Khaberni - Progress in medical physics has long been a cornerstone in developing effective and safe cancer treatment methods. Thanks to advanced medical imaging and modern radiation therapy techniques, it's now possible to diagnose tumors accurately and precisely direct radiation doses to the tumor, allowing for the destruction of cancer cells while preserving the surrounding healthy tissues. In the field of diagnostics, techniques such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and nuclear imaging (such as PET-CT) have contributed to detecting cancer at its early stages and accurately determining its spread, which makes treatment plans more personalized and effective. With advancements in tumor tracking devices during treatment sessions, it's now possible to monitor the tumor's location and movement in real time using MRIguided Radiotherapy or CTonrails, allowing for continuous adjustment of doses and realignment of treatment plans based on the actual condition of the tumor. This cycle of assessment and improvement is known as Adaptive Radiation Therapy, and studies have shown that it reduces unnecessary exposure to healthy tissues and improves the accuracy of dose delivery to the tumor.
In the area of treatment, advanced techniques such as Proton Beam Therapy and IntensityModulated Radiation Therapy (IMRT) have been adopted. According to a systematic analysis and review of 11 studies involving more than 3000 patients with head and neck cancers (including 606 treated with protons and 2394 by IMRT), the results showed that proton therapy was associated with higher overall survival rates: after one year, two years, and five years—as well as improved disease-free survival and tumor control rates compared to IMRT. Proton toxicity was also lower: a significant decrease in mucositis, taste disturbances, swallowing difficulties (dysphagia), fatigue, pain, and weight loss.
In a study conducted on patients receiving ipsilateral radiation in the head and neck areas to treat salivary gland tumors or skin cancers, for example, the use of protons was associated with a significant reduction in doses to critical areas such as the brain stem, spinal cord, mouth, and salivary glands compared to an IMRT plan, which translated into a significant decline in acute complications such as mouth inflammation, nausea, and taste problems.
In treating female cancers (such as endometrial cancer), a study conducted by a group of centers reported that patients who received proton therapy reported lower rates of intestinal toxicity compared to those who received IMRT, suggesting that protons might improve the patient experience in terms of side effects.
In cases of brain tumors in children, like Medulloblastoma, recent analysis found that survival outcomes (Overall and Progression-Free Survival) after proton therapy were nearly equivalent to those of traditional photon radiation therapy, meaning that protons may offer the same effectiveness with the potential for reducing radiation exposure to healthy tissues.
Results also show that some major care centers - such as the Mayo Clinic in the United States - apply protons in several types of cancer (brain tumors, breast cancer, head and neck cancers, prostate cancer, and others) due to their precision and ability to reduce side effects compared to traditional radiation therapy.
However, not everything is conclusive: another study on Oropharyngeal Cancer patients comparing protons and IMRT as radiation treatment methods showed that tumor survival and disease-free rates after two years were close: 94.3% for protons versus 96.8% for IMRT, and overall survival 94.6% versus 95.3%. Also, no significant differences were recorded in patient quality of life or swallowing and nutritional functions between the two methods.
Based on this data, it is clear that medical physics today - through advanced imaging and treatment technologies - is no longer just an auxiliary tool, but has become a fundamental pillar in both diagnosing and treating cancer. While proton therapy shows clear superiority in reducing side effects and improving the safety of surrounding tissues in many cases, options like IMRT remain important and effective, especially when protons are not available.
Continued scientific research, the use of specialized centers, and the development of precise techniques for dose adjustment and treatment planning - especially in complex tumors or tissues sensitive like the head and neck, children, or tumors near vital organs - are seen as gateways to a more accurate and effective medical future, where diagnosis is more precise, treatment more specialized, and side effects fewer, leading to increased chances of recovery and improved quality of life for patients.
In conclusion, physics is one of the major pillars of scientific, medical, and industrial development in the modern world. It forms the basis of innovations that make a difference in disease diagnosis and treatment, in the development of renewable and nuclear energy technologies, and in advanced industries and materials sciences, as well as in scientific research and medical technologies that save lives daily. Promoting a scientific culture about the value of physics, and its deep role in human life, is a fundamental step towards building an aware society that values science, supports creativity, and believes that specialized scientific fields are the gateways to the future and real progress.
