Wir überwinden Grenzen

Freiburg study receives award at the world's most important radiotherapy congress / High-precision radiation enables good tumor control even in advanced liver cancer

Every year, the number of people in Germany who are diagnosed with liver cancer increases. Alcoholic and non-alcoholic fatty liver, viral diseases and severe obesity are some of the reasons for this. Researchers at the Medical Center - University of Freiburg have now been able to show in a study that high-precision radiation is an important treatment option for inoperable tumors. The non-invasive, millimeter-precise irradiation destroys the cancer cells with pinpoint accuracy without damaging healthy tissue. The physicians and scientists compared the success of the treatment with an established invasive procedure in which the tumor's nutrient supply is cut off. The study was awarded the title "Best of ASTRO"at the world's most important radiotherapy congress ASTRO (American Society for Radiation Oncology) at the end of October.

"Our study shows that high-precision radiotherapy is an increasingly important treatment option for liver cancer," said Prof. Dr. Anca-Ligia Grosu, Medical Director of the Department of Radiation Oncology at the Medical Center - University of Freiburg. "It is crucial that the choice of suitable therapy is made jointly by experts from different specialist areas. In this way, we can ensure that everyone receives the treatment that suits them best," says Grosu.

Only less than 20 percent of patients with hepatocellular carcinoma (HCC) can be cured surgically. The disease often only affects the previously damaged liver. This requires local treatment methods that permanently remove the tumor foci and, in particular, do not put any further strain on the liver. If the tumour has already grown into the blood vessels or metastases have appeared in the liver, transarterial chemoembolization (TACE) is the standard treatment. In this procedure, a mixture of chemotherapy and the oily contrast substance lipiodol is injected into the vessels supplying the tumor in order to cut off the tumor's nutrient supply. However, not all patients are suitable for TACE therapy. There is good evidence that external high-precision radiotherapy (SBRT) could achieve at least equivalent results. The HERACLES clinical trial was conducted to test this.

"The special thing about the study is its innovative design. Each patient received a recommendation for either TACE or radiotherapy (SBRT) from a panel of experts as part of the weekly tumor boards. The balanced distribution of patients made it possible to compare the therapies afterwards," explains PD Dr. Eleni Gkika, Managing Senior Physician at the Department of Radiation Oncology at the Medical Center - University of Freiburg. She was part of a team led by Prof. Dr. Thomas Brunner, now Director of the Department of Radiotherapy at the University of Magdeburg, who participated in the study.

A total of 40 patients took part in the study. In patients who were recommended SBRT, the tumor was already more advanced. However, the results showed that physicians were able to achieve better local control with SBRT radiation than with TACE in patients with locally advanced tumors, with fewer side effects. The average lifespan of patients treated with TACE was longer compared to patients treated with SBRT due to the more favorable tumor stages, but the difference was small.

"The advantage of high-precision radiotherapy is that it is less stressful for patients because there is no need to intervene in the vessels and usually no need for hospitalization. In addition, radiotherapy is completed in just a few short sessions, is very well tolerated and causes only minor side effects," says Grosu.

The HERACLES study, funded by the German Consortium for Translational Cancer Research (DKTK) and the Medical Center - University of Freiburg, was conducted in close cooperation between the Department of Radiation Oncology, the Department of Medicine II (Medical Director: Prof. Dr. Robert Thimme) and the Department of Radiology and Interventional Radiology (Medical Director: Prof. Dr. Fabian Bamberg) at the Medical Center - University of Freiburg.

Contact:
Prof. Dr. Anca-Ligia Grosu
Medical Director
Department of Radiation Oncology
Medical Center - University of Freiburg
Phone: 0761 270-94610