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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 elec tron
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 integr al
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.
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