The Radiation Medicine Department is the most modern, best equipped radiation facility in Western New York. This enables the department to offer a variety of state-of-the-art treatment options, many of which are unavailable anywhere else in the region. To ensure that patients receive cutting edge treatment, the RPCI Radiation Medicine Department routinely invests in new equipment and other physical resources which include:
- 4 Linear Accelerator (Linac) Treatment Vaults
- 2 CT simulators
- A Gamma Knife Suite
- A Brachytherapy Suite
- A Day Hospital/Recovery Unit
- An Intraoperative Suite with Private Recovery Room
- 14 Treatment Planning Stations
- A Video Conferencing Center
External Beam Radiation Therapy
Conformal 3-Dimensional Radiation Therapy
Three-dimensional (3D) conformal radiation therapy is a radiation technique that allows a precise radiation dose to be delivered to the tumor while minimizing the exposure to normal tissues. 3-D conformal therapy has become the new standard in radiation therapy, combining modern imaging technology, such as computed tomography (CT) and magnetic resonance imaging (MRI) with state-of-the-art computer planning systems.
Intensity Modulated Radiation Therapy
Intensity Modulated Radiation Therapy, or IMRT is an advanced form of 3-D conformal radiation therapy that links treatment planning software to the actual treatment machine using 3-dimensional imaging and different intensities of radiation according to the tumor’s size and shape. For difficult tumors, such as those very close to critical organs, IMRT allows the varying, or modulating, of the beam providing a safer treatment delivery. The treatment machine contains a multi-leaf collimator (MLC), which is a computer-controlled device with as many as 120 tungsten fingers, or leaves, inside the treatment head. This device is what enables the treatment team to sculpt the radiation beams to the shape of the tumor by adjusting the leaves and moving the treatment machine to treat from several different angles.
Total Body Irradiation (TBI)
Total Body Irradiation is a technique used to deliver irradiation to the entire body. Total body irradiation is part of a complex treatment program for certain conditions and can be combined with high-dose chemotherapy in preparation for blood or marrow transplantation.
Internal Radiation Therapy or Brachytherapy
Prostate Seed Brachytherapy
Brachytherapy is the implantation of tiny radioactive "seeds" into the prostate gland. The specified radiation emitted by the radioactive "seeds" kill the tumor cells. This procedure can be combined with external-beam radiation to increase the radiation dose while sparing normal tissues from damage. Complex 3 dimensional planning of the prostate is done prior to implantation using transrectal ultrasound (TRUS) which creates a three-dimensional map of the prostate. The computer then calculates the volume of the gland, and the number of radioactive "seeds" that are needed along with the specific location where they should be placed.
The procedure, performed on an outpatient basis, takes 45 to 60 minutes and is done under local (spinal) anesthesia. The radioactive seeds are placed by special needles that are inserted through the perineum into the prostate. The seeds contain a radioactive isotope (usually Palladium 103 or Iodine 125), which emits radiation for about 3 months before becoming inert. Brachytherapy patients are discharged the same day and can resume normal activity within two days.
High Dose Rate Brachytherapy (HDR)
This technique allows for High Dose Rate (HDR) radiation to be delivered directly to tumors. Delivery of HDR radiation is administered using an automated, remote after-loading device for the placement of the radioactive source. Small catheters (tubes) are placed in the treatment area and a radioactive source is positioned inside these catheters. This allows therapeutic doses to be delivered in a short period of time.
Low Dose Rate Brachytherapy (LDR)
This technique delivers Low Dose Rate (LDR) radiation to tumor areas. These are usually temporary implants. Catheters are placed in accessible body cavities or interstitially (in the tissue). Radioactive sources are then positioned into these catheters. Interstitial implants, such as radioactive seed implants of the prostate gland, use radioactive sources that remain in place permanently. The radioactivity eventually becomes completely inactive.
Intraopertive Radiation Therapy (IORT)
IORT involves the delivery of high dose radiation by a high activity radiation source housed in a shielded, computer-controlled device and programmed so that the radiation source can be delivered into the patient by remote control. The radiation source enters the patient through a special pencil thin flexible catheter, which is able to conform to most anatomical shapes.
Stereotactic Radiosurgery
Gamma Knife Stereotactic Radiosurgery (SRS)
This the delivery of sharply focused beams of radiation to intracranial (inside the skull) targets. Multiple small beams of radiation intersect at a defined point to create a sphere of high dose radiation, which is then precisely targeted at a brain lesion without opening the skull. The Gamma Knife unit delivers radiation from a fixed array of 201 small radioactive (cobalt-60) sources. A team of neurosurgeons, radiation oncologists and medical physicists precisely plan the brain lesion to be targeted with Magnetic Resonance Imaging (MRI) and a head frame.
Image-Guided Radiation Therapy (IGRT)
Roswell Park among first in North America to offer new treatment for spinal tumors Patients who cannot tolerate surgery for the treatment of spinal tumors now have an attractive alternative with the introduction of stereotactic body radiation therapy (SBRT) at Roswell Park Cancer Institute. With the acquisition of its new Trilogy® system, RPCI is the first treatment center in Western New York and one of only a handful in North America to offer SBRT. The treatment delivers very high doses of radiation, focused with pinpoint precision through the use of image-guided radiation therapy (IGRT). Combining the two technologies results in several benefits:
- The treatment makes it possible to knock out even tumors that were previously resistant to radiation.
- Because it delivers radiation so precisely, it helps protect healthy tissues near the tumor, so high doses can be administered even in areas where radiation was given previously. A CT scan built into the Trilogy IGRT system produces images immediately prior to treatment to ensure the exact location of the tumor.
- Patients can be treated over a much shorter period of time compared with conventional radiation therapy, resulting in greater comfort and convenience. On average, outpatient treatments last three to five days rather than the six weeks usually required for conventional radiotherapy.