Radiation therapy of malignant tumors of the chest (Electronic educational course, 18 hours.)
Audience category: doctors-specialists in the areas of training: "Oncology", " Radiotherapy»
Form of training: correspondence course
Duration of training: 18 academic hours
Radiation therapy is traditionally considered one of the most effective methods of influencing the tumor focus. In developed countries, at least 50% of cancer patients pass through the radiotherapy department at some stage of treatment.
Radiation therapy is one of the leading methods of antitumor treatment, based on the use of ionizing radiation. It can be used as an independent type of therapy, or as part of a combined or complex treatment (together with other methods), as a radical, neo - and adjuvant, consolidating, preventive and palliative therapy.
More than 100 years separate us from the time when ionizing radiation began to be used in the treatment of patients with malignant neoplasms. Over the past years, there have been fundamental changes in the development of radiation therapy for malignant neoplasms, the success of which is associated with the use of new types of radiation, the development of modern treatment methods, the modernization of radiotherapy equipment, the progress of experimental and clinical radiobiology.
The study of the state of medical care in developed countries shows that more than 70% of all patients with malignant neoplasms receive radiation therapy in the form of additional, basic, or palliative methods of treatment. One of the priority areas of scientific research is the development of conservative, organ-preserving methods of treatment of patients with malignant neoplasms, allowing to preserve the quality of life of patients with high rates of treatment effectiveness. In this connection, the role of radiation therapy in the complex program of treatment of cancer patients is increasing.
Nevertheless, humanity continuously continues to study the effects of ionizing radiation on the human body. At the same time, attention is focused on both the positive and negative effects that arise when using it. New methods are being developed that allow us to achieve the maximum therapeutic effect while reducing the negative effect on the body. Equipment for radiation therapy is being improved, and new radiation technologies are emerging.
The effect of radiation therapy is based on ionizing irradiation of a certain area with a stream of particles that can damage the genetic apparatus (DNA) of the cell. This is especially pronounced in actively dividing cells, since they are most susceptible to damaging factors. There is a violation of the functions and vital functions of cancer cells, which in turn stops their development, growth and division. Thus, as a result of radiotherapy, the malignant tumor decreases in size until it completely disappears. Unfortunately, healthy cells that are located on the periphery of the neoplasm can also enter the radiation zone in different volumes (depending on the type of radiotherapy used), which subsequently affects the degree of their damage and the development of side effects. After treatment or in between radiation sessions, healthy cells are able to repair their radiation damage, unlike tumor cells.
Mediastinal tumors are a group of benign and malignant tumors, of various structures, located within the anatomical limits of the mediastinum and having non-organ origin. In the mediastinum, up to a hundred different forms of neoplasms are found, but according to modern concepts, true benign and malignant tumors of the mediastinum include neoplasms whose source of development is tissues that are embryogenetically inherent in the mediastinum, or aberrant, shifted to the mediastinal space during embryogenesis. The frequency of mediastinal neoplasms in the structure of oncological diseases is about 1 %. Malignant and benign occur and are diagnosed in a ratio of 4:1. Mediastinal tumors are detected mainly in young and middle age, men and women are equally often ill.
Lung cancer is one of the most common oncological diseases not only in Russia, but also around the world. Its treatment requires the combined use of various types of therapy, including radiation treatment. Lung cancer is currently one of the most significant problems in oncology. Over the past 20 years, there has been a sharp increase in the incidence of the disease among the world's population. At the heart of the pathology is a malignant degeneration of the epithelial cells of the lung tissue, which leads to a violation of an important function of the body - respiration, and it is impossible to make up for its insufficiency, so lung cancer is an extremely unfavorable tumor.
Over 40 years, the incidence of lung cancer has increased significantly in developed and developing countries around the world. The highest rates of morbidity were registered in Europe and the United States, the lowest - in the Eastern countries. It is worth noting that in almost all countries, the incidence among the female population is 3-10 times lower than in men. Every year, more than 1,000,000 new cases of lung cancer are registered worldwide, including 60,000 in Russia, with an increase in the incidence of 5-8%. According to statistics, cancer most often develops in the right lung (56%). This is due to the peculiarities of the anatomy: the trachea opens almost at right angles to the right lung, so it is more susceptible to the aggressive influence of adverse factors. It should be noted that in most cases, the upper lobe is affected - 60%, then the lower - 30%, and the middle-10%.
The main group of patients is men over 50 years old, although recently there has been a tendency to rejuvenate the disease. The proportion of patients younger than 45 years is 10%, from 46-60 years-52%, 61 and older-38%. Previously, this type of malignant disease was considered primarily a male pathology, but today there is an increase in the prevalence of neoplasms among women.
An alternative to surgical treatment can be radiation therapy - summing up a significant total dose locally to the tumor in a small number of sessions. Modern technologies allow us to study the tumor at the molecular and genetic level, to understand what molecular mechanisms play a key role in the tumor growth in a particular patient. This makes it possible to prescribe personalized treatment, select the optimal combination of chemotherapy drugs for each patient.
Tasks to be solved in the course of training:
1. To form knowledge about the main stages of the history of radiation therapy, types and methods of radiotherapy, as well as about modern equipment for organizing the process of radiation therapy.
2. Provide professional training of a specialist doctor, including the basics of fundamental knowledge in the field of oncology, in particular, the use of radiation therapy for the treatment of tumors.
3. To improve knowledge and skills in the field of modern technical support of radiation therapy (brachytherapy, remote radiation therapy), the use of various equipment for radiation therapy.
3. Provide the course participants with information in the field of radiobiology as a science, in order to develop the ability to interpret the results of research, differential diagnosis, prognosis of diseases, and the choice of adequate treatment in patients with oncological diseases of the chest.
4. Improve the knowledge and skills on radiation therapy to enable the specialist to plan the isodose distribution for the correct assessment of the risks of complications of normal tissues to improve the quality of life of the patient in the treatment of cancer patients.
5. To form knowledge about the features of tumor masses in the mediastinum, their detection by tomographic examination, as well as about the features of radiation therapy of mediastinal tumors.
6. Provide the course participants with information on the epidemiology of lung cancer and the general principles of treatment of unresectable lung cancer by radiation therapy.
Speakers of the advanced training course:
- Pankratov Alexander Evgenyevich, Head of the Department of Radiotherapy of the ORC Balashikha, radiotherapist, radiologist.
- Bayankin Sergey Nikolaevich, Head of the Physical and dosimetric Department of the State Medical Institution SB "Sverdlovsk Regional Oncological Dispensary".
- Alexey A. Molokov, Head of the Department of Medical Physics, ORC "PET-Technology Balashikha".
- Mikhailova Anna Vyacheslavovna, medical physicist, oncologist of the RSCI.
- Usychkin Sergey Vladimirovich, Head of the Department of Radiation Therapy, radiotherapist of the Medscan Cancer Center, Master of Science of the International Master's Program of the Madrid Institute of Oncology on modern technologies in radiation Oncology.
- Natalia V.Dengina, Head of the Department of Radiation Therapy, GUZ Regional Clinical Oncology Dispensary, Saratov, Associate Professor of the Department of Radiation Diagnostics and Oncology, Ulyanovsk State University, Candidate of Medical Sciences.