Bogusław Maciejewski
M Skłodowska Curie Memorial Institute, Poland
Title: From Roentgen discovery to stereotactic radiosurgery
Biography
Biography: Bogusław Maciejewski
Abstract
Enormous, progress in technology and radiotherapy equipment -from simple orthovoltage machines and single dose irradiation through linear accelerators, IMRT, IGRT, particle beams to stereotactic robotic radiosurgery is described and discussed. Also step-by-step progression from 1 H (Holtzknecht) to biologically equivalent doses (NBED) expressed in izobioGy2.0 in relation to dose fractionation modified from conventional to altered hyper-, accelerated and hypofractionation is exemplified by clinical results. Key role of overall treatment time and initial tumor volume seems to be - major factors determining treatment outcome in radiotherapy. Sequential combined therapy is confronted against teragnostic therapy showing therapeutic gain when combined therapeutic methods are individually designed. Importance of molecular margins and genetic and molecular profiling is discussed for selected solid malignant tumors. Significant gain in locoregional control due to combination of microvascular reconstructive surgery combined with postoperative IMRT is illustrated by clinical cases of H&N cancer. Impact of Diffusion Tensor Tractography MRI on efficacy of neurosurgery of glioblastomas is shown as example of stereotactic NeuroRadiosurgery System developed and working in the Gliwice Institute. Examples of clinical importance of molecular profiling of medullary thyroid cancer and breast, stomach and rectal cancers are presented. Significant technological and empirical improvement since Roentgen discovery about 120 years ago result in an increased efficacy of radiotherapy being on important part of individually designed combined treatment strategy.