Faced with the diagnosis of cancer, it is very important to get timely help and highly qualified treatment as quickly as possible. Diagnosis and correct tactics of treatment of malignant tumors at an early stage in 90% of cases guarantees complete recovery.
Radiation therapy is a method of treatment in which a beam of ionizing radiation affects a malignant tumor, causing damage and death of tumor cells. Radiation therapy can be used as an independent technique, as well as within the framework of complex treatment programs.
Oncological center "Medsn.rf" has one of the best and most safe for today technical complexes for radiotherapy - linear accelerator Varian TrueBeam. The equipment makes it possible to implement the newest sophisticated methods of radiation therapy, and most importantly - the most effective in the treatment of cancer patients.
Radiation therapy in "Medskan.rf" also includes a set of procedures for pre-radial preparation. The quality of the preparatory stage largely depends on the result of therapy. Conducting pre-radial training in strict accordance with clinical protocols ensures high quality of treatment - bringing the planned dose to the tumor focus with a minimum dose load on nearby organs.
The therapeutic goal of radiation therapy is suppression of the division of malignant cells and prevention of tumor growth.
Ionizing radiation damages vital cell structures, primarily DNA, resulting in tumor cells losing the ability to divide and die. The resulting defect after the death of tumor cells is replaced by scar tissue. The main goal of radiation therapy is the maximum selective destruction of tumor cells and minimization of damage to normal tissues surrounding them. In many cases, after radiation exposure, the tumor decreases in size, and sometimes it completely disappears.
One of the necessary conditions for the success of radiotherapy is a carefully prepared individual treatment plan, including the determination of the volume and location of the target, the calculation of absorbed doses in the tumor and normal tissues. Preparation of the patient for radiotherapy includes the stage of CT-simulation (marking), contouring of the tumor and surrounding organs, dosimetric planning, verification of the plan (quality assurance of the dosimetry plan).
КТ-симуляция («разметка») и оконтуривание.
Dosimetric planning ("dose calculation") and quality assurance.
At this stage, the medical physicist, on the instructions of a radiopharmaceutical doctor, creates a radiotherapy plan using a computer-based planning system, which includes the calculation of the absorbed dose. At the same time, the level of doses in the volume of the tumor and in the surrounding healthy tissues is strictly regulated by international clinical protocols of radiation therapy. Then the medical physicist together with the dosimetry technician conducts procedures for the quality assurance of the dosimetry plan, making sure that the dose dispensed on the linear accelerator is exactly as planned.
Sessions of radiation therapy.
Varian TrueBeam - a medical linear accelerator of a new class dynamically synchronizing the following parameters: obtaining a tumor image in real time, correcting the patient's position, compensating movements of the tumor volume, forming the radiation beam aperture and dose adjustment. The accuracy check and automatic correction are performed immediately before the irradiation session and during the procedure. Data on the application of the new system in clinical practice confirm the possibilities of radiation therapy that are not available in other existing systems with IGRT capabilities (visual control of the target before irradiation):
Positioning accuracy target of irradiation in the TrueBeam system is within 1 mm (hardware mechanical positioning accuracy within 0,75 mm). It provides new synchronization algorithms between the process of image acquisition, positioning and control of the functions of the device.
Automatic quality control systems the positioning check is performed every 10 milliseconds during the whole treatment session, continuously ensuring the accuracy of the dose of radiation supplied.
New hardware and software package Version 2.5 of the Varian TrueBeam system (Advanced IGRT) allows you to take pictures on the table of the linear accelerator during the treatment session, controlling the deviation of the irradiation target in on-line mode.
Advanced model therapeutic table of the TrueBeam system provides patient positioning with submillimeter accuracy, which allows you to adjust the position of the irradiated volume on the image in real time.
New irradiation regimes allow to increase the radiation dose rate by almost twice as compared to the existing IGRT systems. This reduced the irradiation time with the Varian TrueBeam linear accelerator. For example, the time of a session of stereotaxic irradiation of a tumor can be reduced from 40-60 min, which is achieved on other modern radiosurgical systems, to 5-10 min on a TrueBeam system without loss in the quality of irradiation. Reducing the time of the irradiation session reduces the percentage of possible errors that arise from the movement of the tumor, which is characteristic of long sessions of irradiation.
Coordinated automation of technological processes even more accelerates treatment, allowing almost five times to reduce the time spent on image acquisition, positioning and dose adjustment. For example, the duration of an IMRT session in the routine dose fractionation mode can be reduced from 10-15 min on standard equipment to less than 2 min on a TrueBeam system.
Visual control of the irradiation target (IGRT) during a treatment session using RapidArc technology (VMAT) makes it possible to synchronize image acquisition with simultaneous dose administration during the rotation of the diagnostic and therapeutic radiation beams. The rapid reconstruction of X-ray images in real time, over which the doctor can determine the position of the tumor during a radiotherapy session, allows automatic correction of the patient's position if the tumor has shifted during the irradiation, which ensures high accuracy in bringing the planned dose to the tumor focus.
Radiation therapy is used both as an independent type of treatment, and in combination (most often) with surgical treatment and chemotherapy and some other types of antitumor treatment. Like surgery, radiation therapy is a method of local effect on a tumor, but unlike surgery, it refers to non-invasive methods, i.e. not accompanied by a violation of the integrity of the skin of the patient. The non-invasive nature of the effect of radiotherapy allows, first, to carry out the treatment procedure repeatedly, and secondly, to influence the volume of tissues that is much larger in comparison with surgery, including the use of preventive irradiation, which prevents the development of tumor metastases in high-risk areas.
