Vydehi Cancer Centre was one of the first centers in the country to commission Image guided radiation therapy or IGRT way back in 2007, a very high end radiation unit. At Vydehi Cancer Center, the second linear accelerator machine, Versa HD-Stereotactic Precision Radiotherapy unit (Triple F) located in new Radiation zone was inaugurated on 6th February 2017 by honorable Health Minister of Karnataka. Featuring high precision beam shaping and tumor targeting, Versa HD is designed with new capabilities to provide a faster and more accurate treatment for a wider range of cancers. Versa HD offers both conventional and stereotactic treatments.
These technologies provide solutions in real time monitoring of highly conformal treatments with improved patient safety, which in turn will help in better disease control and quality of life. The department of radiation oncology deals with all the types of cancers. Radiation can be used as a primary modality in certain types of cancers such as cervical and head and neck cancers or it can be used following surgery to prevent local recurrence e.g. Breast cancer. Radiation also plays a role in downsizing the tumor there by facilitating organ and function preservation as in rectal cancer. Finally it is very effective as a palliative modality e.g. in relieving bony metastatic pain.
Infrastructure
Highlights of the new radiation zone
• High Energy Multimodality Linear Accelerator (Versa HD) with Flattening filter free (Triple F) beams which offer 4-5 fold increase in the dose rate, there by reducing the treatment time. This provides potential to provide SBRT/SRS in standard treatment time slot.
• Frameless delivery of stereotactic radiosurgery using FRAXION (Mouth piece with vaccum suction, U frame and rigid thermoplastic mask capable of achieving less than 1mm accuracy)
• Body fix and cover for the delivery of stereotactic body radiation therapy
• Micro multileaf collimators (2.5 mm) to deliver SRS for smaller lesions less than 1 cm. Rapid leaf speeds again help in faster treatment delivery.
• 6D Robotic couch which accounts positional errors in 6 dimensions including rotational errors and ensures high precision radiation therapy.
• Real time imaging during radiation treatment delivery using XVI (Intrafractional verification)
• Acquisition of 4D CBCT for lung and upper abdomen tumors with free breathing to determine tumor motion. No gating software is required
• Treatment planning systems with Monte Carlo based algorithms and radiobiology based optimization (Monaco TPS)
Existing facilities
• High Energy Multimodality Linear Accelerator (Clinac 2300CD).
• Laser Guarded Dynamic Image Guided Radiotherapy (IGRT).
• Respiratory Gating System.
• Dynamic Multi leaf Collimator MLC 120.
• Amorphous silicon Portal Imaging System.
• Precise Patient positioning with room lasers.
• Patient accessories like immobilizing devices.
• High dose rate (HDR) Brachytherapy after loader (Nucletron) with MRI compatible applicators including all range of Gynaec applicators (Ring and Vienna), MRI based volume optimized planning
• Computerized treatment planning system (Eclipse/Helios) with CT/MRI fusion.
• Dedicated 4 D C T simulator (16 slices) with a moveable laser system.
• Associated Quality Assurance & Dosimetric Devices.
EBRT
• Stereotactic Radiosurgery (SRS)
• Stereotactic Body Radiotherapy (SBRT) or Stereotactic ablative radiotherapy(SABR) Both these techniques are important alternatives to invasive surgery, especially for patients who are unable to undergo surgery and for tumors and abnormalities that are hard to reach and located close to vital organs.
• Volumetric modulated Arc Therapy (VMAT): new standard of care with uncompromised treatment in two minutes or less.
• Image guided radiation therapy with cone beam CT (CBCT): for the precise delivery of radiation by determining the position of the tumor every day.
• Respiratory gating for motion management of the tumors which move with respiration.
• Intensity Modulated Radiation Therapy (IMRT) for the better sparing of normal tissues.
• Three dimensional conformal radiotherapy.
• Total Skin Electron Therapy (TSET). This treatment is delivered to a type of lymphoma. The entire skin is treated with electrons. The technique is time consuming to develop and carry out on routine basis.A rigorous quality assurance program needs to be the part of treatment and hence it is being offered at very few selected centers.
Brachytherapy
• Image based intracavitary brachytherapy
• Image based interstitial brachytherapy
• Intravaginal brachytherapy
• Intraluminal brachytherapy
• Surface mould brachytherapy
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India is the third highest country in terms of cancer deaths and this graph is increasing by the day. Established in 2007,Vydehi Cancer Centre, is consistently working 24*7 for the benefit of the patients and our endeavour is to serve them and our society to help fight this dreaded disease.