Radiotherapy

   
 

Radiation therapy is the use of exact, carefully measured dose of ionizing radiation to treat diseases, primarily cancer. About 60% of cancer patients require radiation therapy either with an objective of cure or with an intent to give relief of some distressing symptoms. Many a times, radiation therapy is prescribed as a part of multimodal therapy in conjunction with surgery and/or chemotherapy.

At Jaslok Hospital, radiotherapy facility was initiated in 1973 and till now a large number of patients have been treated. With changing scenario, there is need for better health care with newer technology. Therefore, modernization from time to time and upgradation projects have been taken up to equip this premier medical centre with most sophisticated and ultramodern radiotherapy equipments.

   
  Linear Accelerator:
 

At Jaslok Hospital, Radiation Oncology Services include state-of-the-art equipments as a part of the multidisciplinary approach for comprehensive management of cancer. Technologically advanced “Primus” Linear Accelerator with Multi-Leaf Collimators (MLC) can deliver radiation precisely targeting higher cancericitdal dose to the tumour at the same time keeping the radiation dose lower to the nearby normal/critical organs. The Primus Linear Accelerator generates 6 and 15 MV X-rays and six ranges (energies) of Electron beam which makes it possible to select the appropriate energy of radiation to suit different anatomical & clinical situations.

The Institution has procured one new Linear Accelerator (ONCOR Expression) which can deliver the most modern radiotherapy like Intensity Modulated Radiotherapy (IMRT), Image Guided Radiotherapy (IGRT) & Adaptive Radiotherapy (ART). ONCOR Expression is Siemen’s leading edge linear accelerator featuring Mvisionfor mega voltage 3D Imaging (MVCBCT). The 1000 ST amorphous silicon flat panel portal imaging device for 2D and 3D MV imaging provide wide choice to the oncologist to decide on a given clinical situation. Oncor expression combine leading edge hardware with Syngo-based work space applications such as Adaptive Targeting allowing optimized delivery of IMRT & IGRT. The system is supported for Gated Therapy facility which takes care of internal organ motion and avoids radiation beam to go outside the planned target volume. To summarise the ONCOR Expression is capable of delivering precise radiation dose to the target volume while allowing adequate protection of the surrounding normal tissue / critical organ to achieve best treatment outcome.

   
  Treatment Planning Computers:
 

The incorporation of computer technology into radiotherapy has lead into more sophisticated treatment planning. New comprehensive radiation therapy treatment planning computers offer state of the art dosimetry algorithms combined with morden user interface and sophisticated graphics. These systems allow configurations, which suit clinical requirements. The department is eequipped with Helax-TMS, CMS Xio, PLATO & KonRad Treatment Planning Systems.

3D conformal radiotherapy is feasible for technologically superior treatment delivery. The CMS Xio Treatment Planning System is used for 3D-CRT planning. System is capable of capturing different modalities of imaging i.e. CT scan, MRI, PET scan. These images can be co-registered (fused) for better target delineation. Softwares are available for virtual simulation, multiple plan review in addition to different types of radiation planning. The KonRad TPS is meant exclusively for IMRT planning.

   
 
  Simulation:
 

Simview 2000 is the therapy simulator in use for treatment planning. Optimal beam arrangement is transferred to the patient through the Simulator and it allows alignment of multiple beams of radiotherapy and assessing complicated set-up. When one optimal beam arrangement has been selected, it must be transferred to the patient. A simulator is used for this purpose. It is a modified X-ray unit mounted on a machine similar to a treatment unit to simulate the movements and give a beam's eye view of the patient. This allows the alignment of multiple beams and provides a means of assessing the feasibility of complicated set-up. The screening facility allows real-time visualisation of internal structures.

In addition to the conventional Simulation, we have the newer technique of CT Simulation where in CT scan of the patient is obtained to be transferred electronically through network to the workstation for Simulation (ie placement of beams to target the tumour) and then the simulation parameters are transferred back into the patient.

   
  Microselectron HDR Brachytherapy:
 

Brachytherapy is a special radiotherapy procedure where radioactive sources are inserted into the tumour as a result of which high dose of radiation can be delivered to the tumour area. The adjoining healthy organs are protected. The radioactive material is carried into the tumour through applicators or catheters specially designed for this purpose. The movement of radioactive sources is carried out through computerized remote control unit. The small, flexible source cable can negotiate tight corners; it allows treatment of anatomically complex and difficult sites.

The Microselectron HDR Brachytherapy unit is designed to meet strict safety and reliability parameters and provide better treatment control. The upgraded PLATO Brachytherapy – Remote. Afterloading System is a comprehensive software package for treatment planning of remote after loading brachytherapy techniques. It is designed to streamline the treatment planning process with a clinically based user interface. The software can quickly reconstruct the implant via radiographs, transverse images (CT, MRI, USG) or co-ordinates, activate the source positions and optimize the treatment time to meet all clinical applications. The treatment times are immediately exported to the treatment unit for safe and effective treatment of the patient.

Moreover, with High Dose Rate (HDR) Brachytherapy unit, high dose can be delivered within a short treatment time. The procedure can be carried out on out-patient basis. Tumours of lung, breast, oesophagus, oral/nasal cavity, uterus etc can be better treated by incorporating brachytherapy as a part of planned radiation therapy.

The “Local Area Network Therapy Information System” (LANTIS) is used to capture patient related information including images and to transfer data into therapy management system (Linear Accelerator). This makes the treatment electronically controlled, which is faster and more accurate. LANTIS helps verifying treatment set-up, scheduling activities and producing quality-control checklist.

X-knife Stereotactic system is used for Stereotactic Radiosurgery/ Stereotactic Radiotherapy in brain lesions where extremely small radiation fields are used and delivered using the principles of stereotaxy.

With all these equipments Jaslok Hospital offers state of the art technology for treatment of cancer. To meet the demand of a section of patient, the hospital has offered treatment using Telecobalt (Theratron 780 E) unit. Moreover, the department has also been well equipped with quality assurance tools. The aim of quality assurance is to guarantee performance of the therapy equipments and a high degree of accuracy in dose delivery essential for the success of radiotherapy.

Jaslok has a group of qualified and experienced professionals to carry out the treatment using high-tech equipments. Specialists are available for consultation, planning of treatment and its implementation, follow-up to assess treatment response and advice for post-radiation management. The ancilliary staff is competent and courteous; they help the patients during their course of treatment.

Jaslok Hospital is a teaching Institute accreditated to the National Board of Examinations (NBE). We conduct Diplomate National Board (Radiation Therapy) course with intake of Post-graduate students. The department is active in clinical and research activities to maintain a high standard of academic performance.

The modern equipment with expertise available, Jaslok provides advanced and optimal radiotherapy, which is on par with any of the well-established centers in the world.