Radiation Oncology: Treatment Options
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Specific radiation therapy options
The Department of Radiation Oncology at Eastern consistently seeks out new treatment modalities to aggressively fight the disease. The radiation oncology team provides several innovative radiation therapies, including, but not limited to, the following:
- External Beam Radiation Therapy: A type of radiation therapy in which a machine called a linear accelerator
directs high-energy rays from outside the body onto cancerous tumors and tissue within the body. External beam radiation is distinguished from internal radiation therapy, which places
radioactive materials directly into or near a tumor via injection, a catheter, or other methods.
- 3D Conformal Radiation: A type of external radiation therapy in which a computer produces a three- dimensional image of a tumor, lasers are calibrated to match the exact shape of the tumor, and precisely-focused radiation beams are delivered directly to the treatment area. This exact targeting makes it possible to focus higher levels of radiation on the tumor, while limiting exposure to nearby healthy tissue.
- Intensity Modulated Radiation Therapy (IMRT): A state-of-the-art external radiation delivery system which uses advanced computer technology to create a
three-dimensional model of a tumor, and direct precisely-focused beams of radiation at the tumor with laser accuracy. By precisely modulating (controlling) the intensity of the radiation
beams to conform to the tumor shape, IMRT can treat difficult-to-reach tumors with new levels of accuracy.
This technology allows CTCA radiation oncologists to use higher radiation doses than traditional methods would allow in these areas, while also limiting exposure to surrounding healthy tissue. Thus, if you have previously had conventional radiation therapy and are experiencing recurrent tumors in the treated area, IMRT may be an option.
- TomoTherapy® Highly Integrated
Adaptive Radiotherapy (HI-ART): An innovative form of radiation therapy that combines IMRT, CT scanning technology, and advanced tools for planning and delivering radiation
therapy in one machine. Using a built-in CT scanner to confirm the tumor’s exact shape and position before treatment begins, the TomoTherapy® HI-ART system delivers
precise doses of radiation from a full 360-degrees (instead of from a few fixed directions).
By contouring the radiation beams to the shape of the tumor with pinpoint accuracy, the TomoTherapy® HI-ART system can minimize damage to healthy surrounding tissue. If you have already received your maximum tolerance dose of traditional radiation, or if you have tumors located in sensitive or difficult-to-reach areas, TomoTherapy® HI-ART may be an option.
CTCA at Eastern Regional Medical Center has been providing TomoTherapy® HI-ART since the hospital opened in December 2005. It was the first hospital in the Delaware Valley to provide this treatment option. To date, there are about 150 facilities across North America that offer this technology.
- TomoTherapy® Highly Integrated Adaptive Radiotherapy (HI-ART): An innovative form of radiation therapy that combines IMRT, CT scanning technology, and advanced tools for planning and delivering radiation therapy in one machine. Using a built-in CT scanner to confirm the tumor’s exact shape and position before treatment begins, the TomoTherapy® HI-ART system delivers precise doses of radiation from a full 360-degrees (instead of from a few fixed directions).
Intraoperative Radiation Therapy (IORT): A state-of-the-art radiation treatment option that delivers a single, powerful dose of radiation during tumor removal surgery. By directly targeting the tumor bed, IORT destroys more of the microsopic cancer cells that are often left behind, while sparing nearby healthy tissues. IORT can help to minimize or eliminate the need for additional radiation treatments, often four to six weeks in length.
IORT may be used alone, or in combination with other therapies, to treat patients with a variety of cancer types, including but not limited to: breast, cervical, colorectal, head and neck, ovarian, pancreatic, and soft tissue sarcoma.
High-Dose Rate (HDR) Brachytherapy: An aggressive form of internal radiation therapy in which radioactive “seeds” or pellets are placed directly into or near a tumor through catheters, radiating the tumor from the inside out. By delivering a powerful, precisely-focused dose of radiation directly to a tumor, HDR brachytherapy may reduce damage to nearby healthy tissue and decrease side effects of standard radiation therapy. In addition, the entire treatment takes about five days instead of five to seven weeks.
- MammoSite® Radiation Therapy System (RTS): An innovative form of brachytherapy for breast cancer that uses a single catheter to place radioactive seeds directly to the area where a breast tumor has been surgically removed via lumpectomy. By delivering internal doses of radiation directly to breast tumors, MammoSite® RTS can help avoid damage to surrounding healthy tissue and reduce some of the side effects associated with external radiation therapy. In addition, MammoSite® RTS can be completed in days, compared to weeks for traditional radiation.
TheraSphere®: An internal radiation therapy for liver cancer or cancer that has spread to the liver. With TheraSphere®, radiation is administered directly to a liver tumor using microspheres. The treatment is delivered through a catheter positioned in the hepatic artery, the liver’s main blood vessel. Once the microspheres enter the liver, they get trapped in the small blood vessels that feed the tumor. The radiation then targets the tumor, minimizing injury to healthy surrounding liver tissue.
- Local Hyperthermia Therapy: A very rare, leading-edge medical treatment that uses heat to destroy or damage cancer cells. By exposing body tissue to high temperatures (about 108 degrees) for about an hour twice a week, hyperthermia therapy works to shrink tumors by damaging proteins and structures within cells. If you have advanced or recurrent cancer, hyperthermia may be a promising option for you.
For instance, when radiation therapy is used first, it disrupts something in the cell and then hyperthermia disrupts the repair mechanism. When hyperthermia is used first, it increases blood and oxygen flow and makes a tumor more susceptible to the effects of radiation.
CTCA at Eastern Regional Medical Center has been using local hyperthermia (to heat a small area of cancerous tissue, such as a tumor) since April 2007. In the first year, our radiation oncologists performed 80 treatments. To date, there are 33 medical facilities across the United States, three of which are CTCA hospitals, offering the BSD-500 Hyperthermia System. To the best of our knowledge, the Hyperthermia Program at Eastern is currently one of the largest in the country.
Hyperthermia therapy may also help make cancer cells more vulnerable to the effects of cancer treatments like radiation therapy and certain chemotherapy drugs. Thus, hyperthermia is often used in conjunction with one of these other therapies.
The hospital has also started construction of an Interventional Radiology (IR) Suite. This new addition will house a special procedures room in which our radiation oncologists will be able to perform coil placements and radiofrequency ablations, in collaboration with the surgical oncology team.
“The interventional radiology suite is a significant component of aggressive therapy for advanced disease,” says Chief of Medical Oncology Dr. Rudolph Willis.