THE DEPARTMENT OF RADIATION ONCOLOGY

Conforming to the mandate of the Tata Memorial Hospital, the activities in the departments of radiation oncology & medical physics can be best highlighted under the headings of Service, Research, and Education.

SERVICE

Fourteen Radiation Oncologists, 33 Registrars and post-graduate students, 9 Medical Physicists, 24 Technologists, a Medical Social Worker, Trained Nurses, 9 secretaries and other staff support the Departments of Radiation Oncology and Medical Physics. There are 38 beds for radiotherapy (including 11 beds for patients undergoing brachytherapy). Annually over 4500 patients undergo radiotherapy at the TMH. The infrastructure available for external beam therapy includes three Linear Accelerators with 6 to 15 MV photon energy and multiple electron energies from 6 to 20 MeV (Clinac-2100C and Clinac 2100C/D, Clinac 6EX with millennium MLC) and four Telecobalt units (Theratron-780, Theratron-780C, Alcyon, and Elite 80). In addition there is one Conventional Simulator (Ximatron), a CT Simulator (Somatom-Emotion) with Virtual Simulation (Coherence Dosimetrist / Adac), a C-Arm Simulator and a fully equipped Mould Room.

The facilities currently available are used to carry out sophisticated, state-of-the-art treatments like intensity modulated radiotherapy & radiosurgery (IMRT & IMRS), 3-D conformal radiotherapy (3-D CRT), Stereotactic radiotherapy/ radiosurgery (SRT/ SRS) Total Body Irradiation (TBI), Total Skin Electron Beam Therapy (TSET) & Electron Arc Therapy apart from conventional radiotherapy. Intra-cranial Stereotactic Radiotherapy and Radiosurgery are delivered using the "Brain Lab" system comprising of micro-multileaf collimator (mMLC) and a dedicated planning system. Extra-cranial Stereotactic Radiotherapy and Radiosurgery are done using the Stereotactic Body Frame (SBF). The "Helios" planning software is used for IMRT planning. "Eclipse" is our most recently acquired state-of-the-art planning system used for complex external beam radiotherapy planning. Apart from the usual features it had additional features like image fusion using MRI/ PET/ CT images. It along with CadPlan radiotherapy treatment planning systems are used for external radiotherapy planning and the PLATO planning system is used for both High Dose Rate (HDR) and Low Dose Rate (LDR) Brachytherapy planning. A vigorous quality assurance program and features like the "Online Portal Imaging" ensure efficient and accurate radiotherapy treatment.

Brachytherapy forms an integral part of many treatment protocols in the Department. Various brachytherapy procedures are judiciously practiced in this centre using both remote and manual after-loading systems for a wide range of clinical situations. Interstitial brachytherapy using Iridium-192 was introduced for the first time in the country, at the Tata Memorial Hospital in 1981. Intracavitary and Interstitial brachytherapy with Low Dose Rate (LDR) and High Dose Rate (HDR) is being increasingly used for various cancer sites. The Department of Medical Physics is equipped with sophisticated modern equipment such as Radiation Field Analyzer (Blue Phantom), ionization chambers & brachytherapy dosimetry systems with electrometers, TLD dosimeter, film dosimetry system etc. for accurate and precise dose computation and treatment delivery.

For a modern and busy radiotherapy department at the Tata Memorial Hospital, it is essential to have a fast and efficient patient data archival and retrieval system. The utility of this system is multiplied if it can be networked to the radiotherapy planning and treatment machines. With the "VarisNetworking System" it is possible to transfer data digitally from CT Scan/MRI/PET scan and Treatment Planning System to the Linear Accelerators. This ensures accurate and quick data transfer for conformal radiotherapy, SRT/SRS and IMRT/IMRS with complete verification and accuracy. The Varis system can also be coupled with the "Hospital Information System (HIS)" and storage of data on "PACS". We have recently commissioned the "Radiation Oncology Information System (ROIS)" and is currently under evaluation in the department. This is a versatile system and had already proven to be useful in patient appointments, radiotherapy treatment information archival and departmental audit.

Annually over 4500 patients receive radiotherapy. Our efforts in the department have always been to deliver optimal radiotherapy to all patients. Majority of the patients in the department receives treatment free or at an affordable cost.