Radiation Oncology

A wide range of services are provided for different stages of treatment:

• Radiotherapy consultation
• Second opinion consultations
• Group tumour board consultation with multidisciplinary team
• Radiotherapy treatments for various cancers:
  • Adaptive radiotherapy with surface guided radiotherapy (SGRT)
  • Rapid arc ( VMAT [volumetric modulated adaptive radiotherapy])
  • Image guided radiotherapy (SGRT)
  • Intensity modulated radiotherapy (IMRT)
  • Three-dimensional conformal radiotherapy (3DCRT)
  • Stereotactic radiosurgery (SRS)
  • Stereotactic body radiotherapy (SBRT)
  • Brachytherapy
• Post treatment follow-up care
• Palliative care and symptomatic management
• WeCan cancer support group
• Onco-dermatology services for management of skin reactions in radiotherapy patients
• Onco-rehabilitation services, such as dietician consultation, physiotherapy, speech & swallowing therapy, counselling, and yoga therapy for radiotherapy patients.

At the Department of Radiation Oncology, radiation treatment is provided for various types of cancers. Some of them are enumerated below:

• Cancers of mouth and throat (head and neck cancers)
• Breast cancers
• Lung cancers
• Gynaecological cancers (cervical cancers, uterine cancers)
• Prostate cancer
• Gastrointestinal cancers (oesophageal, stomach \, rectal, and pancreatic cancers)
• Liver and biliary tract cancers
• Brain tumours
• Paediatric tumours
• Extremity sarcomas and other rare tumours
• Palliative radiotherapy treatments for symptom control

Radiotherapy is a cancer treatment that uses high energy X-rays or gamma rays. This treatment can be administered from outside the body (external beam radiotherapy), or from within the body (brachytherapy). External beam radiotherapy is administered using specialised machines known as linear accelerators. The department of radiation oncology is equipped with India’s first and the most advanced ETHOS linear accelerator with SGRT. Sir H. N. Reliance Foundation Hospital is the only facility in Maharashtra offering Adaptive Radiotherapy, in which individual patients are provided with highly customised radiotherapy each day depending on the status of the tumour and internal organs.

Radiotherapy treatment equipment:

1. ETHOS adaptive linear accelerator with SGRT:

Welcome to a new era of cancer treatment at Sir H. N. Reliance Foundation Hospital and Research Centre with the ground-breaking ETHOS linear accelerator in combination with SGRT. Adaptive intelligence based precision radiotherapy is the future of radiation therapy, and with ETHOS, we are at the forefront of this revolutionary technology. The advantages of ETHOS are as follows:

• Customised treatment for every patient each day: ETHOS enables a patient-centric approach by providing personalised treatment plans based on individual’s unique anatomy and changes in the tumour over time. With the help of advanced imaging techniques, such as onboard cone-beam computed tomography, ETHOS allows for real-time imaging during treatment sessions. This ability to adapt and adjust the treatment plan throughout the course of therapy ensures precise targeting of the tumour and minimises radiation exposure to healthy tissues.
• Enhanced tumour control and reduced side effects: ETHOS adapts to changes in the tumour shape, position, and size during treatment. By accurately tracking and adjusting the treatment beam in real-time, ETHOS maximises the radiation dose to the tumour while minimising damage to surrounding healthy tissues. This ensures optimal treatment, improved outcomes, and reduced side effects.
• Faster treatment and better outcomes: ETHOS is more than three times faster than conventional linear accelerators. Hence, the patient’s time on the machine reduces, making the process more comfortable. Moreover, faster treatment ensures less variation in the tissues while treatment is being delivered, which improves the treatment outcomes.
• Integrated tumour tracking: The doctors are able to use patient’s previous imaging, such as PET scan, MRI, and CT scan to track the tumour daily. This is a significant change from other linear accelerators, where only CT scan taken during radiotherapy planning is available for comparison. This significantly improves the visibility of the tumour, and the ability to track it accurately.
• Enhanced safety: ETHOS has an intuitive user interface and automated treatment planning algorithms that makes the whole process completely automated and free from errors. The rigid safety protocols during radiotherapy planning and treatment ensures that there is no room for error and the treatment is delivered precisely and safely.
• Increased precision and accuracy: Compared to non-adaptive treatment methods, ETHOS has state-of-the-art imaging and motion management capabilities and can account for daily anatomical variations and intra-fraction motion, ensuring that the radiation beam is precisely targeted to the tumour, even when the tumour moves due to patient’s breathing or motion of the organs. This level of precision allows for higher treatment doses to be safely delivered to the tumour, while minimizing the risk to surrounding healthy tissues.
• Improved patient experience and quality of life: Adaptive radiotherapy using ETHOS offers patients a superior treatment experience with minimal disruptions to their daily lives. By precisely targeting the tumour and minimising radiation exposure to healthy tissues, patients experience fewer side effects, leading to improved quality of life during and after treatment. The streamlined workflow and reduced treatment times enable patients to spend less time in the treatment room and more time with their loved ones while focussing on their recovery.
• Unique combination of SGRT and ETHOS: We at Sir H. N. Reliance Foundation Hospital and Research Center are the pioneers of SGRT in India. This is a unique technology which helps us to continuously track the patient’s body to ensure precise treatment, which significantly enhances the accuracy of the ETHOS adaptive radiotherapy. This technology enables us to avoid putting any tattoos or permanent markings on the patient’s body.

2. TrueBeam STx linear accelerator with SGRT

Our institution launched India’s first ever most advanced TrueBeam STX liner accelerator in the year 2015. It specialises in providing high precision radiation treatments such as Stereotactic radiosurgery (SRS), Stereotactic body radiotherapy (SBRT). This linear accelerator is also equipped with SGRT which was India’s first ever SGRT facility. This linear accelerator is being specially used for treatment of young children.

3. Varian brachytherapy GammaMedplus iX

Brachytherapy or internal radiotherapy forms an important aspect of treatment for cancers such as cervical cancers, uterine cancers, breast cancers, and sarcomas. This involves placing of specialised tubes inside the patient’s body near the tumour region and radiation is given through these tubes in close proximity of the tumour.

4. Radiotherapy Quality assurance (QA) equipment

QA is of paramount importance in ensuring safe and precise radiotherapy. We follow strict guidelines to ensure QA of the equipment as well as QA of each patient’s radiotherapy treatment plan. In case of adaptive radiotherapy, the QA is done every day a new adaptive plan is designed.