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Letter to the Editor
Intensive care in cancer patients in the age of the multidisciplinary approach of cancer treatments: The radiotherapy perspective
Cuidados intensivos de pacientes oncológicos en la era del tratamiento multidisciplinar: la perspectiva desde la oncología radioterápica
A. Illescas-Vacas
Corresponding author
aillesva@gmail.com

Corresponding author.
, N. Abu-Omar, C. Míguez, E. Bayo-Lozano
Unidad de Oncología Radioterápica, Unidad de Gestión Clínica de Oncología Radioterápica y Radiofísica, Hospital Universitario Virgen Macarena, Sevilla, Spain
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    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Intensive care in cancer patients in the age of the multidisciplinary approach of cancer treatments&#58; The radiotherapy perspective"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have been following with great interest Carmona-Bayonas et al&#46;&#8217;s paper on the multidisciplinary approach that needs to be taken into account in the prognosis of cancer patients who are experiencing reversible critical conditions&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> We are on the same page with the authors when they talk about the progress made in the management of multiorgan failure in intensive care units &#40;ICU&#41;&#44; added to the revolution we have experienced in the anti-tumor therapeutic arsenal&#44; which leads to re-think the real possibilities of patients with severe acute conditions with neoformative processes&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">However&#44; when it comes to describing the therapeutic advances made in the management of cancer patients&#44; the authors do not mention the use of radiotherapy &#40;RT&#41;&#46; As a matter of fact&#44; there has been a revolution in the field of cancer radiotherapy during the last few years and this is something that should be taken into consideration&#44; since this also contributes to increasing the life expectancy of patients with neoplastic diseases who can end up in the ICU&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As Atun et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> put it &#8220;Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care&#8221;&#46; As a matter of fact&#44; the new modalities of RT including its applications in intensity-modulated radiotherapy &#40;IMRT&#41;&#44; image-guided radiotherapy &#40;IGRT&#41;&#44; high dose-rate brachytherapy &#40;HDR&#41;&#44; stereotactic body radiation therapy &#40;SBRT&#41;&#44; stereotactic radiosurgery &#40;SRS&#41;&#44; proton therapy&#44; and carbon ion radiotherapy &#40;CIRT&#41; have significantly improved local control&#44; the possibilities of survival&#44; and the quality of life of patients&#44; and all thanks to optimizing the distribution of the radiation dose absorbed in the tissues with millimetric accuracy&#46; A recent example includes the use of SBRT for the management of non-small cell lung cancer in early stages&#44; where dose hypofractionation significantly increased local control and the overall survival of these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Also&#44; during the last few years&#44; it has gained special interest the immunomodulating effect of RT&#44; that has been enhanced when adding the immunotherapy drugs described by Carmona-Bayonas et al&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Such an effect increases antigen expression giving immune cells more capability to recognize and destroy the tumor&#46; Surprising findings such as the response of non-irradiated metastatic lesions at a distance from the tumor treated with RT have already been reported&#46; This effect known as the abscopal effect is part of the actual experimental lines and future progress of this type of cancer treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Lastly&#44; and as it was already exposed by the scientific journal <span class="elsevierStyleItalic">Nature</span> back in September 2015&#44; if we want our initiatives to successfully impact health and improve scientific knowledge&#44; a multidisciplinary approach of medical conditions is essential&#44; where each specialist plays a particular and fundamental role to improve our results&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Illescas-Vacas A&#44; Abu-Omar N&#44; M&#237;guez C&#44; Bayo-Lozano E&#46; Cuidados intensivos de pacientes oncol&#243;gicos en la era del tratamiento multidisciplinar&#58; la perspectiva desde la oncolog&#237;a radioter&#225;pica&#46; Med Intensiva&#46; 2018&#59;42&#58;569&#8211;570&#46;</p>"
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Article information
ISSN: 21735727
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