The Gurgaon based multi super speciality hospital Artemis Health Institute is the first hospital in the entire northern India to offer Image Guided Radiation Therapy (IGRT) to its patients. It has acquired an Elekta- Synergy platform which is enabled to do IGRT along with the intensity modulated radiation and 3-D Conformal radiotherapy.
The system permits treating cancers within the moving organs with a very high precion. The tumours best treated with this technique are cancers of lung, prostate, pharynx and liver. The image guidance can visualize the exact position of the tumour in real time and activate the radiation therapy delivery.
Talking to pharmabiz Dr Tejinder Kataria radiation oncologist, said, "Our mission is to treat patients with empathy and compassion and this will be spirit to receive oncology patients. This treatment is especially beneficial in gynaecological cancers, oral cancers and cancers of oesophagus and intra bronchial lung cancer".
"To facilitate the patient immobilization special accessories, which have been, provided for adult as well as paediatric patients. The planning images will be acquired on PET/CT for all patients requiring this treatment in a protocol-based manner for the first time in the country. The Institute has also purchased and commissioned a Microselctron HDR machine, which has a high strength Iridium-192 source with special applicators that can be placed within the patients with minimum discomfort. The patient can go home either on the same day or after an overnight stay, Kataria further added. "
Earlier treatment by radiotherapy would locate the approximate location of the tumour and target radiation to the surrounding healthy cells. The delivery of radiation therapy often also had to rely on assumptions about target locations based on historical data, which could be a week or more old at the time of treatment.
The earliest radiotherapy devices used primitive X-ray tubes to generate very weak radiation not enough to cure or to penetrate the body very deeply. But after few decades, new radiation therapy treatment came into existence namely cobalt machine. This system offered higher energy but it has delivered relatively slow treatments that lengthened in time as the radioactive source within the machine weakened.
IGRT uses a linear accelerator, equipped with a kilo voltage-imaging source and solid state X-ray detector. Linear accelerator (LINAC) is the device used for external beam radiation treatments for patients with cancer. It delivers a uniform dose of high-energy x-ray to the region of the patient's tumour. These x-rays can destroy the cancer cells while sparing the surrounding normal tissue. The machine combines both IMRT (Intensity Modulated Radiation Therapy) with X-ray Volume Imaging Technology, which allows a real time clear image of the tumour site immediately before treatment. Once the exact location of the tumour is detected, the linear accelerator sends out targeted radiation to the cancerous cells, thereby killing them. The radiation beam of the linear accelerator can be shaped to match the dimensions of a tumour and a high dose of radiation can be delivered to a malignancy without harming surrounding normal tissue.
The advantages of IGRT over traditional forms of radiotherapy are manifold. The chances of recurrence of cancer goes down drastically as the detection of the exact tumour location and size and the precise method of destroying the cancer cells leaves very little room for the cancer to manifest itself again. It also leads to a significant reduction in the margin of healthy cells affected by the radiation. Because of reduced side effects, patient compliance is also much more with this kind of treatment. A larger number of patients undergo the complete treatment because of lower levels of discomfort and distress; hence success rates with IGRT treatment are much higher than other therapy.