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Radiation Therapy

Radiation therapy is non-invasive treatment that uses high-energy X-rays to kill cancer cells and it can help you in your fight against cancer. It begins with a session to discuss treatment with your doctor and if you and your doctor decide on radiation, you will return for a simulation. The simulation is a planning session that helps the doctor target your cancer. He or she will design a radiation plan to protect normal tissues. When the simulation and plan are completed, you will begin your daily treatments. Treatment is usually once daily Monday to Friday and it takes less than a half an hour. Sometimes you may need radiation twice a day, with usually 6 hours between treatments. After the course of radiation is complete, you will be scheduled for follow-up appointments to make sure the cancer is under control and to make sure that any side effects from the treatment are minimized.

Types of Radiation Therapy at CHI Health

External Beam Therapy

External Beam Therapy includes the use of a linear accelerator as part of the cancer treatment to control or kill malignant cells. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery (for example, early stages of breast cancer). Radiation therapy is often used along with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers.

  • Intensity Modulated Therapy - Intensity Modulated Radiation Therapy uses a computer to control the linear accelerator allowing precise delivery of the radiation dose to the malignant tumor. Treatment is carefully planned using computed tomography (CT) or magnetic resonance (MRI) scans. 3D images of the patient are used in conjunction with computerized dose calculations to determine the dose intensity pattern that best conforms to the patient’s tumor size and shape. This custom-tailored radiation dose maximizes tumor dose while minimizing dose to adjacent normal tissue. 
  • SBRT: Stereotactic Body Radiation Therapy also SRT Stereotactic Radiation Therapy - Type of external beam radiation therapy typically given to very small tumors.  Special devices are used to keep the patient entirely still.   The treatment is given with tremendous accuracy minimizing dose to surrounding tissue.  The treatment is given in high doses over the course of 1-5 treatments.  
  • SRS: Stereotactic Radio Surgery - Type of external beam radiation therapy typically given to very small tumors in a single treatment.  Patients are placed in specialized immobilization devices allowing for a very precise, high dose of radiation treatment given to the brain or spinal cord. 
  • 3D Conformal Therapy- Therapy which uses 3D images (CT, MRI, etc) to shape the beam to match the shape of the tumor minimizing dose to normal tissue and maximizing it to the tumor area.  

Image-guided Therapy

Image-guided radiation therapy is special imaging technology that allows the Radiation Therapists to image the tumor immediately before the radiation is delivered, while the patient is positioned on the treatment table. These images are taken using an On-Board Imager and then evaluated by the doctor using specialized software and compared to the reference images taken during simulation. Any necessary adjustments are then made to the patient's position and/or radiation beams to more precisely target radiation at the tumor.

  • Optical Surface Monitoring System (OSMS) – Specifically designed non-invasive, non-ionizing real-time 3D imaging technology producing high resolution and accurate 3D surface data that detects even slight patient motion while mapping the 3D external surface of the patient. Allows for instantaneous beam gating so clinicians can reduce uncertainty margins throughout treatment and is fully compatible with non-coplanar treatments and monitoring, allowing optimization of motion in all six degrees of freedom.
  • DIBH: Deep Inspiration Breath Hold - Treatment for breast cancer that minimizes radiation to the heart by having the patient take a deep breath which expands the lungs pushing breast tissue away from the heart.
  • Respiratory Gating - Respiratory Gating is used when there is a concern that the tumor may move during treatment due to normal patient breathing patterns. This system allows the radiation beam to be “gaited” or turned on and off in response to tumor motion.

Brachytherapy

Brachytherapy, also referred to as “internal radiotherapy”, “intra-cavitary radiotherapy”, “interstitial brachytherapy”, “seed therapy”, or “implantation”; places a radiation source directly into or near the treatment area so that fewer surrounding healthy cells are exposed to the radiation.  By using internal radiation therapy, the clinician can give a higher total dose of radiation to the target area in a shorter time than is possible with external treatment. These implanted sources can either be left in permanently or removed once the dose has been delivered, and can be used in conjunction with external beam radiation therapy. Brachytherapy is used to treat cancers of the prostate, cervix, endometrium, breast, skin, bronchus, esophagus, and head and neck, as well as soft tissue sarcomas and several other types of cancer.

  • High Dose Rate (HDR) Brachytherapy - This very specialized treatment involves the placement of a very small highly radioactive source of Iridium near the area of interest.  The procedure involves the placement of a small catheter or applicator that will guide the radioactive source during the treatment delivery.  After treatment the delivery device(s) are removed.  Patients may receive this form of treatment several times. 
    • Gynecologic HDR – Commonly treated using a cylinder, tandem & ovoid, or tandem & ring applicator.  Patients commonly receive 3-6 applications with this technique.
    • Breast HDR (MammoSite, Savi) – This technique for administering partial breast irradiation delivers dose via a special catheter/applicator that is placed into the lumpectomy site minimizing exposure to the heart and lungs.
    • Breast HDR (AccuBoost) – Non-invasive HDR brachytherapy administering partial breast or tumor bed boost. Utilizes mammography imaging and immobilization to deliver a uniform dose to the lumpectomy site while minimizing exposure to the heart and lungs.
    • Lung HDR – This procedure involves the placement of a temporary bronchial catheter into the lung.
    • Esophageal HDR - – This procedure involves the placement of a temporary esophageal catheter into the esophagus.
    • Skin HDR – offers non-melanoma skin cancer patients a non-surgical treatment option with minimal risk of complications and scarring. A specially designed applicator is placed directly on the surface of the skin.
  • Prostate Low Dose Rate (LDR) Brachytherapy – outpatient cancer treatment that consists of permanent implantation of radioactive seeds into the prostate gland through the perineum for early stage prostate cancer.  

Radiopharmaceuticals

Radiopharmaceuticals transport targeted doses of radiation directly to the tumors and its metastases, thereby sparing normal healthy tissue. 

  • Xofigo (Radium Ra 223 dichloride) Used to treat hormone resistant prostate cancer that has spread to the bone.
  • Samarium (Sm-153 Lexidronam Pentasodium) -. Samarium is given to help reduce pain in a person whose cancer has spread to the bones

Other Therapies

Optune - a wearable, portable treatment used to treat adult patients with recurrent glioblastoma multiforme (GBM).

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