A few weeks ago the RTOG3515 study (PACIFIC 4) was launched as an international trial that will include the main centres involved in the treatment of lung cancer in the world. Humanitas, with its Medical Oncology Units directed by Professor Armando Santoro and Radiotherapy and Radiosurgery Units directed by Professor Marta Scorsetti, has also been selected to participate in the study.

The study involves the treatment of patients with primary pulmonary neoplasia during the first stage, to be treated with stereotactic radiotherapy (SBRT – treatment already standard in in inoperable patients) with a subsequent randomization (i.e. a random choice) to a treatment with one of the new generation immunotherapists (Durvalumab) or placebo. The aim of the study is to assess whether the addition of immunotherapy after radiotherapy can significantly reduce the risk of recurrence of disease and thus improve patient survival.

Humanitas is the first centre in Italy to receive Radiotherapy accreditation

As part of the procedures for being selected to participate in this study, one of the key steps was the accreditation of radiotherapy to assess the ability to perform the required treatment according to the highest international standards. Humanitas was the first centre in Italy to be internationally accredited as having all the requirements for participation in the RTOG3515 trial.

Humanitas Radiotherapy has extensive experience in SBRT treatments. They are radiotherapy treatments that deliver a high dose of radiation directly to the tumor volume, minimizing it to the healthy critical organs, with extreme accuracy and precision, in terms of dosimetry, mechanics and imaging.

The accreditation required an external dosimetric technical audit by MD Anderson, conducted at Humanitas by the Radiotherapy Medical Physics service. The MD Anderson Center, located in the United States, is a global benchmark in cancer prevention, education, research and treatment. In 2018, it was again ranked first as the “best hospital” in the United States’ annual cancer report.

How does the accreditation verification work?

Accreditation has developed in several stages that analyzed the entire Humanitas SBRT treatment process, following the path of the radiotherapy patient.

An anthropomorphic model provided by the MD Anderson center and defined as “puppet”, simulates the patient with its respiratory movements and with the presence of critical internal organs such as lungs, marrow and heart, in addition to the lesion to be treated. The puppet was subjected to radiotherapy treatment as if it were a real patient, starting with the acquisition of CT images and optimal treatment planning, up to pre-treatment dosimetric verification and final delivery.

Thanks to the physical presence of detectors and films inside the puppet, through experimental measures it was possible to verify the correspondence, accuracy and precision of the absorbed radiations with those prescribed by the clinician, i.e. of our entire workflow, in every aspect from the planning of the treatment to its completion. The verification also involved the accuracy of the daily positioning of our patients, analyzing randomly and anonymously the images acquired in our department every day before the radiotherapy.

The results obtained by Humanitas have largely met the criteria established by MD Anderson and the study groups that collaborate with him, far beyond the limits required.