"Video" Gospel!Real -time adjustment of the radiotherapy target area and dose, the latest technology allows patients to "eat less rays"

Author:Yangcheng Evening News Yangche Time:2022.09.20

Text, picture, video/Yangcheng Evening News all -media reporter Zhang Hua Niu Zhijie

Intern Shu Anqi

With the rapid development of tumor medical care, excellent tumor therapy technology has emerged endlessly. Among them, radiation therapy has become one of the three major treatment methods of tumor clinical treatment because of its targeted, painless, and non -invasive characteristics. However, radiological surgery has not been fully developed at present, and the speed of promotion is limited by equipment. The standards and meanings of precise radiotherapy are still a relatively vague concept for the tumor medical industry.

On September 17th, at the 2022 CSCO Oncology Precision Medicine Conference and Precision Radiotherapy Summit Forum, hosted by the China Clinical Oncology Society and the Guangzhou Anti -Cancer Association, and hosted by Guangzhou University of Traditional Chinese Medicine, the reporter learned the latest precision radiotherapy technology, especially the latest precision radiotherapy technology, especially During the treatment process, the target area and dose are "real -time adaptive", and precise radiotherapy is performed to the maximum extent, thereby greatly improving the efficiency of eliminating tumors and protecting normal tissues and organs.

Latest radiotherapy technology

"Real -time adaptive" artificial intelligence development

Over the years, precision radiotherapy has been emphasized in tumor treatment, but its goals and technologies are around the positioning, positioning and therapeutic dose of radiation therapy. Recently, new radiotherapy equipment ETHOS has entered the clinic, and the technology of "real -time adaptation" has entered the more accurate era.

"Clinically, the implementation of 'adaptive adjustment' is the latest technology in radiation therapy and the most challenging technology." Vice Dean Wang Yang, the leader of the Radiotherapy Discipline of Jinshazhou Hospital of Guangzhou University of Traditional Chinese Medicine, told reporters, "We give it every day When the patient treats the position, the daily volume of the tumor target area will be observed through the ICBCT image. There will be some changes in the shape and position of the shape and position. The target area changes in shape and position, which will cause the position and shape of the tumor to be different every day. The change is sometimes 0.5-3 cm. The usual approach is to expand the volume of the target and the area of the irradiation to ensure that the treatment is not off. Increased the amount of irradiation around the surrounding tissue, which greatly increased the side effects of the treatment. "

"In addition, after a period of treatment, if the tumor is sensitive to treatment, the tumor will soon be reduced. If it is still continued to be treated in accordance with the original treatment plan, radiotherapy may not be accurate. Do a simulation positioning scan, and then the doctor re -outlines the target area and the treatment plan to re -calculate the dose of the ray. "Wang Yang said," This process takes two or three days. "

How can we rule out these interference factors and master the precise positioning of radiotherapy? Wang Yang said: "Accurate radiotherapy is inseparable from the support of high -precision equipment. On September 12, Warian's adaptive radiotherapy system ETHOS settled in Jinshazhou Hospital. At present, this is the third domestic and South China region. . In addition to the Jinshazhou Hospital of Guangzhou University of Traditional Chinese Medicine, only this machine has introduced this machine and the PLA 301 Hospital has introduced this machine. It is expected to enter the clinic at the end of the year. "

Wang Yang introduced to reporters that the adaptive function of the system will make adaptive adjustments on the shape of the target area and the correct position of the day before re-dose calculation. After 15-20 minutes, a new treatment plan is passed back to the return to the return to In the system, it saves time for the reconstruction of patients to make the treatment plan. From a simple position checking inspection to the position, shape, volume, the exposure doses are adjusted and re -calculated, so that the patient's treatment can be treated every day. To make precise adjustments, this new technology has promoted the concept of precision radiotherapy forward.

Latest treatment method

Radiotherapy surgery is as important as surgery

Compared with the radiotherapy of the "beard eyebrows" that was not protected in the past, the radiotherapy technology has improved a lot. Professor Long Zhixiong of the first radiological surgery chairman of the Chinese Medical Doctors Association introduced that at present, a high dose of killing the tumor during radiotherapy can be used to protect the normal tissue outside the tumor. This is the advantage of radiation surgery. It can do it. By the same dose than the original routine radiotherapy, and at the same time, the number of radiotherapy is reduced to achieve the effect of surgical resection. Especially early lung cancer, liver cancer, kidney cancer, brain tumor, brain metastases, etc.

"Like early lung cancer, international data has been confirmed that early lung cancer surgical resection and radiological surgery have been confirmed, and 5 years of survival is about 70%. Said that under the same effect, patients have a higher quality of life obtained by radiotherapy. "Professor Long Zhixiong said.

In addition, like liver tumors, surgery may occur, or even the possibility of death. Using precision radiotherapy surgery can retain the function of the liver, and at the same time eliminate the tumor. For another example, patients with laryngeal cancer can speak normally after radiotherapy; radiotherapy for patients with cervical cancer can also retain female sexual signs. There are uterus and ovaries, and the quality of life of patients will be higher.

Professor Long Zhixiong pointed out that the biggest advantage of radiation surgery is to protect normal tissue and organs during radiotherapy, which makes the goal of tumor treatment not only live longer, but also better. Therefore, I also hope that my country's radiotherapy level can reach a higher level, and more doctors can accept new concepts of radiological surgery, so that more patients can get this treatment.

Emphasizing precision individualization, and at the same time, the precise treatment of "combination boxing" combined with the treatment of tumors is almost 80%of the entire precision medicine. Professor Luo Rongcheng of Jinshazhou Hospital of Guangzhou University of Traditional Chinese Medicine pointed out that tumor treatment emphasizes precision individualization and combined combination of combination. "I used to treat a patient with breast cancer, using endocrine therapy, and tumor metastasis occur in one year. Finally, we used a 4 -cycle combined with venous chemotherapy and switched to oral drugs for treatment. Endocrine therapy, because the new endocrine therapy drugs have appeared. At present, patients have stable condition and have just been over 20 years since the illness. Such patients are everywhere. Posted the treatment plan according to the condition. "

Therefore, from another perspective, tumors have become a chronic disease. Luo Rongcheng said that for breast cancer, 10 years of survival is a low standard; 30 years of survival is the basic standard. "I have been in the whole patient for 18 years recently. The tumor has recurred, but the condition is still well controlled."

At present, the targeted therapy and immune therapy of tumors have also achieved rapid development. Luo Rongcheng said: "The progress of tumor immunotherapy can be said to be the fastest and most flavorful in all fields. Although overall, the efficacy of immunotherapy is only 10%-15%, but through molecular typing, the indicators of predictive efficacy are displayed well if they are good. Then the efficacy of immunotherapy can reach 45%-50%of some people, which is also amazing. "