Radiation Oncology

Varian - TrueBEAM (Linear Accelerator)

TrueBeam is one of the advanced linear accelerator that integrates all the accessories, the hardware and the software needed to treat cancer patient with external beam radiotherapy with all possible prevailing techniques.

3-DCRT (3-Dimensional Radiation Therapy):

This technique allows giving the highest possible dose of radiation to the tumor, while sparing the normal tissue as much as possible.

IMRT (Intensity-modulated radiation therapy):

This technique is an advanced type of radiation therapy technique using conformal beams for the tumors thereby sparing the nearby organs effectively.

VMAT (Volumetric Modulated Arc Therapy):

In VMAT (Rapid Arc) technique, the linear accelerator rotates around the patient during which the beam is modulated to deliver as desired volume. This technique delivers the highly shaped conformal beam to tumors in a very short time.

IGRT (Image Guidance Radio Therapy):

IGRT is a Guidance technique to ensure the patient position, tumor as well as organ locations precisely by using either an on board X-ray image or a cone beam CT image before delivery of the radiation dose. The verified locations of the tumor can be positioned using 6D (6-Dimensional) couch. This technique enables to deliver the highly shaped IMRT and VMAT beams to tumor accurately in order to achieve the expected clinical goals.

RGSC ( Respiratory Gating for Scanners):

Respiratory Gating and motion management is a gating technique that monitors breathing movement of the patient during CT as well as Treatment. It follows the breathing pattern of the patient and controls the radiation beam as per the tumor movement. It minimizes radiation exposure to normal tissues, which is useful for treating lung and liver tumors.

SRS/SRT/SBRT:

• Stereotactic Radio Surgery (SRS) is a technique to deliver a high dose to the tumor in a single fraction by using either Image guidance based IMRT or Rapid Arc.
• Stereotactic Radio Therapy (SRT) and SBRT (Stereotactic Body Radio Therapy) are the techniques used to deliver high dose to the tumors in fewer fractions by using either Image guidance based IMRT or Rapid Arc.
• Flattening Filter Free beam also called as True Beam with higher dose rate can be used in SRS/SRT/SBRT treatment plans to deliver highly conformal dose in a shorter time.

BLOOD IRRADIATION:

For immune suppressed patient treatments, irradiation of the blood and its products can be done.

Total Body Irradiation (TBI):

TBI is used along with chemotherapy to destroy diseased cells in the body, blood, and bone marrow. It may also be used to suppress or lower the immune system to allow the donor bone marrow to engraft.

Gamma MedPlus-iX HDR unit

It is a Brachytherapy treatment machine loaded with an Iridium 192 isotope with 24 channels, with 48 dwell positions per channel available for treatment. It is single reversed stepping source with a stepping size varying from 1-10mm and a dimension 0.9mm dia x 3.5mm length with a half life span of 73.8 days. The activity of the source is 10 curie (10Ci). It is high dose rate machine with a dose rate of more than 12Gy per hour.

• Brachytherapy is a type of internal radiation therapy in which a small radiation source (Iridium-192) is placed inside or in close proximity to the tumor.
• Brachytherapy is often used to treat cancers of the head and neck, breast, cervix, prostate, and esophagus.
• Brachytherapy allows delivering higher doses of radiation to more-specific areas (in or near the tumor).

The following techniques are used in our Brachytherapy facility. The techniques are classified as per the placement of catheters and/or needles and flexible catheters at various places.

The various techniques and the tumors that can be treated with each are listed below:

• Intra cavity Brachytherapy (ICBT):
  • Carcinoma cervix
  • Carcinoma Endometrium
• Intra luminal Brachytherapy (ILBT):
  • Carcinoma esophagus
• Interstitial Brachytherapy (ISBT):
  • Head and neck carcinoma
  • Carcinoma cervix
  • Carcinoma Breast
  • Soft tissue sarcoma
  • Penile carcinoma
  • Carcinoma Prostate
  • Carcinoma anal canal
  • Mould or surface :
    • Carcinoma penis superficial
    • Skin cancers
    • Keloids

PET-CT simulator:

• The PET-CT images enable better delineation of the tumor based on the metabolic activity.
• This system has the capable of acquiring 4DCT images which are used for gating treatment.