The department of radiation oncology at Kokilaben Dhirubhai Ambani Hospital is a state-of-the-art unit having the latest technology and equipped personnel ,delivering services of high international standards. The department has the first installed Trilogy and NovalisTx in the country presently available only in few big centres in the world. It is capable of performing all the high end treatments like IMRT, IGRT intracranial sterotactic radiosurgery and radiotherapy, extracranialstereotaxy, total body irradiation, total skin electron treatment.
There is facility for brachtherapy for all sites in the form of remote after loading HDR brachytherapy system with a 3D planning facility.The department works in close coordination with surgical oncology and neurosurgical subspecialities (e.g. Head and neck, thoracic, breast, urology and gynae oncology, neuro-oncology) maintaining a high quality evidence based practice for the particular subsite.
The department is equipped with the most sophisticated technology and personnel with an extremely patient friendly ambience .We take efforts to minimise patient waiting time and the atmosphere is bright contrary to a perceived dull atmosphere of a cancer centre.We also have an excellent physical medicine and rehabilitation support for various forms of physiotherapy/speech therapy and rehabilitationThe specialised services provided in our department are:
Three-dimensional (3D)taken into account the axial anatomy and complex tissue contours . The process starts with immobilisation followed by scanning of the area of interest and generation of plans ( conformal to the 3 dimensional shape of tumour using multileaf collimators which shape the beams). This helps in delivering the lowest acceptable doses to the surrounding normal structure.
This is a specialised form of 3 D conformal radiotherapy . As the name implies, intensity-modulated radiation allows us to modulate the intensity of each radiation beam which is divided into thousands of beamlets , so each field may have one or many areas of high intensity radiation and any number of lower intensity areas within the same field, thus allowing for greater control of the dose distribution with the target. This achieves maximum dose envelop to the tumour sparing the surrounding normal structures.
IGRT is a step forward of IMRT in which various biological and anatomical imaging techniques are integrated into the radiation therapy process. The overall goal of IGRT is to target tumors more accurately while better sparing the normal tissues .Our machines have on board CT scanner with KV imaging facility capable of online and offline matching of planned image with treatment image accurately.
Stereotactic radiosurgery is a highly precise form of radiation therapy used primarily to treat tumors and other abnormalities of the brain of extracranial site. Despite its name, stereotactic radiosurgery is a non-surgical procedure that uses highly focused x-rays to treat certain types of tumors, inoperable lesions and as a post-operative treatment or to obliterate abnormal blood vessels in congenital arteriovernous malformations.
The treatment involves the delivery of a high-dose of radiation beams that converge on the specific area of the brain /extracranial site where the tumor or other abnormality resides
It is a form of radiotherapy used primarily as part of the preparative regimen for bone marrow transplantation. TBI involves irradiation of the entire body. Meticulous shielding measures are applied to save lungs from receiving excess radiation doses.
Useful in conditions like mycosis fungoides (cutaneous T cell lymphoma), due to unique property of electrons which deliver a high dose superficially and effect wears out in the deeper structures minimising dose to deeper vital organs .
We have facility for brachytherapy for head and neck, cervix, oesophagus, endobiliary, endobronchial, breast and soft tissue sarcoma.
|Gamma Knife||Cyber Knife|
|Tumor shaping||Exactly to the shape of the disease with a uniform dose inside disease-better control||Divides the tumor in circles-lot of gaps and empty spaces in between-no uniform control-increase side effects||Divides the tumor in circles-lot of gaps and empty spaces in between-no uniform control-increase side effects|
|Frame||Frameless/ frame based adds to patient convenience||Frame based –heavy frame patient discomfort||Frame or Frameless|
|IGRT||Setup errors detected and corrected at sub mm level highest level of accuracy||No such component||X ray based crude|
|Energies||Multiple energies depending on tumor depth||Fixed and low energy||Fixed and mid range energy|
|Treatment times||2-20 minutes comfortable for the patient||120 minutes cumbersome||35-90 minutes, tiresome for the patient|
|IMRT||Yes to conform even better and to achieve high gradient with better sparing of normal organs||No||No|
X knife is superior to Both Gamma and Cyber Knife as it has got an option of intensity modulation, different energies and image guidance in the form of couch correction and real time monitoring