がん放射線療法 : 技術革新がもたらす真の治療適応

Technical innovation in radiation therapy symbolized by stereotactic irradiation, intensitymodulated radiation therapy, image-guided radiation therapy, and brachytherapy using remote controlled after-loading system made it possible to deliver ideally distributed radiation dose to the target with great accuracy, while sparing the adjacent organs at risk. The high tumor control ability led by new technology changed radiation therapy into effective and minimally invasive cancer therapy. What we should mention specially for radiation therapy is to have become excellent alternative to surgery for asymptomatic small brain tumors, part of early stage lung cancer or metastatic lung cancer, and low-risk prostate cancer.
In locally advanced stage of cancer, randomized controlled trials established the chemoradiation therapy as a standard treatment option for patients with head and neck cancer, lung cancer, esophageal cancer, and gynecological cancer represented by uterine cervical cancer. Radiation therapy has also important role in palliative care and oncologenic emergencies with consistently high response rates.
Minimally invasive therapy will come to be emphasized its needs in the background of increased tendency of elderly patients with cancer, and it shows us where the radiation therapy stands and has to go toward. However, much more radiation therapy professions than the present Japanese situation are indispensable to fully demonstrate ability inherent in highly-sophisticated radiation therapy technology. Establishment of an education system for radiation oncologist, radiation therapy technologist, and medical physicists is our current most important issue.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html