic index in terms of effectiveness, treatment tolerance, development of late reactions, and quality of life. Recent literature evidence points to proton therapy as the best radio therapy method in the event of re-irradiation.

Re-irradiation with proton therapy is effective in various tumour pathologies, such as those involving the brain, the head-neck area, the lungs, the spine, the esophaegus, or the pelvis. Currently, at our centre, we evaluate re-irradiation treatments for the brain, head-neck area, spine, esophaegus, and pelvis (rectum, anus-prostate).