Radiation Oncology

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The department of Radiotherapy at Patel Hospital is equipped with the only working lineal accelerator in the state of Punjab.Even Himachal, Jammu & Kashmir, Haryana do not have this facility.

How does radiation therapy work ?

Radiation therapy uses a machine that directs high energy rays at the cancer site from outside the body. The radiation may be in form of X-Rays, Gamma Rays, Electron beam or particle therapy.

Equipment at our department

1. Linear Accelerator (Dual Energy) (Photons & Electrons)
   It is the latest machine used now-a-days for external radiation. Linear accelerator has better dose delivery and lesser complications in comparison to cobalt machine.

2. CT Simulator
   Tumor and normal tissues are marked and are reconstructed to give 3D image. It gives more accurate information than a conventional simulator because exact tumor marking is done on individual CT slices.
3. 3D Planning System
   It is used for calculating dose and time for radiation hence helps in reducing dose to normal tissue and giving maximum dose to tumor. 3D Planning system is more accurate than conventional planning system.
4. Mould Room
   It is equipped with gadgets to make immobilization devices and shields. Immobilisation devices help reduce set up error due to patient movement and shield are introduced into the treatment area to protect normal organs.

How Safe is the Facility?

Radiation safety measures adopted by our department confirm to the AERB requirements. We have installed

• RFA (Radiation field Analyzer)
  Analyses the dose as it is distributed all over the field and not only at centre. It helps ensure the accuracy of treatment
• Conventional Dosimeter
  Helps us to maintain stringent quality control by measuring daily doses as being delivered to patients.
• Ionchamber based victoreen survey meter
  For detection of radiation leak in the surrounding areas.

Pros and Cons of Linear Accelerator V/S Cobalt.

Linear accelerator is a better machine than cobalt for treating cancers. Virtually all developed countries are using linear accelerator as basic treatment machine.

Feature	Linear Acc.	Cobalt
Source disposal	Nil, hence better safety profile	Major environmental problem
Source Change	None	Every 7 years
Source Change	Less	More
Radiation leak	Once machine is off there is no radiation in the room	Some radiation is always in the room & never zero
Energy	Higher, So treats deep seated tumor with better doses.	Inferior in matter of deep seated tumor
Dose rate	Does not change every month	Reduces with time due to radioactive decay
Precision	More precise as there is continuous dose monitoring and recording	Less accurate
Minimum field size	0.5x0.5cm, hence every small areas can be treated.	5x5 cm
Electron beam	Is present hence superficial tumors can be treated without harming deep structures	Not possible
Stereotactic Radiotherapy	Possible	Not possible

Process of Radiotherapy Planning & Implementation

• History, Genera physical examination & Investigation
• Staging
• Defining area of interest
• Immobilisation
• 3D Imaging of Tumor & critical organs
• Defining target areas on individual slice of CT Scan
• re-construction (Digitally reconstructed radiograph)
• 3-4 Plans made for each patient
• selection of best plan
• pre-treatment verification
• treatment delivery

Indications of Radiotherapy

1. Primary modality
   1. Skin Cancer (Basal and squamous cell)
   2. Head & Neck cancers
   3. Lung Carcinoma
   4. Eso phageal Cancers
   5. Ano rectal tumors
   6. Seminoma testis
   7. Prostate Cancer
   8. Hodgkins Lymphoma (Stage I & II)
   9. Carcinoma cervix
   10. Retino blastoma
2. As Adjuvant
   1. Medullo blastoma
   2. Brain Tumors
   3. Breast Cancers
   4. Carcinoma body uterus
   5. Soft tissue and bone sarcomas
   6. Non hodgkins lymphoma
   7. Advanced hodgkins lymphoma
   8. Thyroid Cancers
3. Palliative
   1. Bone pains due to metastatic bone disease.
   2. Intractable bleeding in cancers
   3. Superior vena cava obstruction.
   4. Spinal Cord Compression.