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Anales de la Facultad de Ciencias Médicas (Asunción)

Print version ISSN 1816-8949

An. Fac. Cienc. Méd. (Asunción) vol.52 no.2 Asunción Aug. 2019 


Advanced radiant oncology

Gustavo Adolfo Guggiari1 

1 Ministerio de Salud Pública y Bienestar Social, Instituto Nacional de Cáncer. Itauguá, Paraguay.

Even though, more than half the number of oncological patients will at some point require radiotherapy, this is still now, one of the less known oncological treatments 1.

The German physicist Wilhelm Conrad Röntgen may have started the History of Radiotherapy in December 1895 through his discovery of ionizing radiation which is used, nowadays, in image medicine, nuclear scintigraphy and radiotherapy.

In January, 1896, a homeopathic physician, Emil Grubbe, in the United States, applied the first radio-therapeutic treatment, using X rays for a period of an a female patient with an inoperable breast cancer 2.

Radiotherapy has undergone an important technological and scientific transformation, in the past it was considered part of Radiology, whereas now is an oncological specialization.

The development of Radiant Oncology has been amazing. From the old orthovoltage equipment, the cobalt units or pumps to the sophisticated equipment that emit multiple types of radiation as the modern multi-leaf linear photon or electron accelerators, as well as the newer proton accelerators which have considerably increased the therapeutic effectiveness of the treatment while diminishing the toxicity linked to modern therapeutic schemes 3.

At present, Advanced Radiant Oncology uses very high doses of radiation restricted to the tumor or to the tumor bed with minimum irradiation to healthy tissues which reduces the risks of medical complications.

These technological developments increased the healing indexes using the techniques of advanced radiotherapy, for instance IMRT(Intensity Modulated Radiation Therapy) or IGRT(image-guided Radiation Therapy) Stereotactic Radiotherapy, Intraoperative Radiotherapy, Radiosurgery, High dose rate Brachytherapy and radiotherapy with Proton accelerators all of which assure the application of clinical indications within protocols and treatment guides with a dynamic approach adjusted to each individual patient which is now known as adaptive radiation therapy 4.

The addition of new specialized personnel, like medical physicist, radiobiologists, dosimetrists, technicians, maintenance engineers and specialists in radiation protection demonstrate that advanced radiant oncology is a highly complex specialization which requires highly trained human resources and permanent technological updating.

50% of the patients under radiant treatment are submitted to it because of curative indications whereas the other 50 % are under palliative indications.

In the initial stages healing indexes reach 90 %.

Nowadays it is estimated that one of the above mentioned highly sophisticated equipment is needed for each 500.000 inhabitants. In our country 14 (fourteen) such equipment are needed to meet the demand, taking into consideration our population. Hence, we are more than 60% behind at present, in terms of necessary equipment 5.

Only second to cardiovascular conditions, cancer is the most important cause of death, it is probable that in the next few years with the increase of incidence, cancer will be the first cause of death in the country.

The challenge we face is to increase the number of advanced radiotherapy equipment in the country so as to cope with the present needs and also with the foreseeable expansion of demand in the next few years


1. Xia P, Godley A. Strategies For Radiation Therapy Treatment Planning, 2019.Springer Publishing Company. [ Links ]

2. Urdaneta N, Vera A. Radioterapia Oncologica. 2009. (27-58). MMIX DISINLIMED C.A. 2009. [ Links ]

3. Calvo F. Oncologia Radioterapica. 14-121. 2010. Ediciones Aran Madrid España. [ Links ]

4. Jawerth N. El comienzo de una nueva era, La radioterapia destruye más células. Boletin I Ciencia y Tecnologia nucleares. OIEA (Organismo Internacional de Energia Atómica), 2019 https//www-pub-iaea.orgLinks ]

5. Mai K Bish. Radiation Therapy Availabity in Africa an LatinAmerica. INTERNATIONAL Journal Of Radiation Oncology Biology Physics. Volume 102 490-498 November 2018 [ Links ]

Received: June 08, 2019; Accepted: June 11, 2019

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