SBRT technology and the latest updates on radiotherapy technologies, is it effective or does it come with the whole package of side effects and discouraging results?
Introduction:
Did you know that cancer incidence in 2023 in the United States alone was 1,958,310 new cancer cases and 609,820 cancer deaths(1) and the numbers are unfortunately increasing year by year. Cancer rates are not the only thing increasing, but hopefully, Cancer therapies also. And today we are discussing one of the latest radiation therapy techniques used in oncology, and that is the Stereotactic Body Radiation Therapy and what makes it different from other radiotherapy techniques.
Some of the questions this article will answer:
- What is SBRT and what are the types of cancer does SBRT treat?
- How does SBRT ensure the least damage to surrounding tissues?
- What are the advantages of SBRT? What are the side effects of SBRT?
Background on Cancer:
To understand how this new technology works, we need first to know some basic concepts about cancer and tumors, what are they? How do they develop? And most importantly how generally do cancer therapies treat cancer?
As a rule of thumb, our body cells live in a state of balance (homeostasis), a balance between cell growth and cell death. Once this balance disrupts and moves towards cell growth, whether due to genetic causes, chemical agents, or even environmental causes, cells start to grow uncontrollably and abnormally, this is simply cancer.
Most cancer types share many common characteristics that you can notice in every tumor, some of these are the spreading to surrounding tissues (metastasis), building its blood supply for further growth and defense against the body’s own immunity, etc.
Cancer therapies tend to attack these characteristics and oppose them to stop further growth and spreading. For example, a therapy can cause blockage to a tumor’s blood supply leading to regression in size and growth.
Radiotherapy Basics:
Radiation therapy, or radiotherapy, treats cancer by using powerful rays (like X-rays) to damage or kill cancer cells. The goal is to stop these cells from growing and spreading.
How It Works:
During radiotherapy, the rays target the cancer cells and damage their genetic material (DNA). This makes it hard for cancer cells to grow and divide, eventually causing them to die. The challenge is to do this while causing as little harm as possible to healthy cells, which is not the case for most radiotherapy solutions.
Historical Evolution:
Scientists discovered a long time ago that certain specific types of rays could affect living tissues. Over the years, they improved the usability of these rays to be used for cancer treatment. Advances in technology have made that possible and made treatment more precise, reducing side effects and making it a more effective tool against cancer.
Introduction to Stereotactic Body Radiation Therapy:
Stereotactic body radiotherapy (SBRT) is a type of radiotherapy that uses multiple beams of energy. The beams are carefully delivered in precise intense doses of radiation, targeted on growths of cancer cells, anywhere found in the body, while reducing as much as possible damage to healthy tissue. The precision of beam delivery is achieved by using sophisticated imaging involving three- or four-dimensional imaging that exactly pinpoints the location of the tumor.
SBRT is also called stereotactic ablative radiotherapy (SABR). When used on the brain, it is often called stereotactic radiosurgery (SRS).
SBRT is typically used to treat small early-stage lung cancer, pancreatic cancer, or metastatic cancers that have spread to the lung, liver, adrenal gland, or spine(2). Also, SBRT can shrink tumors, stop the spread of disease, and even stimulate the body’s immune system to fight cancer.
How does SBRT work?
SBRT uses several radiation beams of different intensities aimed at the tumor from different angles. This requires one or more treatment planning sessions. During the sessions, the patient will have a CT scan, MRI, or any other imaging exam. Doctors use these images to point to the tumor’s exact specific location and shape. Then, using these images, oncologists create a customized treatment plan that sets the angles and strengths of the radiation beams.
After planning, patients undergo between one and five SBRT sessions. Sessions are either once a day or once every other day. Most sessions last about 30 minutes.
SBRT is delivered through devices called linear accelerators. These devices form beams of fast-moving subatomic particles, as a result all types of stereotactic body radiotherapy work similarly. The device focuses beams of radiation on the target. Each beam does little damage to the tissues it passes through. The spot where all the beams meet gets a high dose of radiation.
The high dose of radiation causes tumors to downgrade in size. Over time, this radiation causes blood vessels to close, starving tumors from their blood supply.
But how does SBRT ensure the least damage to surrounding tissues?
SBRT uses 3D or 4D imaging and highly concentrated radiation beams to deliver radiation to the targeted area. This results in the least amount of damage to the healthy tissues around the area.
Advantages of SBRT:
- SBRT is usually an outpatient procedure. This means you likely won’t need to stay in the hospital after treatment.
- Each treatment takes mostly up to an hour and usually is not necessary to have someone come with you to treatment.
- SBRT isn’t painful and thus requires no anesthesia. You’ll be able to talk to a member of your healthcare team or a family member during the procedure.
- SBRT is usually given in five or fewer daily sessions. This can ensure better outcomes and fewer side effects than traditional radiation therapy. Traditional radiotherapy is typically delivered in relatively small doses each day over several weeks and this can delay or interfere with other cancer treatments, such as chemotherapy.
What are the side effects of SBRT?
Side effects can be early and/or late side effects.
- Some of the early side effects:
- Hair loss in the treatment area
- Mouth problems and difficulty swallowing
- Eating and digestion problems, and NVD (nausea, vomiting, diarrhea), etc.
- On the other hand, late side effects that You may develop a cough, shortness of breath, or rib pain months after your treatment.
- One common side effect of SBRT is fatigue.
- Other side effects depend on the tumor’s location, for instance, a patient treated for an abdominal tumor may get gastrointestinal side effects. A patient with a tumor near the bones could experience bone damage, etc.
Conclusion:
In summary, this article explores the role of Stereotactic Body Radiation Therapy (SBRT) in modern cancer treatment. SBRT stands out for its precision, exactness, and delivering highly intensive doses of radiation to target tumors while causing the least damage to surrounding healthy tissues. We discussed the treatment process and how SBRT works. We also mentioned some of the advantages of SBRT, including shorter treatment duration and reduced side effects, making it a significant advancement in cancer care
This article also highlights the importance of considering SBRT as a viable treatment option, thus readers and concerned cancer patients are encouraged to explore SBRT as part of their cancer journey. However, a crucial emphasis is placed on consulting healthcare professionals for more detailed advice and make decisions tailored to their unique medical situations. Ultimately, SBRT represents a promising and hopeful approach within the wide range of cancer therapies.
References:
(1)cancer incidence in 2023 in the United States
(2)types of cancer that SBRT is used in
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