By Dr. Bùi Lê Phước Thu Thảo, Specialist II, Radiation Oncologist, Vinmec Central Park Hospital Cancer Center
More than 50% of cancer patients are recommended to undergo radiation therapy. To stop the tumor's growth while minimizing the impact on surrounding healthy tissues, radiation therapy requires the highest intensity and precision. Vinmec Central Park is one of the first hospitals in Vietnam to use the most advanced radiation systems worldwide and apply them in many complex medical cases.
Precision in Radiation Therapy to the Millimeter
With symptoms of headaches and nausea, Mr. Đ.C. Bình (34 years old) visited Vinmec Central Park Hospital, where he was diagnosed with a multi-focal germ cell tumor in his brain, causing ventricular dilation. After surgery for biopsy and ventriculostomy, his condition worsened unexpectedly, with altered consciousness and coma.
The medical team at Vinmec Central Park immediately consulted and recommended emergency whole brain and spinal cord radiation therapy (including the brain and spinal cord) while Mr. Bình was still in a coma and on a ventilator. This radiation technique is highly complex as it involves four adjacent radiation fields, posing risks of dose overlap (potential permanent spinal cord damage) or dose deficiency (risk of recurrence). Therefore, the patient's radiation treatment required strict precision to the millimeter to avoid any errors.
The VMAT (Volumetric Modulated Arc Therapy) technique used for Mr. Bình ensured that the radiation dose was accurately distributed to the targeted tumor volume while minimizing impact on surrounding healthy tissues. This cutting-edge technique offers near-perfect precision, detecting and correcting even the smallest discrepancies (<1mm) before treatment begins.
Fortunately, after three rounds of radiation, the tumor shrank, the ventricular dilation and intracranial pressure improved, and Mr. Bình regained consciousness. After two years of treatment, follow-up MRI scans showed that the brain tumors had completely dissolved, and he returned to normal life.
Dr. Bùi Lê Phước Thu Thảo, Radiation Oncologist at Vinmec Central Park, said:
"High-tech radiation therapy focuses precisely on the tumor's location, effectively killing cancer cells while minimizing the impact on surrounding organs and tissues. This approach helps patients avoid the side effects typically seen with older radiation techniques."
Traditional radiation techniques have limitations, often causing damage to surrounding healthy tissues. High-tech radiation technologies at Vinmec now allow for personalized treatment plans, significantly reducing damage, preserving healthy organs, and minimizing pain to help patients cope with treatment. This is considered a breakthrough in cancer radiation therapy, and Vinmec is one of the first hospitals in Vietnam to implement these special technologies.
Application of Radiation Therapy in Complex Cases
High-tech radiation therapy has many forms: VMAT for head and neck, stomach, esophagus, and pelvic cancers; SRS (Stereotactic Radiosurgery) for central nervous system tumors; SBRT (Stereotactic Body Radiotherapy) for lung and liver cancers, combined with synchronized breathing techniques (4D-RT) for breast, liver, and lung cancers. All these techniques share the ability to focus high radiation doses on the tumor in a short time while minimizing radiation to surrounding healthy tissues. This achieves optimal treatment outcomes, reduces radiation time, and minimizes side effects.
Mr. N.M.Lý, 70, was diagnosed with prostate cancer during a routine health checkup but did not want surgery due to its risks and potential complications. He came to Vinmec for radiation therapy advice. The doctors at Vinmec recommended high-dose radiation therapy while preserving surrounding healthy tissues like the bladder and rectum. Using older techniques for such high doses was nearly impossible, as it was difficult to control the radiation dose to nearby healthy organs, posing a high risk of complications.
Therefore, Vinmec's oncology department recommended the VMAT technique with near-perfect precision. This technique helped concentrate the radiation dose to the exact tumor volume while minimizing dose to surrounding healthy organs. With the help of the integrated CBCT (Cone Beam CT) imaging system (IGRT), the tumor and healthy organs were checked before each radiation session, ensuring accuracy and minimizing post-treatment complications. Additionally, any minor patient movements during treatment were detected by the OSMS surface monitoring system, which would automatically stop the radiation if the displacement exceeded the allowed limit. After radiation therapy at Vinmec, Mr. Lý responded well, and his cancer was under control, making radiation therapy an effective alternative to surgery.
High-tech radiation therapy can be used as a substitute for surgery, pre- or post-operative radiation to shrink tumors and prevent cancer cell growth. It is also used for late-stage cancer patients and other complex cases.
Mr. Đ.V.Chiến, 50, a patient with stage III nasopharyngeal cancer treated in 2005, later developed stage IV tongue base cancer in early 2021, and was initially recommended for simple radiation at another hospital. However, he came to Vinmec for consultation and was advised to undergo intensive radiation therapy combined with chemotherapy.
Dr. Bùi Lê Phước Thu Thảo, Radiation Oncologist at Vinmec Central Park, noted:
"Second-time radiation for head and neck cancers is challenging due to the toxicity from previous radiation and the high risk of toxicity from the second round. Some head and neck organs have low radiation tolerance, and re-radiating them risks permanent damage, such as to the spinal cord, salivary glands, or lower jaw."
In this case, the patient underwent radiation combined with chemotherapy, which, though increasing treatment toxicity, enhanced effectiveness and yielded better results. The VMAT technique used for this patient ensured that the radiation dose was sufficient for the tumor and metastatic lymph nodes while maximizing protection of nearby healthy organs, minimizing side effects, and improving the patient's quality of life.
Using precise radiation techniques combined with chemotherapy, Mr. Chiến showed complete clinical response. After two years of treatment, he returned to normal life, maintaining a good quality of life without significant difficulties.
Another complex case – Mr. T.N.Thịnh, 59, with stage IV esophageal cancer, had extensive damage and complete esophageal narrowing, making it impossible for the patient to eat or drink. After treatment at Vinmec, the patient had a gastrostomy to nourish him, followed by successful chemo-radiation therapy that shrank the tumor and metastatic lymph nodes, paving the way for subsequent esophagectomy surgery.
These complex cases at Vinmec show that precise radiation techniques are essential for preventing tumor growth without harming surrounding tissues and preserving other organs. This approach increases survival rates and improves quality of life for patients.
Clearly, radiation therapy plays a crucial role in cancer treatment and has important applications for various medical conditions such as preoperative radiation, conservative surgical replacements, and combined radiation therapy for complex cases.
With its modern infrastructure and expert team, Vinmec Central Park offers cancer patients the assurance of effective treatment in Vietnam, saving time and costs while achieving the best results. Cancer treatment requires collaboration among multiple specialties. All cancer cases at Vinmec are discussed in multidisciplinary tumor boards to develop comprehensive treatment plans for optimal outcomes. The oncology department is a key area of focus and is being developed into Vietnam's first center of excellence in cancer treatment, offering internationally standard cancer care and giving hope for healthier lives to cancer patients.
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