Proton Beam Therapy, a revolution in radiation oncology, brings a new ray of hope to cancer patients

HYDERABAD: Apollo Proton Cancer Centre (APCC), the first and only proton treatment centre in South Asia and the Middle East, has successfully treated an 11-year-old girl from Hyderabad with a brain tumour and a 16-year-old girl with skull base chordoma with proton beam therapy (PBT).

Joshmitha sought a complete examination following complaints of headache, weakness of the left upper and lower limbs, and mouth deviation to the right. An MRI of the brain revealed a big malignant growth on the right side of the brain. During surgery, she was diagnosed with Ependymoma of the right temporoparietal lobe, a rare brain tumour occurring in youngsters.

A follow-up MRI scan after a few weeks of brain therapy revealed a residual mass in the same location. After a detailed discussion with a multidisciplinary tumour board meeting, another surgery was planned at Apollo Proton Cancer Centre, followed by postoperative radiotherapy.

She was recommended proton beam therapy because of her young age, potential for long-term control, and the need to protect the functions of essential structures such as the visual and auditory cerebral pathways, as well as the brainstem. There was a significant improvement after proton therapy, and she is still living a healthy life.

The expected number of cancer incident cases in India in 2022 is 14,61,427. According to the International Association of Cancer Registries (IARC), about 24,000 people die from brain tumours each year. The APCC has so far treated 336 cases of brain tumours, 20 of which were from Telangana.

Kancharla Akhila, a 16-year-old girl, was evaluated for right eye deviation and underwent two endoscopic debulking surgeries in Hyderabad in 2021 before being diagnosed with skull base chordoma, a rare tumour that typically occurs in inaccessible locations, such as near the base of the skull or adjacent to the spinal cord.

A multidisciplinary tumour board evaluated her at the APCC, and she was advised to have surgical debulking followed by immediate postoperative radiotherapy. Relatively resistant tumours, such as chordomas, require extremely high doses of radiation for the successful eradication of the disease.

She was given consideration for proton beam therapy because high doses of radiation to such a young child could endanger her ability to carry out fundamental tasks. This treatment enables the safe delivery of high doses of radiation while sparing normal, healthy structures.

Dr Srinivas Chilukuri, Radiation Oncologist, Apollo Proton Cancer Centre, Chennai, said “Proton beam therapy is the most sophisticated form of radiation therapy currently available in the world. At the Apollo Proton Cancer Center, we have the latest PBS technology, which enables us to deliver highly focused protons, spot-by-spot and layer-by-layer, encompassing the entire tumour with a reduced or even no dose to the adjacent healthy tissues. In cases such as this, where the tumour is in a risky location such as the base of the skull or in the lung, proton therapy delivers a beam of protons to disrupt the tumour and better target radiation to the size and shape of the tumour without damaging the surrounding healthy tissue. It has been proven to be successful in curing or controlling many cancers when used appropriately. Proton therapy reduces the immediate and long-term side effects of treatment in many patients, leading to not just an improvement in survival but also survivorship.”

Sharing her experience on the treatment received, Patient Kancharla Akhila said, “I am very truly thankful to the Apollo Proton Cancer Centre team for their constant care and attention to give me a healthy life. I will always be grateful and thankful to them for giving me a new lease of".

Joshmitha said, “Being at APCC for my cancer treatment was the silver lining among the darkest of clouds in my life. I am grateful to my doctors and staff for being supportive and understanding of every need I had as a patient. I would strongly recommend the finest treatment to any friend who is hoping to win over cancer.”

“My treatment for cervico-medullary pilocytic astrocytoma at APCC was a holistic experience. The doctors and clinical staff were very considerate of my choices and had a detailed treatment plan in place. Intensity-modulated proton therapy was a game changer in my battle with a brain tumour. The environment was such that I didn’t feel like a hospital,” says Mr Navadiya Jemin Mansukhbhai, who was treated at APCC.

The major advantage of proton therapy treatment is that protons slowly deposit their energy as they travel towards the cancerous tumour and deposit most of the radiation dose directly in the tumour without damaging the body further thus maintaining healthy tissues and organs without any complications.

Proton therapy has been shown to have excellent local control of various cancers located in some of the most difficult areas such as skull-base regions of the body which are otherwise difficult to treat. The latest breakthroughs in this technology including pencil beam scanning, highly precise image guidance and tremendous refinements in the machine set up have led to the adoption of this technology throughout the world in hospital settings in the last few years.

Proton therapy is being used to treat a variety of cancers, including brain and spine tumours, skull base tumours, oral cancers, gastro-intestinal cancers, bone and soft tissue tumours, breast cancers, thoracic cancers (lung cancer), genitourinary cancers (prostate cancer), and, with the exception of leukaemia, primarily in paediatric cancers.