Radiation therapy can be prescribed:
The decision on the magnitude of the total dose of irradiation and the number of fractions for which it is possible to take it is taken by a specialist - a doctor-radiotherapist depending on the location, size, histological type of the tumor, the patient's condition and many other factors.
The technique of remote radiation therapy has practically no absolute contraindications (with the exception of pregnancy, lactation period and some other conditions).
Each case is considered by a doctor-radiotherapist personified taking into account the anamnesis, the state of the organism and the patient's well-being, and also the need for other methods of treatment. In some cases alternative methods of treatment are more suitable, in others - the patient's condition does not allow to conduct the course of irradiation. The decision on the appointment of radiotherapy by a radiotherapist takes together with other specialists - oncologists, chemotherapists and surgeons at a consultation.
Radiation therapy is one of the most easily tolerated methods of antitumor treatment, which does not require hospitalization, anesthesia and a recovery period. Nevertheless, some side effects are possible (reaction of the body to irradiation), which in most cases are temporary and eventually disappear without consequences.
After the completion of the radiotherapy course, the radiotherapist will give recommendations on the performance of the follow-up examinations (CT, MRI, ultrasound, PET and other studies) and analyzes, and a schedule of follow-up visits will be made. Careful and timely implementation of these recommendations is very important for an adequate assessment of the course of the course of the disease after treatment. As a rule, dynamic observation lasts several years after the end of radiation therapy.
At the medical center "Medsn.rf", a team of highly qualified specialists provides medical assistance to patients who have been practicing in leading cancer clinics in the US and Europe (UPMC Whitfield Cancer Center, etc.)
Radiation therapy is carried out using modern diagnostic and high-tech equipment, which makes it possible to provide medical care to patients even in the most complicated clinical picture, despite the stage of the disease.
Thanks to the technology, the doctor can apply various variants of position and parameters of the installation, which allows creating a large number of modifications of the targeted effect on malignant neoplasm. In the automatic mode, not only the formation of a directed beam of rays occurs, but also the regulation of the power and radiation dose.
It allows to carry out radiotherapy with intensity modulation when performing 3D scanning of tissues for high-precision direction of radiation beams to neoplasm at various angles.
Natalia Morozova
Radiologist
Nina Ikonnikova
Alexey Shchikota
Ultrasonography specialist
Sergey Demichev
General doctor
Alexey Moiseev
Head of medical physics department
Dmitry Savkin
Konstantin Borisov
Head of Chemotherapy Dept.
Kirill Petrov
Head of Radiology Dept.
Sergey Usychkin
Head of Radiotherapy Dept.
Sergey Rusetsky
Medical physicist
Fedor Vasiliev
Dmitrii Olkin
Oncologist
Natalia Kalakutskaia
Olga Gornastoleva
Pavel Lutsenko
Daler KHamidov
Roman SHuldeshov
Therapist, сardiologist.
Clinical examination of patients undergoing antitumor treatment is carried out within the framework of the "Medsn.rf" Cancer Center. Thanks to this, it is possible to correctly assess the dynamics of the course of the disease and begin timely treatment in case of its return, as well as to adjust the side effects of therapy.
ChemoradiotherapyTo improve the therapeutic effect of patients in combination with radiation therapy can be appointed chemotherapy course. Thanks to the multidisciplinary approach, it is possible to achieve better results in the fight against cancer.
To select the treatment methods and determine the protocol of radiotherapy, specialists from the best Russian and foreign oncology centers can be involved, which will help to agree on the optimal strategy for combating cancer.
Patients can be prescribed maintenance symptomatic therapy in combination with palliative radiotherapy, aimed at alleviating the symptoms caused by the progression of cancer, reducing the growth rate of the tumor. This allows to reduce the manifestations of respiratory failure in lung cancer, to ease the pain caused by metastatic damage, to stop bleeding from tumors of internal organs.
A patient at the age of 75 years was diagnosed with right breast cancer 1.1. pT1N0M0, R0, L0V0, G2, ER +, PR +, Her2 / neu -. In the case history - carrying out radical resection of the tumor in the upper-outer quadrant of the breast. At the medical consultation it was decided to conduct a course of radiation therapy according to the scheme of hypofractionation. A single focal dose of radiation was 2.66 Gy, the total focal dose was 42.56 Gy. In total, the patient underwent 16 sessions of radiotherapy. Negative reactions were reduced to zero. Thanks to complex treatment, it was possible to significantly improve the patient's quality of life. She can lead an active life, when performing simple medical recommendations.
A patient at the age of 55 turned to the oncology center "Medsn.rf" for help after many public and private oncological centers refused to treat her. Clinical diagnosis is ovarian cancer stage IV. The medical consultation, after reviewing the medical history and current results, recommended a course of chemotherapy. Negative reactions were reduced to zero. Against the background of treatment, the patient's condition improved, and a re-examination of PET-CT confirmed the absence of foci of pathological metabolic activity of RFP. Thanks to the treatment, it was possible to significantly improve the patient's quality of life. She can lead an active life, when performing simple medical recommendations.
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