Skip to main content

The Future of Cancer Therapy with X-rays: Patient Numbers, Innovations, Clinical Trials, and the Problem of Generating Evidence

  • Chapter
  • First Online:
Strategies for Sustainability of the Earth System

Part of the book series: Strategies for Sustainability ((STSU))

  • 1024 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. 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

  2. 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

  3. 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

    Google Scholar 

  4. 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

    Article  Google Scholar 

  5. 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

    Google Scholar 

  6. Feyerabend P (1980) Erkenntnis für freie Menschen [Knowledge for free people]. Edition Suhrkamp

    Google Scholar 

  7. 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

    Google Scholar 

  8. 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

    Article  CAS  Google Scholar 

  9. Grotzer et al (2015) Microbeam radiation therapy: clinical perspectives. Phys Med 13(6):564–567

    Article  Google Scholar 

  10. Heindl W (2019) Lecture DEGRO congress, Münster

    Google Scholar 

  11. Horsmann MR, Vaupel P (2016) Pathophysiological basis for the formation of the tumor microenvironment. Front Oncol 6:66

    Google Scholar 

  12. 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

    Google Scholar 

  13. Molls M, Vaupel P, Nieder C, Anscher M.S, ed (2009) The impact of tumor biology on cancer treatment and multi-disciplinary strategies. Springer

    Google Scholar 

  14. 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

  15. Pfeiffer F et al (2008) Hard-X-ray dark-field imaging using a grating interferometer. Nat Mater 7:134–137

    Article  CAS  Google Scholar 

  16. Physics World: Clinical linear accelerator delivers FLASH radiotherapy, 23 April 2019

    Google Scholar 

  17. Postow MA et al (2012) Immunologic correlates of the abscopal effect in a patient with Melanoma. N Engl J Med 366:925–931

    Article  CAS  Google Scholar 

  18. 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

  19. Speech by Health Minister Jens Spahn on 18 January 2020, at the DLD Innovation Conference in Munich

    Google Scholar 

  20. 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

    Article  CAS  Google Scholar 

  21. 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

    CAS  Google Scholar 

  22. Süddeutsche Zeitung, 29 December 2019, Newsletter. Deutscher Hochschulverband [German Association of University Professors and Lecturers], 1/2020

    Google Scholar 

  23. 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

  24. 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

    Article  Google Scholar 

  25. 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

    Article  Google Scholar 

  26. 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

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Molls .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

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

Publish with us

Policies and ethics