Adaptive Radiotherapy

Adaptive radiotherapy refers to the modifications made in the planning of cancer treatments after assessing the changes they have caused in both the tumor and the patient.

Adaptive radiotherapy is primarily applied in long-duration cancer treatments. This procedure is based on analyzing the evolution of the tumor's size, shape, and location, as well as variations in the patient's weight or changes observed in the organs and tissues surrounding the cancerous cells. In this way, modifications can be made to the radiotherapy dose to improve its impact on the tumor and reduce side effects.

The use of adaptive radiotherapy machinery allows for adjusting treatments daily. These studies provide information on the actual amount of radiation the patient receives, which may differ from the prescribed dose due to morphological changes, achieving a higher level of personalization. The basis of this procedure is image-guided radiotherapy (IGRT), which allows for checking the tumor's size and potential alterations in adjacent structures during each session.

How does it work?

In adaptive radiotherapy, imaging studies (computed tomography, magnetic resonance imaging, or X-rays) are combined with radiation sessions. After analyzing the images, the treatment is planned to be the most suitable, as the number of sessions, frequency, and radiation dose are determined based on both the tumor's and the patient's characteristics.

Unlike conventional methods, a new image test is performed before each new session to adjust the parameters to the actual situation. In some cases, images are taken while radiation is being administered.

What are the benefits of adaptive radiotherapy?

The main benefit of adaptive radiotherapy is that it administers the most appropriate dose of radiation based on the tumor's size, location, and shape, as well as the patient's weight.

Receiving adaptive radiotherapy allows for:

Treating tumors more effectively.
Reducing the amount of radiation healthy tissues receive.
Minimizing side effects.
Keeping a precise follow-up on the patient's progress.
Adjusting treatment in the shortest possible time.

When is it indicated?

Adaptive radiotherapy is still under development, so its application in some types of tumors is in the research phase. Currently, this type of treatment offers excellent results in various types of cancer, such as:

Lymphoma.
Bladder cancer.
Cervical cancer.
Head and neck cancer.
Lung cancer.
Rectal cancer.
Prostate cancer.

What to expect from adaptive radiotherapy

Adaptive radiotherapy sessions are usually divided into two phases that take place on the same day:

Image acquisition: The patient must remove any metallic objects they are wearing and wear the gown provided by the medical center. It is recommended not to use makeup or nail polish. Once lying on the table, a contrast substance may be administered intravenously. Afterward, the patient is moved inside the device that takes the images, which rotates around them. As the machine emits very loud noises, earplugs are provided to the patient.
Radiation administration: The patient remains lying on the table as still as possible. Meanwhile, the accelerator that dispenses the radiation moves around the area being treated. This process is painless for the patient.

Adaptive radiotherapy treatments are outpatient procedures, so the patient can resume their routine once completed. The duration of each session varies depending on the tumor's characteristics but typically lasts about twenty minutes.

Some patients report side effects, such as general fatigue or skin irritation in the area affected by the radiation.