Professor Zhang Yuxi: Radiotherapy is still the most potent tumor therapy

Professor Zhang Yuxi, Professor of Life at the University of Texas MD Anderson Cancer Center, Director of Thoracic Radiation Oncology and Stereotactic Radiology, Chairman of the Radiation Lung Cancer Group of the American Society of Radiology, and Chairman of the China-US Radiation Oncology Association. Committed to stereotactic radiotherapy for the treatment of tumors, is the top expert in radiation oncology research. Professor Zhang is an associate editor of the Journal of Radiation Oncology Biology Physics (Red Journal) and a member of the editorial board of many international medical journals including the Journal of Thoracic Disease (JTD).

A few days ago, Professor Zhang shared his understanding of radiation tumors with the editor of the Lilac Garden and analyzed the role of American radiotherapy in cancer treatment.

Lilac Garden : Please tell us about the role of radiation therapy in cancer treatment in the United States.

Professor Zhang : As we all know, there are three main treatment methods for cancer treatment. One is surgery, the other is chemotherapy, and the other is radiation therapy. About 70% of all cancer treatments in the United States require radiation therapy during treatment; 70% of these are radical or involved in radical treatment, including primary or secondary treatment in radical treatment. And 70% of these 70% of radical (participatory) treatments are cured; that is, radiation therapy cures / participates in the cure of 35% of tumors. In the United States, the cure rate of tumors is about 60%-70%, that is, half or more than half of the tumors are cured by or with radiation therapy. In addition, data from the US Federal Health Service show that the cost of all treatments for radiation therapy is less than 5%, that is, we use less than 5% of social resources to cure/participate in treating 35% of cancer patients. Not to mention its role in other palliative care. It can be said that radiotherapy is the most effective treatment method when the indications are met.

Lilac Garden : As far as you know, what are the differences between the domestic hospital radiology department and the United States?

Professor Zhang : The update of radiology equipment in large hospitals in China is very fast, but there is a big difference. The number of patients in domestic hospitals is very large. Many people have large hospitals. The load on large hospitals is too large, so many It is very difficult to do very fine. In the United States, one machine receives 30-40 patients per day, while a domestic one receives 100 or more patients every day, so it is really difficult to do it; again, every hospital in China The differences between the experience and the training of radiologists are also uneven. This is a place where improvements can be made, so I think the problem with software is more important, that is, the training of personnel in the United States, a radiotherapy department. The doctor first graduated from college for four years, four years of doctoral studies, and five years of radiotherapy, and finally the radiotherapy doctor. In contrast, the domestic training period is much shorter, so there is indeed a gap here. In the United States, the best students in colleges and universities apply to medical schools, and the best students in medical schools report radiotherapy. Therefore, the overall quality of radiotherapy doctors is very high, which is why American radiotherapy doctors have higher clinical and academic status. one.

Lilac Garden : Do you know what misunderstandings people have about radiation therapy?

Professor Zhang : Some people think that radioactivity "causes" cancer, not "treats" cancer; (everyone) fears that radiation damages normal cells and thinks it will cause cancer. People often ask, doctors in radiology often do for patients. Radiation therapy, will not lead to infertility, etc. In fact, the current (doctors, patients) are well protected, there will be no such situation. In fact, radiation is not terrible. Every day in our daily life, we are exposed to radioactive materials. For example, a day's CT radiography is actually equivalent to the amount of radiation we must receive in a year. Radiation itself is of course not beneficial to the human body. If it is not necessary, we can avoid it. However, from the perspective of tumor treatment, the significance of this dose on tumor treatment is much greater than its possible side effects. of.

The second misunderstanding is that everyone thinks that radiological equipment is more expensive. Indeed, its initial investment is very expensive, but the general radiology equipment is put in one operation. After the equipment is started, the patient can be treated as long as the power is plugged in every day, and the cost can be recovered. Compared with chemotherapy, many imported drugs for chemotherapy and targeted therapy, the annual investment is more than 10,200,000, or even the US dollar, which is a huge investment than the radiation equipment, so from the perspective of hospital investors Said that its price-to-price ratio is also relatively high.

Lilac Garden : What development space do you think has in domestic radiotherapy?

Professor Zhang : I think we need to change the hospital, the formulation of national policies and the public's views on radiation therapy. If we think that radiotherapy is only a palliative treatment, surgery is the only cure. Secondly, people change it. The fear of radiation therapy. In fact, everything has side effects, drinking water will also catch up, driving will also crash, side effects are not afraid, mainly we need to know how to apply, how to avoid. In fact, there is already a lot of data showing that in the treatment of early stage lung cancer, the cure rate and survival time of stereotactic therapy for radiotherapy are no different from surgical resection, and even data published in some major journals show that in some cases The effect of radiotherapy is better than surgical resection. Side effects and surgical procedures have side effects. For example, the resection of lung cancer patients accounts for 5% of the deaths from surgical complications within 30 days of surgery. There may be 5 patients who died of complications, but in contrast, radiation therapy did not say that they died of radiation therapy within 30 days in the early treatment of lung cancer. People are more likely to accept traditional surgical methods because surgical treatment has existed for a hundred years, and it is difficult to accept new treatment methods. This is understandable, but there is an intellectual handover, and people need to receive new treatments. In some cases, its therapeutic effect is the same as surgery, and even some things that surgery can't do can still be done. I am happy to do some handover with the domestic radiotherapy community, the oncology community and the public. In fact, through my personal contact, many Chinese patients have given up surgery and received radiation therapy, especially in some early, older patients with poor lung function. obvious.

Lilac Garden : Can you tell us about the progress made at the MD Anderson Cancer Center?

Professor Zhang : My center has treated nearly 2000 cases of early stage lung cancer with stereotactic treatment. The rate of disease control is 98.5%, that is, only 2 patients in 100 patients have relapsed. This number is no longer good. . I am not saying that radiotherapy can cure all patients, or all of them require radiation therapy, but in the right circumstances, with good quality control and good technology, it has many functions that are much better than people think. In this regard, I prefer to have more exchanges with the domestic people.

Lilac Garden : Thank you for sharing!