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A new technique has reduced the number of radiation therapy sessions for prostate cancer. For the disease, usually 40 sessions are planned. With the so-called moderate hypofractionation treatment, he has reached 20 years. Now, the first ultrahypofracted radiotherapy initiatives against this type of tumor appear in Brazil, reducing the number of sessions to five
In this format, doses of radiation on the tumor, which allows for fewer applications . The approach, also known as extreme hypofractionation or SBRT, is already adopted against certain types of cancer, such as lung cancer. But it's new when it comes to the prostate – second most prevalent in men. It is estimated that this year will be 68,220 new cases of the disease.
It has been offered in recent months at the hospital Sírio-Libanês and at the Hospital Mãe de Deus of Porto Alegre. In the A.C. Camargo cancer center, the first two cases of SBRT were observed this month. "The benefits are a shorter treatment time, less discomfort with moving, and probably an improvement in the biochemical control index of the disease," says Antônio Cássio Pelizzon, head of the department. AC Camargo radiotherapy team
. Alemão Oswaldo Cruz Hospital, in São Paulo, is also preparing to adhere to extreme hypofraction for prostate cancer, after installing a new equipment in Brazil, Halcyon linear accelerator. In addition to allowing fewer sessions, this makes each session faster – from 25 minutes to eight minutes. "Instead of treating four patients an hour, I can treat six." It expands access, adds value and reduces the cost of innovation, "says Rodrigo Hanriot, radiation therapist coordinator at the University of Toronto. 39, hospital
. For now, extreme hypofraction for low-risk or intermediate-risk prostate tumors. Patients with chronic urinary problems are not good candidates – studies show that, especially in this group, there can be side effects (burns and increased urinary frequency), says Andrea Barleze da Costa, director of radiotherapy of the Mother of God
. ] Moderate hypofraction has gained momentum after ten Phase 3 (high level of evidence) clinical trials conducted in large research centers have demonstrated that the technique is as effective as conventional. For Arthur Accioly Rosa of the Brazilian Society of Radiotherapy, the model is a paradigm shift.
Efficient, the technique has become a trend in several countries. But, as Elton Leite of the São Paulo Cancer Institute (Icesp) says, extension in the country involves problems related to equipment and compensation models. To apply high doses of radiation safely, technology is needed to monitor the precise location of the tumor.
One option is IGRT (Image-guided Radiotherapy), available in Brazil and without compensation by the SUS and the operators. Another is Calypso, recently installed by the Syrian, who works with the emission of signals – devices implanted in the prostate warn (25 times per second) if it is on the target and, in case of deviation, the radiation is interrupted
. In general, radiotherapy in the country is paid according to the total number of sessions – if there are fewer, the value decreases. "It's a real paradox," explains João Luís Fernandes da Silva, from Sírio's radiotherapy department. When José Nei Garcez, 80, discovered that he had prostate cancer, in March 2017, he started a cancer treatment program in which he was diagnosed with prostate cancer in March 2017 . treatment. The resident of Dom Pedrito (RS), on the border with Uruguay, went through doctors from two other cities before being reported for extreme hypofractionation at the Mãe de Deus hospital.
After a week, he went home. "If it was several days, I could get sick and I was homesick," he says. "Treatment in less time was a great benefit for the emotional aspect," says daughter Clarisse, 41. He, who does hormone treatment every three months, says that he has no side effects. "Today, I feel good, it was a success."
See the most common types of cancer in Brazil:
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