LONG TERM FOLLOW-UP

Belgian physicians try and offer to all patients a follow-up after concluding the primary treatment. Radiation oncologists are no exception and prefer to keep an eye on patients, even when these patients are also followed up by organ specialists or medical oncologists. Radiation oncologist will be able to recognize possible side effects from the radiotherapy treatment and are well placed to inform patients about treatment options.

Short term tolerance

A radiotherapy treatment can induce undesirable effects in the short term (days-weeks) after the treatment. Most of these are mild, predictable, controllable and temporary. If for a given patient a more severe problem would arise, the radiation oncologist will still be in contact with this patient and propose adequate treatments.

Long-term tolerance

But in the long run, months to years after a radiotherapy treatment, there can still be 'late' toxicity induced by the radiotherapy treatment. This is specific to radiotherapy and mostly linked to late damage of neural, vascular and fibromatous tissue. Again, because of the high precision of modern radiotherapy, these problems are less prominent than before. Patients are best helped by radiation oncologists in this case, and that explains why, depending on the pathology or the body area treated, a long-term follow up can be proposed.

Outcome analysis

Modern radiotherapy is a very precise treatment technique. A radiation oncologist calculates for each small area of the body the exact dose received by the tissue and weighs between different treatment plans to obtain the best compromise between high dose on the target volume and low dose to surrounding tissue. If after a treatment there is insufficient tumour response or tumour recurrence, or if there is an undesired effect of radiation, the radiation oncologist can be greatly helped if the exact location of this problem would be available. It is then possible to go back to the initial dose distribution to verify if an explanation for the problem can be found. Closing the feedback loop helps radiation oncologist to make even better treatment decisions for future patients.