Intensity-Modulated Radiotherapy (IMRT)
It is an improved modality of the three-dimensional conformal radiotherapy. Considering the tumor volume and the healthy tissue volumes determined by the physician in the same computerized-planning systems, intensity of the treatment is modulated for different body areas by the computer. In our day, IMRT is also used in treatment of prostate cancer, head-neck cancers, breast cancer, thyroid cancer, and lung cancer in addition to the treatment of gynecologic tumors, liver tumors, brain tumors, lymphoma, and sarcoma. Moreover, IMRT works in the treatment of pediatric tumors.
Intraoperative Radiotherapy, which has been commonly used for a decade in average around the world, is a treatment method with many clinical trials conducted in treatment of breast cancer. Prospective randomized studies made on IORT are related to the breast cancer. This treatment modality has many advantages especially in terms of time and cosmetics in comparison to conventional radiotherapy of the breast cancer.
It is also used in the treatment of some intra-abdominal tumors though it is not common as in the treatment of the breast cancer. It is also used especially in pancreatic cancer and periampullary tumors, and in gastric cancers, colorectal cancers, and soft tissue tumors. The most important advantage of this modality is the ability to deliver the boost dose within minutes, and the radiotherapy treatment can be completed in a short time by delivering beams directly to the tumor especially for unresectable tumors, and to the area, where recurrence is probable, for resectable tumors.
Next-Generation Radiotherapy – The Bull’s Eye in Cancer Treatment
VERSA HD is the newest generation radiotherapy technology which has changed the standards in cancer treatment and achieved a significant breakthrough in treatment of particular tumors.
It not only shortens treatment period of SRS and SBRT, which can be performed by the devices such as GammaKnife and CyberKnife, it can also perform the treatment methods of CONFORMAL RADIOTHERAPY, IMRT, IGRT, and VMAT, quickly and accurately.
Through its Multi-Leaf-Collimator structure which reduces the leakage 5 folds, it minimizes the negative effect of radiotherapy on healthy organs, and it has the lowest values in the risk of secondary cancers. Thus, it is substantially advantageous in CHILDHOOD TUMORS.
In addition, the target volume is better covered by the Multileaf Collimator (MLC) that has the highest leaf number (160), and the dose exposure of healthy organs is minimized.
Through the final version of Treatment Planning System (TPS), it provides an opportunity to correctly determine the location of the target and the critical organs as PET/CT, MR, and CT images are accurately fused. Thus, the tumor target is very accurately located.
With MONACO TPS, which has used the Monte Carlo Algorithm regarded as the gold standard around the world, the doses delivered to patients can be calculated correctly and precisely.
During the treatment with Conebeam CT (Low-dose volumetric CT), the position of the patient is controlled every day in order to perform the treatment at the most appropriate position. As the tumor shrinkage is detected by the Conebeam CT during the treatment, delivery of overdose to healthy tissues can be reduced by the Adaptive Radiotherapy which is a method of area reduction.
CyberKnife Robotic Radiosurgery System ensures accurate removal of immobile lesions, measuring <0.5 mm in size, and mobile lesions, measuring 0.75 mm in size.
The system is designed to treat lesions located at any part of the body, and on the contrary to conventional treatment devices, special tracking algorithms that are developed according to the location of the lesion in the body are used when radiation treatment is given. As the treatment is completely guided by images, users and patients are provided with maximum safety and treatment accuracy.
In brachytherapy, radiation sources are placed very close to the target site or sometimes directly into the tumor. In brachytherapy, radiation sources are manually placed or they are loaded to specific apparatus afterwards.
Beam sources are radioactive materials that can penetrate at limited distance. For example, needles are inserted into the prostate gland in a minor surgery for early stage prostate cancer. Due to limited penetration, the radiation originating from needles is confined to the prostate gland. This provides an advantage as the healthy tissues around the target volume is exposed to almost zero radiation and such tissues are protected against possible side effects of the radiation. Radiation emission by the needles disappears over the time.