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Radiation Oncology

Radiation Oncology

Radiation Oncology is the branch of cancer medicine dealing with the administration of radiation therapy to cancer and certain benign conditions. As a treatment modality for cancer, radiation therapy has been around for more than 100 years. Radiation therapy is the use of high energy ionizing radiation to bring about cell death which in turn results in control and cure of cancer. The forms of radiation commonly in use are X-Rays, Gamma Rays and Electrons. Other charged particles like Protons and Heavy ions are also used in radiation therapy but rarely.

There are two primary modalities of radiation therapy – namely,

  • External beam radiation therapy or teletherapy where cancer is targeted by a radiation source kept at a distance (usually around 1 metre) and housed in a machine
  • Brachytherapy or internal radiation therapy where a radioactive source is introduced through tubes or catheters inside or next to a tumor
SERVICES PROVIDED

At PSG, we aim to deliver cutting edge high precision radiotherapy to the needy at affordable rates so that the gap in cancer care can be bridged.

CONFORMAL RADIATION THERAPY

We offer image based conformal radiation therapy where computer based treatment plans are generated and executed in such a way that side effects can be minimized and chances of cure maximized. Treatment is coupled with on couch imaging where in the exact relative position of the tumor and normal organs can be verified before treatment execution. The types of conformal radiotherapy offered at PSG are as follows

  • 3Dimensional Conformal Radiation Therapy(3DCRT)
  • Intensity Modulated Radiation Therapy (IMRT)
  • Volumetric Modulated Arc Therapy (VMAT)
  • Image Guided Radiation Therapy (IGRT)

STEREOTACTIC RADIATION THERAPY

A highly precise form of radiation therapy, Stereotactic Radiation Therapy includes Stereotactic Radiosurgery(SRS) and Stereotactic Body Radiation Therapy(SBRT) which uses multiple radiation beamsto achieve very high dose gradients thereby targeting extremely small targets/ targets located at close proximity to critical structures. Treatment is delivered only after image verification of relative position of target and normal tissues

Stereotactic Radiosurgery(SRS) is generally offered on a single day for lesions in the brain. When multiple sittings of radiation therapy are deemed necessary, the same process is called Stereotactic Radiation Therapy(SRT). When a similar technique is used in rest of the body – including but not limited to lung, liver, pancreas, spine and prostate – the procedure is called Stereotactic Body Radiation Therapy(SBRT).

ELECTRON BEAM THERAPY

Targets at or close to the body surface can be treated with the help of electron beams. A relatively easy but highly effective technique, electrons beams are delivered using specialized collimators and are used to treat malignancies of the skin. They are also beneficial in adjuvant breast and chest wall irradiation

SURFACE GUIDED RADIATION THERAPY

Surface guidance radiation is a relatively newer concept which helps in tracking any and all external movement of the patient while the radiation beam is on. An auto cutoff feature allows automatic beam cessation once the patient moves out of tolerance limits. This ensures that the beam is focused on the target at all times resulting in better clinical results

4 DIMENSIONAL RADIATION THERAPY/GATED RADIATION THERAPY

4 Dimensional Radiotherapy eliminates the effect of respiration on tumor motion. With respiratory gating radiation can be delivered at pre-determined specific phases of respiration thereby regularizing tumor position at every fraction of radiotherapy. This is specifically useful for tumors of the lung and upper abdomen (liver, pancreas) which are affected by respiration.

ADAPTIVE RADIATION THERAPY

Adaptive radiation therapy is a technique by which radiation treatment can be tailored to the variations in tumor size and position during the course of radiation. This takes into account the shrinkage of tumor size during a radiation course as well as relative displacements in tumor position due to changes in the relative positions of nearby structures or changes in body contours due to weight loss.

