Service Portfolio at IMED Elche

Radiotherapy is a treatment that involves the use of high-energy radiation. It is more commonly used to treat cancer, but can also serve other purposes.

The following article will focus to a great degree on the use of radiotherapy for cancer treatment.

What is radiotherapy?

Radiotherapy uses high intensity energy, known as radiation, such as x-rays, gamma rays, electron beams or protons. The purpose of using radiation to treat cancer is to kill or damage cancer cells and stop them from growing and multiplying.

How does radiotherapy work?

Radiotherapy damages cancer cells in the area being treated. Although the radiation can also damage normal cells, they can usually repair themselves. Also, depending on the source of the radiation (a particle linear accelerator), it will be possible to target a very precise part of the organism were the tumor is located, sparing al surrounding healthy tissues.

Why is radiotherapy prescribed?

Many people (almost 50%) diagnosed with cancer will have radiotherapy as part of their cancer treatment. Research shows that at least one out of two people recently diagnosed with cancer would benefit from radiotherapy. It can be used for several reasons:

  • Cure: Radiotherapy is prescribed with the aim of curing cancer on its own or combined with other treatments, such as surgery or chemotherapy.
  • Control: Radiotherapy may be used to control the cancer by making it smaller or stopping it from spreading.
  • Help other treatments: Radiotherapy is used before neoadjuvant therapy or after (adjuvant therapy or) other treatments, such as surgery or chemotherapy. The aim is to make the main treatment more effective.
  • Symptom relief: Radiotherapy is often able to relieve cancer symptoms, such as pain or bleeding, and to help the patient to feel better.

How is radiotherapy performed?

It can be performed in two ways:

  • External radiotherapy: A machine from outside the body aims radiation beams towards the cancer and surrounding tissues where the cancer may have spread.
  • Internal radiotherapy (brachytherapy): A radiation source is put inside the body on or near the cancer.

Depending on the type and size of the cancer, and where it is in the patient’s body, the patient may be prescribed one or both types of radiotherapy.

High quality and versatility of our services allows us to practice a range of techniques ranging from traditional to the newest and more sophisticated ones requiring high precision and a very powerful source of energy. Below there is a detailed description of our techniques:

Radiotherapy techniques:

3D Conformal radiation: conformed 3D treatments are performed on tumors where conventional radiotherapy would be the standard treatment. Most of them are done with chemotherapy or new associated drugs.

    • Brain
    • Thorax
    • Oesophagus
    • Lungs
    • Abdomen
    • Pelvis
    • Breast
    • Palliatives

Intensity Modulate Radiation Therapy (IMRT): a specialized way of radiotherapy with external beams, where the capacity of modern multi-layer accelerators to match the beams is used. The objects are varying in the radiation beam intensity and adapt it to shapes and concavities of tumors protecting healthy tissues. It is especially useful to shorten treatments, increase dose, or to protect organs that can be damaged by irradiation.

  • Brain: Re-irradiation on or near to critical areas.
  • Thorax: on tumors with central or esophageal localisation where there is a need to protect structures. Limited doses (heart, lungs, etc.).
  • ORL tumors: shows a clinical improvement of conical toxicity resulting in dosage reduction that salivary glands receive.
  • On these areas the advantages facing tridimensional radiotherapy are very important, in terms of both side effects and survival rates.

 

  • Abdomen:

 

  • Stomach and pancreas cancer: in those particular places where limited dose structures (kidney, stomach, intestinal loops, and liver) can make conventional treatment difficult.
  • Retro peritoneal sarcoma: Essential to limit kidney and intestinal toxicity.
  • Pelvis
  • Prostate cancer
  • Rectum cancer
  • Gynaecological tumor

Volumetric Modulated Arc Therapy (RapidArc/VMAT): An evolution of IMRT that joins conformation advantages offered by variable intensity fields with security and quickness that the arc treatments of radio surgery style provide.

During VMAT a lineal accelerator rotates itself around the patient and at the same time it modulates beam and turn speed, obtaining the complex conformations of IMRT, being five times quicker. RapidArc is the implementation of VMAT carried out by Varian Medical Systems. RapidArc is an revolutionary advance that allows a fast treatment with VMAT, most of the times with only one machine rotation around the patient, distributing the dose adjusted to the size and shape of tumor, with less radiation.

Fractionated stereotactic radiotherapy: uses focused radiation beams targeting a well-defined tumor like radio surgery. The advantage of SRS/SBRT is that it delivers the right amount of radiation in a shorter amount of time. Non-invasive focusing is used, allowing the administration of doses in various fractions without losing precision.

It can be applied on intra cranial and extra cranial levels, on different tumors or metastasis treatments.

Imaging control:

To be effective in this type of treatments and at the same time minimizing damage to healthy surrounding structures, it is important to locate the exact lesion location. IMED Radiotherapy department has special equipment to verify the exact position of the lesion using CT scanning equipment in the treatment room. This is called image guided radiation therapy IGRT.

Our team has a monitoring system that allows it to develop different kinds of IGRT specifically tailored to each patient’s needs.

Megavoltage Computed Tomography relays positional information of patient within its inherent coordinate system.

  • ConeBeam CT allows a TC in the treatment room, detecting the patient’s bone structure and soft tissues.

Brachytherapy:

Our equipment is conceived to perform interstitial and intracavitary brachiotherapy. This is used to treat the following:

Gynecological tumors:

Vaginal, cervix or endometrial tumor boost after surgery,

Cervix tumors boost after a radical treatment (no surgery).

In both cases, we can combine magnetic resonance, ultrasound and CAT scan to reduce the volume of treatment and increasing quality.

Prostatic tumor:

The goal on this process is reducing dose on bladder and rectum. We work together with Vitesse (real time planning), allowing for an easier and faster work system than conventional brachytherapy.

Breast tumors:

It is usually complementary to external radiation in order to apply an external radiation dose (boost) on tumor, facing the rest of treated area.

Immobilization system:

To keep exactly the same position before receiving radiotherapy session is crucial to maximize the effect of radiation against cancer cells and to preserve healthy surrounding structures. To ensure that during each session the same position is treated and to avoid involuntary movements of the patient we have special support fittings offering great precision and versatility in all types of treatments adding comfort and convenience.