Advances in Intraoperative Treatments

Interview Prof. Wenz, University Medical Center Mannheim, Department of Radiotherapy and Radiation Oncology · 2018

Interview Prof. Wenz

In radiotherapy, brain tumor treatment is considered a supreme discipline. What are the particular challenges here?

When it comes to treating tumors in human brain, technical innovations and medical research have resulted in considerable advances. This concerns radiotherapy above all else: such treatments can be administered in precise doses and in a targeted manner, and give patients much better perspectives. The difficulties still lie in the rare yet sometimes serious consequences of radiotherapy, such as neurological complications or mental disorders, which is why qualified rehabilitation and neurological follow-up treatment are key.

That means the greatest need for research is in this area. To what extent has medicine advanced in recent years?

Dynamic developments have been recorded in the technology of medical devices. The aim is to integrate the radiotherapy systems that are used before, during and after surgery. Looking to the future, digital models with augmented reality could be the next step.

How do you think the treatment will advance, and what should the priorities be?

In terms of further development, the focus is on integration. In particular, targeted intraoperative radiotherapy (IORT) is a focal point for tumors that cannot be removed completely.

What needs to be done to ensure these advances are permanently implemented?

I believe that structured procedures are vital in oncology, for instance to create guidelines and establish systematic training programs. Targeted research is one way of ensuring this. In particular, I’m referring to the comprehensive INTRAGO II study on IORT, which is multi-centric and global in scope. Four centers in Germany are taking part in this study.

What is the standard of care in the treatment of brain metastases?

In cases of brain metastases and the associated symptoms, fast surgical resection is the method of choice for immediately relieving pressure in the brain and minimizing any long-term damage. Radiation therapy is normally a second step in the treatment procedure, or is prescribed in the absence of any acute symptoms, however radiation therapy is currently administered standardized with external radiation therapy after wound healing.