BRACHYTHERAPY

Brachytherapy or internal radiation therapy involves the placement of radiation sources via specialized catheters inside or in close proximity to the tumor. Catheter placement may/may not be done under anesthesia depending on the location of the tumor and ease of procedure. A highly conformal treatment, it helps in dose escalation in areas which are otherwise technically difficult to target with EBRT Brachytherapy techniques are usually varied depending on the applicator used and location of the tumor

  • Intracavitary Brachytherapy
    Catheters are placed inside hollow body cavities before radiation delivery
    eg. Gynecological malignancies
  • Interstitial Brachytherapy
    Catheters are placed inside the tumor or tumor bed before radiation delivery
    eg. Sarcoma, Head and neck cancer
  • Intraluminal Brachytherapy
    Catheters are placed inside hollow cylindrical organs before radiation delivery
    eg. Carcinoma of the Esophagus and Nasopharynx
  • Surface Mould Brachytherapy
    Catheters are placed at the body surface before radiation delivery
    eg. Skin malignancies
RADIATION EQUIPMENTS AND SOFTWARE

VARIAN TRUEBEAM™ SVC

A state of the art modern clinical linear accelerator equipped with multiple beam energies and designed to deliver radiation dose to various clinical sites with submillimeter accuracy. The TruebeamTM also possesses advanced imaging capabilities including gated and triggered imaging allowing seamless 4 dimensional treatment delivery. The Flattening Filter Free(FFF) beam allows delivery of radiation doses in a matter of minutes further improving patient compliance and comfort. The linear accelerator is equipped with certain high end technology which improves radiation conformality

  • ECLIPSE™ V16.1
    A highly advanced treatment planning system which helps in creating and delivering extremely conformal treatment plans as per patient requirements
  • HYPERARC® THERAPY
    A cutting edge tool which helps in treating multiple intracranial targets faster with high precision and automated imaging
  • RESPIRATORY GATING FOR SCANNERS
    Varian’s RGSC includes an infrared camera and reflector block which helps in gated respiratory phase specific radiation therapy eliminating the effects of respiration on tumor motion
  • RAPIDPLAN™
    Customized treatment plans based on Artificial Intelligence and Machine learning tailored for patient and site specific treatment.

ACCURAY RADIXACT X9 TOMOTHERAPY

Tomotherapy is a form of radiation therapy used in cancer treatment. It combines intensity-modulated radiation therapy (IMRT) with computed tomography (CT) imaging to deliver highly targeted radiation to tumors while minimizing damage to surrounding healthy tissue. In Tomotherapy, a linear accelerator (a machine that generates high-energy X- rays) is mounted on a rotating gantry that moves around the patient. At the same time, the patient is moved through the gantry on a specially designed couch. This allows for precise targeting of the tumour from multiple angles while adjusting for the patient’s position and any movement during treatment. One of the key advantages of tomotherapy is its ability to deliver radiation with highly conformal dose distributions, meaning it can shape the radiation beams to match the shape of the tumour while sparing nearby organs and tissues. This can result in fewer side effects and better outcomes for patients. Additionally, the CT imaging capabilities of tomotherapy allow for more accurate targeting of tumors and monitoring of treatment progress.
Tomotherapy is used to treat a variety of cancers, including those of the prostate, breast, lung, head and neck, and brain, among others. It may be used as a primary treatment or in conjunction with other therapies such as surgery, chemotherapy, or immunotherapy.

ELEKTA FLEXITRON HDR BRACHYTHERAPY WITH ONCENTRA PLANNING SYSTEM

Flexitron is a 10 channel High Dose Rate Brachytherapy Afterloading platform. Oncentra planning software makes advanced brachytherapy planning easy and coupled with a full set of applicators, it helps in delivering brachytherapy to all accessible sites.

 

C-RAD SURFACE GUIDED RADIOTHERAPY

The C-RAD Catalyst+ HD Optical tracking system is a complete solution for patient positioning, intra-fraction motion management and respiratory gating. Our hospital is the first to introduce the 3 camera optical tracking system in Tamil Nadu.
The C-RAD Sentinel 4DCT system is a laser based surface scanning system which helps in 4D reconstruction and gated imaging.

SIEMENS SOMATOM CONFIDENCE RT PRO 20 SLICE CT SIMULATOR

The Somatom Confidence is a wide bore dual energy CT simulator with inbuilt noise and metal artifact reduction algorithms for optimal image reconstruction and radiation planning.

VELOCITY

A comprehensive software which takes care of all patient imaging needs during, before and after treatment. It helps in easy comparisons of past treatments done across different centers using different equipment and software.

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