The Apollo hospitals recently introduced Intensity Modulated Radiation Therapy (IMRT) for the first time in South India, claimed to bring in new and safer radiation therapy for the treatment of cancer. Thalavai Sundaram, Minister for Health, government of Tamil Nadu, inaugurated the IMRT services last week.

According an Apollo communication, the more safer and effective radiation treatment of IMRT is based on the principle of accurate radiation, which is delivered to cancer cells without damaging normal cells. In the past, the treatment was by using multiple radiation beams that passed through the patient from many different angles. The benefit of IMRT is the delivery of a high radiation dose to the tumour, while sparing the nearby critical structures, thus minimizing radiation-induced complications.

The sources said IMRT requires a lot of expertise on the part of the professionals and the main workflow process involves treatment planning and delivery along with quality assurance practices. Apollo has entrusted experienced physicians and physicists to monitor the treatment. The technologists at Apollo are certified RTT's (Radiation Therapy Technologists) and many are registered nurses. Besides, the hospital has set up a complete physics department staffed by registered Medical Dosimetrists and supervised by a PhD level medical physicist, said the press release.

In IMRT, the treatment plans are based on CT scans which eliminates the possibility of human error, and get an inside view of the body from any angle to get a "beam's eye view" of the area to be treated. The sources said IMRT has clinical advantages over the conventional 3D Conformal Radiation Therapy (3DCRT) technique. It uses the concept of shaping the radiation beam to the tumour, and is more complex as the fields are shaped in terms of dose-volume constrains for tumour and for normal tissues. Forming different Multileaf Collimator shaped segments for each beam angle, and delivering from different directional beams, the integral dose to the tumour is made uniform. At the same time, the critical structure dose is limited, and therefore the IMRT dose prescription is more complex than standard prescription. The treatment planning, its execution and verification are all networked and are under remote computer control (known as the "LANTIS" Treatment data management system).

According to Dr Janos Stumpf, administrator and director Research, Radiation Oncology, Apollo Specialty Hospitals, though effective, IMRT is practiced only in few, mostly academic institutions because of the complexity and labour of the method.

As part of the inauguration, a workshop and hands on training for radiation oncologists from across the country and an academic session for doctors were held at Apollo. The scientific session were attended by an international faculty including Dr R Hawliczek, Donauspital, Vienna and Dr Mary Kara Bucci, radiation oncologist, University of San Francisco.