MedUni Vienna: Cancer in Austria: patients benefit from intensive research activity and rapid application of oncological innovations

World Cancer Day on 4 February 2022 - new radiotherapy procedure revolutionises breast cancer treatment

Cancer accounts for a quarter of all annual deaths in Austria. According to Statistics Austria, however, the risk of developing cancer or dying from it is declining. This is due, among other things, to the fact that new procedures and new knowledge are constantly being obtained as a result of intensive cancer research in Austria and the fact that medical innovations can be quickly introduced into everyday clinical practice. One example of this is a new radiotherapy regime that will benefit around one-third of breast cancer patients. This innovative procedure is being pioneered by the Department of Radiation Oncology of MedUni Vienna and University Hospital Vienna.

In addition to surgery and drug therapy, radio-oncology or radiation therapy is one of the three main pillars of cancer treatment. As in all areas of oncology, intensive research is being conducted in the field of radiation oncology with a view to improving treatments and reducing side-effects.

Cancer researchers at the Comprehensive Cancer Center (CCC) of MedUni Vienna and University Hospital Vienna are also helping to improve procedures in this area. One example of this is our participation in a large-scale, international study of partial breast irradiation using brachytherapy in low-risk patients, that is to say patients with small breast tumours without lymph-node involvement, which has received a great deal of attention in specialist circles. In this procedure, the radiation source is temporarily introduced into the tissue via several applicators. In contrast to whole breast irradiation, partial breast irradiation only targets the area from which the tumour was previously surgically removed. The study showed that partial breast irradiation using brachytherapy protects against recurrence just as well as traditional whole-breast irradiation, while exposing far less normal tissue, such as skin, lungs or heart, to radiation. As a result of this finding, partial breast irradiation has quickly become established as a standard treatment in Austria as well. In addition to brachytherapy, partial breast radiation therapy by means of external beam irradiation has also become established over the last few years and is currently performed on an outpatient basis within one to three weeks with excellent tolerability.

Drastic reduction in treatment time with excellent tolerability

However, even conventional radiotherapy has been revolutionised over the last few years. Since the 1980s, it had been standard procedure for patients to undergo five to six weeks of daily radiotherapy after breast-conserving surgery and even after a mastectomy and this amounted to between 25 and 30 treatments. As early as 2013, long-term data on so-called hypofractionation showed that reducing the treatment to 15 radiotherapy sessions produces equally good treatment outcomes with fewer side-effects.

The most recent data on the shortening of treatment times, which have been incorporated into the latest treatment guidelines from the European Society of Radiation Oncology (ESTRO), now show that, for a significant proportion of breast cancer patients, as few as five radiation treatments are sufficient to achieve optimum treatment outcomes. Although, with five treatments, there is a significant increase in the daily radiation dose, this is offset by a drastic reduction in the total dose and overall treatment time. Daniela Kauer-Dorner, from the Department of Radiation Oncology of MedUni Vienna and University Hospital Vienna and member of the CCC explains: "This means that our patients can now have an equivalent treatment outcome for a lower radiation dose and fewer side-effects (skin irritation and fatigue) and less time expenditure. This is particularly relevant for women who work, have children to look after or live a long way from the treatment centre."

Rapid implementation of the innovation

The ESTRO guideline for the administration of ultrashort radiotherapy was published in January. The Department of Radiation Oncology of MedUni Vienna and University Hospital Vienna is already preparing to implement the treatment regime at the start of the second quarter of 2022. Joachim Widder, Head of the Department of Radiation Oncology at MedUni Vienna and University Hospital Vienna and Head of the CCC comments: "The new radiotherapy regime is the result of consistent clinical research and is based on the highest level of evidence. It revolutionises the treatment of early-stage breast cancer by not only offering patients a better quality of life with the same treatment outcome, but by making radiotherapy even more efficient than before."

Prevention essential

In addition to the advancement of diagnosis, therapy and follow-up treatment, the representatives of the CCC are keen to emphasise that prevention is particularly important and meaningful when it comes to cancer. Widder comments: "Many cancers were preventable. For example, smoking, chewing or sniffing tobacco and even passive smoking, excessive alcohol consumption and an unhealthy lifestyle with minimal exercise, significantly increase the risk of developing cancer. With HPV vaccination, cervical cancer and potentially other cancers may disappear completely in a few decades time."

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