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MEDICLINIC CITY HOSPITAL COMPREHENSIVE CANCER CENTRE

Technology
 

In addition to chemotherapy, hormone therapy and surgery, radiotherapy is one of the most important methods for the treatment of tumours. This method involves the use of high-energy forms of electromagnetic radiation and particle beams.

On these pages you will find a description of all technologies that are used at the Comprehensive Cancer Centre.

Our institutes are equipped with the latest generation of linear accelerators. In addition to conventional radiation, this high-tech device also enables us to perform stereotactic radiotherapy with an exceptional accuracy of deviation of less than one millimetre, so that even tumours, which are located close to critical areas, can be targeted extremely precisely. As a result of the incredible precision higher single doses of radiation can be administered, whilst the overall number of single doses can be reduced. Based on the high dose rate the treatment time can be reduced from one hour to between 10 and 20 minutes.

The device registers movement caused by the patient breathing and, with respiratory gating, allows the radiation to be applied only during defined phases of breathing so that damage to healthy tissue is reduced.

Computer Tomography (CT) Stimulation - Imaging prior to Radiation Delivery

After the initial consultation and decision to use radiation treatment, the next session is usually a planning session, which is called a CT -Simulation.

The CT simulator does not deliver radiation treatment, but instead allows the radiation therapy team to determine the exact location, shape, and size of the tumour to be treated. The simulation process ensures that treatments will target the area of concern, while missing surrounding critical structures. CT simulation includes a CT scan of the area of the body to be treated with radiation. The CT images acquired during your scan will be reconstructed and used to plan the best and most precise bespoke treatment plan.

A variety of immobilisation devices may be used during the CT-simulation such as Vac-Bags a special cushion-like device that holds its shape when the air is removed. Another type of immobilisation device is the thermoplastic mask. This mask might be used if receiving radiation to the head or neck region. The firm plastic mask is moulded around the face and secured, so it gently holds the head in place. Some masks may extend to cover shoulders, as well. The goal of using immobilisation devices is to make sure you maintain the same position every day, ensuring treatments are as accurate and precise as possible during radiotherapy treatment. The centre of the treatment area will be defined and marked as a reference point to be used during your treatment. Ink to create a very small tattoo (size of a freckle) in this area will be done. This will be discussed with you before simulation and only takes a few minutes. The permanent dots will be used to make sure you are accurately positioned at each treatment session. During CT-simulation sometimes patients will receive contrast material (liquid with dye in it), Itmay be swallowed or injected into your body so internal organs are precisely defined and thus aid in contouring and planning advanced techniques such as IMRT and VMAT. The average length of CT-simulation including patient positioning, making immobilisation devices, Reference point marking and CT data acquisition is between 30mins andone hour.

Treatment Planning

The best quality images obtained during the CT-simulation will be used to create a plan for the radiotherapy treatment. The treatment planning process is the step that occurs after the CT-simulation and prior to treatment. During treatment planning, the Radiation Oncologist outlines the area to be the treated and prescribes the dose to be delivered. A specialisedcomputer planning system is used to facilitate the calculation of the radiation dose and to plan the complex techniques such as Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT). It may take several days for treatment planning to be completed. After all treatment planning is complete, radiation therapy treatment can start.

Linear Accelerator

The linear accelerator (LINAC) has been in use for over 50 years. The basic principle has not changed during this time. Electrons are accelerated in electromagnetic fields, in which a voltage of several megavolts is created and accelerated and then either used directly for therapy (particularly for surface tumours) or converted into photons (pure energy quanta). These extremely high-energy photons penetrate the body and release energy depending on the irradiated tissue. A modern linear accelerator can thereby be used to irradiate any part of the body. A linear accelerator (LINAC) is a particle accelerator which accelerates charged particles to high energies. In this process an energy dose, which has been pre-determined, is released. Linear accelerators with an electron beam to produce x-ray radiation are used in medicine for cancer tumour radiation therapy.

With our linear accelerators, which have an integrated positioning-control-system, irradiation can be performed to an accuracy of one milimetre. Healthy tissue is therefore protected to the greatest possible extent; harmful side effects are reduced to a minimum. The linear accelerator is also equipped with further functions: the breathing-based control takes into account the tumour movements whilst breathing out and with the intensity-modulated radiotherapy technique it is possible to adjust the individual radiation fields to the tumour volume.

   

 

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