Advanced Radiotherapy


Kauvery HCG houses the latest and best in medical technology, expertise, and innovation, so that patient can have access to the best in cancer care.

Cancer is on the rise in India due to multitude of factors. Most of the patients with cancer require radiotherapy during some part of their treatment. The availability of latest technology allows us to treat the patient with less morbidity, with better accuracy and precision. The following techniques are available at our Centre – 3D Conformal Radiotherapy, IMRT (Intensity Modulated RadioTherapy), IGRT (Image Guided RadioTherapy), RapidArc, Stereotactic treatment (SBRT) and Brachytherapy.

Flattening Filter Free (FFF)

Our centre is equipped with TrueBeam which is one of the latest Linear accelerators available in the entire world. HCG was the first in India to introduce ‘Flattening Filter Free’ (FFF) treatment in India.

The TrueBeam is precise to submillimetre level and it has dynamic motion correction. With this technology the treatment will be delivered at a very high rate so that the treatment delivery time is reduced from minutes to seconds. Escalated radiation doses can be delivered to the tumour with lesser doses to the surrounding normal tissues, resulting in fewer side effects and better tolerance to treatment.

Image Guided Radiation (IGRT)

Before daily treatment execution, patient has to be positioned correctly and his tumor should be localized perfectly to achieve treatment precision. For this we have a set of various imaging techniques such as kV cone beam CT (CBCT), Planar kV imaging, Fluoroscopic kV imaging and kV imaging during RapidArc treatment delivery for tracking. The quality of the image is very critical to ensure a good matching. The CBCT with TrueBeam provides a good quality of image.

Setreotactic Radiotherapy (SRT)

Setreotactic radiotherapy is a well established treatment paradigm for Brain tumours. The precision and accuracy of treatment preserves the important normal brain to preserve the neurocognition and other functions.

TrueBeam machine
TrueBeam machine
MultiLeaf Collimator
MultiLeaf Collimator

 

  • Radiotherapy in CNS Malignancies
    neuralgia
    MR Image of patient with Trigeminal Neuralgia
    pituitary_tumor
    Pituitary Tumor

    Radiation has important role in other common CNS malignancies which include gliomas (both high grade and low grade), oligodendrogliomas, astrocytomas, and metastatic brain tumors. In these tumors radiotherapy forms an integral part of either adjuvant or definitive treatment.

    Clinical cases:

    One of our patients presented with severe pain over the face and twitching of the muscles of left side of face for the past 3 years. MRI showed lesion in the brain which was indenting and displacing an important nerve. She was given radiotherapy using RapidArc technique which controlled her disease and she is now asymptomatic.

    Another patient was diagnosed with a pituitary tumor and post surgery he had a residual disease. As Pituitary is very close to the Eye and nerves which transmit the visual impulses to the brain, careful planning and execution of treatment is necessary to deliver correct dose to the correct site to prevent toxicity vision will be afftected. He was treated successfully for the same and his disease is now well under control.

    Brain tumours are most common solid malignancies in pediatric age group. Radiotherapy is important component for these patients who are diagnosed with brain tumours like medulloblastoma, PNET, etc. These patients have very good cure rates. Hence it is critical to reduce the dose to the normal tissue as they and should not be hampered in their future life due to the treatment related side effects.

    tumor

    Figure 1 - Radiotherapy planning for Pituitary Tumor.

    Figure 2 - This Image depicts how radiation was delivered exactly to the tumor with sparing of neraby normal brain and nerves.

    Figure 3 - Radiotherapy planning for child with medulloblastoma. The dose is very confined to the Brain and the spinal cord only.

  • Radiotherapy for Bone Tumours
    brachytherapy

    Historically radiotherapy has been used for treatment of Osteosarcoma. However Radiation is used not only for primary bone tumours but also for tumours that affect the skeletal tissue which includes Sarcoma and other round cell tumour like Ewing’s Sarcoma.

    Radiotherapy is considered when surgery is too morbid especially in centro-axial tumours, or the lesion is inoperable, or when clear margins cannot be attained, or to preserve the joint functions. Similarly Radiotherapy is integral part of adjuvant treatment for round cell tumors like Ewings. Modern radiotherapy techniques available for Bone tumors include – 3D Conformal Radiotherapy, IMRT (Intensity Modulated RadioTherapy), IGRT (Image Guided RadioTherapy) and RapidArc. These help to achieve better accuracy and precision of treatment while at the same time reduces the dose to the surrounding normal tissue.

    brachytherapy
    Brachytherapy tubes being placed over the tumor bed.

    Extracorporeal Radiation Treatment (ECRT)

    This is used for Osteosarcoma patients. It includes enbloc resection of the tumour and surrounding soft tissue which is then irradiated and then this sterilized tissue is reimplanted in to the patient’s body with or without additional prostheses. The advantage is that being patients own tissue, it is perfect fit unlike other prosthesis etc.

    HDR Brachytherapy

    Brachytherapy can be used to deliver either the entire radiation dose or part of the treatment. Immediately after surgical excision of the tumour, catheters are placed in a single plane or multiple planes so that the entire tumour bed is encompassed. After that orthogonal images or CT scan of the site is taken and radiotherapy is planned. The number of days of treatment depends on the dose to be delivered. After the treatment is completed the catheters can be pulled off. The advantage is that the treatment is completed in a few days with fewer side effects.

Back to Top