Abstract
When Roentgen discovered the X-rays 125 years ago, his finding was soon recognized as a breakthrough in research and awarded with the Nobel Prize. Today X-rays are widely used in natural and applied sciences and even art. In medicine, X-rays have made an impressive impact far beyond their original domain of diagnostic imaging. In cancer treatment, X-rays are indispensable for reaching the goal of uncomplicated and lasting tumor control. Using the possibilities of modern technology and the innovative mind of physicians and physicists, definitive cancer cure cannot only be achieved by combination of surgery and radiation, but also by radiotherapy alone. One prominent example is the application of single high radiation doses with optimal geometrical precision through image-guided stereotactic radiotherapy. The article aims to highlight past, current, and future sustainable developments in oncology in general, but in radiation oncology, especially. We discuss the very complex challenge of generating evidence by clinical research. In this context, the tumor registries play a very important role. The data of tumor registries and the results of clinical studies demonstrate the benefit for cancer patients who experienced individualized radiotherapy. For cancer cure, it is most important to treat in an early, localized stage of the disease.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Abel S et al (2019) Stereotactic body radiation therapy in early-stage NSCLC: historical review, contemporary evidence and future implications, Lung Cancer Manag 8(4). https://doi.org/10.2217/lmt-2018-0013
Burger K et al (2017) Multi-harmonic generator and synthesizer for experiments in tailored, intense femtosecond laser fields. In: 2017 conference on lasers and electro-optics Europe & European quantum electronics conference (CLEO/Europe-EQEC), Munich, p 1. https://doi.org/10.1109/CLEOE-EQEC.2017.8086733
DEGRO press release, Strahlentherapie verdoppelt Überlebenszeit bei oligometastasiertem nicht-kleinzelligen Lungenkrebs [Radiation therapy doubles survival in oligometastatic non-small cell lung cancer], 5 July 2019
Demaria S et al (2004) Ionizing radiation inhibition of distant untreated tumors (abscopal effect) is immune mediated. Int J Rad Oncol Biol Phys 58(3):862–870. https://doi.org/10.1016/j.ijrobp.2003.09.012
Eckert F, Fietkau R, Fokas E, Gaipl U, Hecht U, Krause M (2018) Statement on radiotherapy in combination with immunotherapy, german society for radiooncology, 24th Annual Meeting
Feyerabend P (1980) Erkenntnis für freie Menschen [Knowledge for free people]. Edition Suhrkamp
Gomez D et al (2019) Local Consolidative therapy vs. maintenance therapy or observation for patients with oligometastatic non–small-cell lung cancer: long-term results of a multi-institutional, Phase II, randomized study. J Clin Oncol 37(18):1558–1565
Grosu A et al (2007) Hypoxia imaging with FAZA-PET and theoretical considerations with regard to dose painting for individualization of radiotherapy in patients with head and neck cancer. Int J Radiat Oncol Biol Phys 69(1):541–551
Grotzer et al (2015) Microbeam radiation therapy: clinical perspectives. Phys Med 13(6):564–567
Heindl W (2019) Lecture DEGRO congress, Münster
Horsmann MR, Vaupel P (2016) Pathophysiological basis for the formation of the tumor microenvironment. Front Oncol 6:66
Kessel K.A et al (2016) Mobile apps in oncology: a survey on health care professionals’ attitude toward telemedicine, health, and oncological apps. J Med Internet Res 18(11):e312
Molls M, Vaupel P, Nieder C, Anscher M.S, ed (2009) The impact of tumor biology on cancer treatment and multi-disciplinary strategies. Springer
Munafò M, Nosek B, Bishop D et al (2017) A manifesto for reproducible science. Nat Hum Behav 1:0021. https://doi.org/10.1038/s41562-016-0021
Pfeiffer F et al (2008) Hard-X-ray dark-field imaging using a grating interferometer. Nat Mater 7:134–137
Physics World: Clinical linear accelerator delivers FLASH radiotherapy, 23 April 2019
Postow MA et al (2012) Immunologic correlates of the abscopal effect in a patient with Melanoma. N Engl J Med 366:925–931
Sauer R et al (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. In The New England Journal of Medicine October 21, 2004 N Engl J Med 2004; 351:1731–1740. https://doi.org/10.1056/NEJMoa040694
Speech by Health Minister Jens Spahn on 18 January 2020, at the DLD Innovation Conference in Munich
Stadler P et al (1999) The hypoxic subvolume influences the prognosis of head and neck cancer. Int J Radiat Oncol Biol Phys 44(4):749–754
Streffer C, van Beuningen D, Bamberg M, Eigler FW, Schabronath J (1984) An approach to the individualization of cancer therapy—determination of DNA, SH-groups and micronuclei. Radiotherapy 160:661–666
Süddeutsche Zeitung, 29 December 2019, Newsletter. Deutscher Hochschulverband [German Association of University Professors and Lecturers], 1/2020
Vogel MME et al (2017) mHealth and application technology supporting clinical trials: today’s limitations and future perspective of smartRCTs. Front Oncol 13 March 2017. https://doi.org/10.3389/fonc.2017.00037
Wasserstein RL, Schirm AL, Lazar NA (2019) Moving to a world beyond “p < 0.05” . Am Stat 73:1–19. https://doi.org/10.1080/00031305.2019.1583913
Yung-Hung L et al (2019) 5-year overall survival in patients with lung cancer eligible or ineligible for screening according to US Prevention Services Task Force criteria: a prospective, observational cohort study. Lancet Oncol 20(8):1098–1108
Zimmermann et al (2006) Stereotactic hypofractionated radiotherapy in stage I (T1–2 N0 M0) non-small-cell lung cancer (NSCLC). Acta Oncol 45(7):796–801
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Molls, M., Dapper, H., Specht, H. (2022). The Future of Cancer Therapy with X-rays: Patient Numbers, Innovations, Clinical Trials, and the Problem of Generating Evidence. In: Wilderer, P.A., Grambow, M., Molls, M., Oexle, K. (eds) Strategies for Sustainability of the Earth System. Strategies for Sustainability. Springer, Cham. https://doi.org/10.1007/978-3-030-74458-8_20
Download citation
DOI: https://doi.org/10.1007/978-3-030-74458-8_20
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-74457-1
Online ISBN: 978-3-030-74458-8
eBook Packages: Chemistry and Materials ScienceChemistry and Material Science (R0)