At ACTC we take pride in providing our patients with the techniques and technology to effectively and safely treat cancer with radiation therapy.
Forms of Radiation Therapy
There are several forms of radiation therapy, all of which use the main general principles. Each patient’s treatment is individualized. Radiation may be used alone or in combination with other therapies such as surgery, chemotherapy and immunotherapy. Two patients - even if they have the same kind of cancer - may not receive the same kind of radiation therapy. Depending on the type of cancer and the location, Radiation therapy is delivered one of two ways, either externally using a linear accelerator in combination with treatment devices or internally with the implantation of radioactive ‘seeds’
External Beam Radiation
The most common use of radiation is called external beam. This entails the use of a complex machine called a linear accelerator that generates high energy x-rays. These x-rays are directed at the cancer and administered via a collimator that is attached to a rotating gantry. The combination of the rotating gantry, collimator and adjustable table allows the radiation oncologist to precisely manipulate the direction of the radiation beam.
The use of special devices, planning software and techniques add to the precision of the delivery and allow the radiation oncologist to conform the beam to the shape of the tumor. These techniques also assist the radiation oncologist in avoiding the delivery of radiation to non-cancer areas thereby sparing normal tissue.
Conventional Radiotherapy delivers fractionated radiation doses over many visits. The target area usually includes a margin of normal tissue. Patients have an initial consultation and simulation in which a treatment plan is developed, and will return daily over several weeks to receive the complete radiation dose.
American Cancer Treatment Center offers several services that enhance external beam radiation including…
Intensity-Modulated Radiotherapy (IMRT)
Intensity Modulated Radiation Therapy or IMRT allows us to conform high doses of radiation to tumor cells while sparing normal surrounding tissues. With sophisticated treatment planning software, we are able to design a specific plan to deliver different dose levels to different target areas, allowing us to better optimize each patient's treatment to the risk and tolerance of each body area. †The radiation dose is designed to conform to three-dimensiona; (3-D) shape of the tumor by modulating or controlling the intensity of the radiation. A Multi-leaf collimator (MLC) is able to “shape” and change the sizes of different beam angles to obtain the required dose distribution. This leads to improved radiation delivery to tumors, while signifacntly reducing† side effects.
Image Guided Radiation Therapy (IGRT)
Some tumors may move slightly due to occurrences such as organ filling, loss of weight or breathing. To help better deliver the radiation to the tumor, Radiation Oncologists sometimes use Image Guided Radiation Therapy (IGRT). IGRT involves conformal radiation treatment guided by imaging such as CT, ultrasound or X-rays, taken in the treatment room just before the patient is given the radiation treatment on a daily basis.
All patients first undergo a CT scan as part of the planning process. The information from the CT Scan is then transmitted to the computer in the control area to allow the doctors and therapists to compare the earlier image with the images taken just before treatment. During IGRT, doctors compare these images to see if the treatment needs to be adjusted or shifted. This allows doctors to better target the cancer while avoiding nearby healthy tissue. In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for the IGRT. This helps to account for organ/tumor motion even if the body is immobilized by a casting device.
Stereotactic Radiotherapy (SRT)
Stereotactic radiation therapy, or SRT, is a newer form of external radiation treatment used to eradicate cancerous growths. With SRT, a series of precise radiation beams are simultaneously aimed at a tumor from many different directions. The radiation dose is higher and much more precise, resulting in fewer treatments necessary than traditional radiation therapy. Because SRT delivery is precise, there is less risk of damage to the healthy tissues surrounding the tumor.
SRT often is used to treat cancers in the radiation-sensitive areas of the brain, head and neck — but it can often be used in other locations where radiation is effective. A linear accelerator uses larger beams of radiation and can treat large tumors in a short time by delivering high-energy, X-ray photons in curving paths.
When your brain, head or neck is being treated with SRT, your head is immobilized in a special frame. This minimizes the chance that you will move and inadvertently cause damage to normal tissues near the tumor. When SRT is used to treat other areas of the body, a body cast or frame will be used to keep your body completely still during treatment. Occasionally, the doctor will inject small gold pellets, or “markers,” into the tumor. CT scans or MRIs help map the exact location of the tumor in relation to the markers, body cast or head frame.
Each SRT session can last from a few minutes up to one hour with the entire treatment taking one to six weeks depending on the cancert.
Internal Radiation Therapy- Brachytherapy
Brachytherapy delivers a high dose of radiation from within the tumor through the surgical implantation of radioactive material into the tumor. The radioactive material is sealed in catheters, seeds or capsules. For some procedures, the patient stays in the hospital for several days while the radioactive seeds deliver their dose to the tumor. The implant stays in permanently, and the patient may go home soon after the procedure is completed.
High-Dose Rate (HDR) Brachytherapy
HDR brachytherapy is a form of internal radiotherapy where a catheter (a small plastic tube or balloon) is temporarily implanted in the tumor area. A device called a remote afterloader carefully, precisely and safely, places a highly radioactive material inside the body via the catheter for a calculated period of time.
Multiple sessions may take place, at the end of which the catheter is removed. HDR brachytherapy is most commonly used with cancers located near the outside of the body. New devices make it an option for some breast cancers, thereby shortening the number of treatment visits while delivering the same amount of radiation necessary to destroy the tumor as with conventional radiation therapy. Because it is delivered internally, higher doses can be delivered at each visit, thereby reducing the number of treatments. American Cancer Treatment Center was the first cancer facility in Florida to utilize the Nucletron Digital Afterloader.
Electron Beam Therapy.(EBT)
Electron Beam Therapy (EBT) is another type of external beam radiation except instead of photons, electrons are emitted from the linear accelerator. The physical properties of electron beams vs. photons are different in that electron beams are superficial and don’t penetrate. Electron Beam Therapy is primarily used in the treatment of skin cancer and is an alternative to surgery because no incisions take place and tissue is not removed. This is especially advantageous for large skin cancer or when it is ..locations such as the nose.
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