Chapter 10: Future Developments in Radiotherapy

Abstract

Radiotherapy has advanced rapidly during the past two decades, mainly through developments in high-voltage equipment and diagnostic methods that can better define tumor boundaries. Methods to improve the application of these developments are constantly being refined. Knowledge is increasing about treatment plans for different types of tumors, mainly concerning dosage and fractionation. Continued optimization efforts and quality improvements should be able to increase the 5-year survival rate among radiotherapy patients in Sweden, just with the application of current knowledge. Based on extrapolations from estimates concerning potential improvements in radiotherapy methods, it is estimated that an additional 10% of radiotherapy patients could be cured during the next 10 years. Since approximately 30% of all cancer patients in Sweden receive radiotherapy with curative intent, an additional 3% of the total cancer population could be treated with curative results. Naturally, these estimates involve some uncertainty. For example, a report from EU (1) estimated that an improvement in the quality of radiotherapy in Western Europe should improve survival for 5% of the cancer patients, a somewhat higher value than has been estimated for Sweden.

Trials are under way to use radiosensitizing substances and new laboratory tests to further define the radiosensitivity of tumors. The result may be improved, individually-oriented radiotherapy. The combination of radiotherapy and chemotherapy has mostly shown discouraging results thus far. The combination of radiotherapy and surgery is used often and further developments can be expected. The extent to which these new developments improve therapy is, however, difficult to project.