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Radiation Oncology

Basavatarakam Indo-American cancer hospital and research Institute is one of the largest radiation oncology departments in Asia with 6 Linear accelerators, High Dose rate Brachytherapy Unit, CT-Simulator, Digital Conventional Simulator and tele-cobalt unit.   
We are the first in this part of India to introduce Radiation Treatment through Novalix Tx RapidArc supported by brain lab.

The department was started in 1999 with scientific support from Weill Cornell and Presbyterian Hospital, New York, USA under the supervision of renounced radiation oncologist Dr Nori Dattatreyudu.

More than 4422 IMRT cases and 500 IGRT cases were treated. In Brachytherapy on an average we are treating 10 cases per day since the beginning of this department. The department is having more than 20 eminent radiation oncologists, 10 physicists and 30 Technologists.

Services provided by the department:

Tele gamma therapy

Treatment of cancer using gamma rays from radioactive material placed at some distance away from the patient is called Tele-gamma therapy. Radioactive cobalt is the most popular and ideal source for this type of treatment. We are having Theratron 780E tele therapy unit since 1999.

Teletherapy using linear accelerators

Linear accelerator is modern equipment which produces X-rays and electrons of different energies. Introduction of lineacs changed the scenario of cancer therapy. We have six modern linear accelerators with SRS, SRT, IMRT, IGRT, IMRS, Rapid Arc facilities. Indo-American is the first hospital having linear accelerator in Andhra Pradesh. Compact lineac and IGRT are the first of its kind in India installed in India.

Conventional simulator

Treatment simulation with orthogonal fluoroscopy using conventional simulator is the standard practice, since a long time for treatment verification. It has the advantage to detect some movements of the patient during the process which helps to perform possible corrections to the planned beams. We have most modern simulator facility namely Varian acuity digital simulator.

CT-simulation

It is basically a CT unit with flat couch used for radiotherapy planning purpose and moving lasers. We have Philips big bore CT which is first of kind in India with 16 slice and 85 cm bore size.

Virtual simulation

In virtual simulation patient is required only at the time of scanning. Simulation can be done using planning CT slices and planning software without requirement of patient. We are having three virtual simulation stations (Focal –sim) for this purpose.

Stereotactic Radio Surgery:

SRS is a non-invasive technique to deliver a single high dose of radiation to limited, well defined target volume while avoiding normal tissues and critical structures near to it. Modified high energy linear accelerators with micro multileaf collimator facility (mMLC) are the most versatile radiation producing machines for radio surgery. It is a linear accelerator based sophisticated method of delivering a high dose of radiation very precisely to a small volume of tissue. We have two different mMLC based SRS facilities namely DIREX system and BRAIN LAB. For this iPlan and accsoft planning systems were used.

Three dimensional conformal radiotherapy.

Three dimensional conformal radiation therapy (3D CRT) developed as a method of allowing higher dose to tumor, limiting dose to normal tissue, and improving local control and patient outcomes. Linear accelerators with multileaf collimator arrangements are capable of doing this technique. We have four linacs and powerful planning systems with this facility.

Intensity Modulated Radiotherapy

Intensity modulated radiotherapy (IMRT) is a most sophisticated, advanced technique for the radiotherapy planning. In this method, intensity of each beam will be modulated in an optimal way to get the required distribution according to the prescription. Intensity modulated beams will be directed from different directions. It is an advanced 3D conformal radiotherapy. MLC based linear accelerators are required to deliver IMRT treatment. We have four IMRT capable linear accelerators.

Image Guided Radiotherapy

It is a most important delivery technique advancing rapidly in radiotherapy. Linear accelerators which have the facility for X-ray volume imaging are capable for doing this technique. Patient setup can be verified three dimensionally before the delivery of dose fraction. Therefore patient can be treated accurately by correcting these errors. We have two ultra modern linear accelerators capable of doing IGRT namely elekta synergy and varian Novalis Tx. IGRT with Active Breath Control.

Active Breathing Control (ABC) based IGRT is mainly for lung/liver cancers. ABC allows temporary and reproducible immobilization by monitoring the breath cycle and achieving a breath hold for a preset time at a pre determined volume level. This facility is available since long time.

High Dose Rate (HDR) Brachytherapy

Small sealed radioactive sources are kept very close to (within the natural body cavities or implanted directly) the tumor in this method. A small single stepping source will generate the required dose distribution by moving to different preplanned positions. HDR brachytherapy solves the potential disadvantages of Low Dose Rate (LDR) brachytherapy method. Treatment time is only few minutes. Therefore no hospitalization is required. We have high end HDR brachytherapy unit Varisouce IX with 20 channels which uses Ir-192 source. With this machine we have been doing implants, Templates and all kind of intracavitary radiotherapy procedures.

Rapid ARC and Intensity Modulated Radio Surgery:

Rapid arc technology is a new and advanced form of intensity modulated radiotherapy which delivers precise treatment in shorter time. It is many times (5 to 8 times) faster than conventional and helical IMRT techniques. Intrafractional patient setup errors can be effectively minimized when compared with other techniques which improves quality and comfort. With Inbuilt micro MLC it is capable of performing IMRS also with the help of iplan Treatment planning system from Brain lab.

Intraoperative Radiotherapy:

Intrabeam, Intraoperative radiotherapy system was installed at our center in 2009 which is the first of its kind in India. With 50kev and 40microamps it is capable to treat all intraoperative tumors. Especially it is useful in intact breast cases. We can treat other cases like brain, soft tissue, vagina, rectum etc. The main advantage of this instrument is, it is capable of delivering dose immediately after surgery. Instead of taking more than 25 fractions in linear accelerator, single fraction is sufficient and patient can be treated on outpatient basis.

Technologists:

More than 30 technologists are working in this department. They are all trained in Radiotherapy technologist course and also certified by Babha Atomic Research Center, Mumbai.