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  • Tolgay Şatana

Proton Beam Therapy

Used in radiotherapy

In malignant and invasive benign skeletal tumors, radiotherapy is applied in addition to chemotherapy before / after surgery. Since sarcoma cells are more sensitive than carcinomatous cells and the majority of skeletal tumors have this structure, radiotherapy continues to be used as part of the treatment.

Radiotherapy reveals its lethal effect by stopping the division in cells with increasing proliferative rhythm. Since normal cells are also damaged during regeneration in the entire area where the rays are targeted, Proton Beam Therapy has emerged as a result of investigating therapies that focus directly on the tumor area to reduce unwanted effects.

Proton beams, without using X-rays like conventional radiotherapy agents, can deliver intense radiation to the tumor area with beams as wide as the size of the tumor, or even very narrow beams. While reaching the tumor, it is a great advantage that it does not pass behind the targeted tissue, although it causes radiation by passing through the normal tissues.

This is why proton beams are tried to be applied to the patient as shortly as possible by giving certain positions, since the focusing of the radiation beam, which concentrates only on the tumor area, cannot be performed yet. With a good planning, no matter how deep the tumor is, the most appropriate treatment is planned by selecting the ray trace.

In which types of cancer is it effective?

Most childhood tumors are extremely sensitive to radiation.

  • Prostate cancers,

  • Brain tumors,

  • Spinal tumors,

  • Skeletal Sarcomas (Muscle / Bone / Cartilage),

It is effective in breast cancers and their metastases.

How is proton therapy different from conventional radiotherapy?

Proton Beam Therapy is known to cause less tissue damage than conventional radiotherapy. It destroys the cancer cells without damaging the surrounding tissues and the tissues behind the tumor. Compared to conventional radiotherapy, the 3-year survival rate is expected to exceed fifty percent. The number of fully healed cases is increasing.

Proton beam acquisition is very costly and difficult compared to conventional radiotherapy. It requires the construction of a special building the size of a football field, in this center all waste systems are specially designed. A proton center costs millions of dollars and can be made operational with at least two years of work.

Advantage in Orthopedic Surgery

Orthopedic tumor surgery results in limb loss in severe cases. Removal of large areas of limbs, especially pelvis and spine tumors, may not be compatible with life. In this case, it is a fact that Proton Beam Therapy and radiotherapy prolong life in cancers that cannot be reached or removed.

In treatments that require limb loss, radiotherapy can never be a preference for limb protection, but it helps prevent limb loss. Orthopedic tumor surgery can be given before surgery to reduce the margins. Concomitant chemotherapy is often applied. After surgery, the disappearance of satellite tumors or the spread of the tumor is greatly reduced by radiotherapy.

Tumor Treatment in Our Center

International algorithms are valid in the approach to orthopedic tumors in our clinic. Treatment is planned after tumor classification and grading of patients diagnosed with or detected masses. Classification of tumor size (T), lymph node extension (N) and metastasis status (M) is the basis of a classical approach, but when the tumor grading depends on the cell structure, biopsy is the basic step of the algorithm after obtaining almost accurate information about the tumor type according to radiological scientific experience. . Biopsy may be needle, excisional, marginal or may include compartment.

Limb preserving or treatments that will cause limb loss are not applied before the cell structure is definite. After the cell structure is determined, the surgeon decides whether the cell is in situ and directs it to the treatment, this decision is definitely surgical, it is made in cooperation with the patient in line with the recommendations of the physicians who will form the council (Oncologist, Radiologist, Pathologist, etc.) If complementary or terminating surgery is delayed at such critical stages, not disrupting radiotherapy and chemotherapy will prolong life and prevent metastasis.

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