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Radiation therapy is the use of ionizing radiation for treatment of diseases and the specialized field of using ionizing radiation for the treatment of cancers is known as Radiation Oncology.

Radiology as a specialty was practiced in India as early as in 1920, though meagre documentation is available from that time. In the early 1940s, four Radium Institutes were established in the four corners of the country in Patna, Agra, Madras (Chennai) and Lahore, providing radiation treatments for both benign and malignant diseases, within existing Medical College Hospitals.

Around the same time the Tata Memorial Centre (1941) in Mumbai and the Chittaranjan Cancer Hospital in Kolkata were also established, both being conceived as centres of excellence to deal with cancer alone.  Similar to radiological sciences and departments in other centres world over at this time, the inception of the department of radiation oncology at the TMC lies in a combined department of diagnosis and therapy, the Department of Radiological Sciences as it was called then. However, what distinguishes this department from other centres in the country is the presence of Medical physicists as a part of the department early on.

The infrastructure available in the department from the beginning to the present day is a reflection of the foresight of the people managing the Institute and department.

The evolution from deep X-rays to telecobalt (megavoltage) took place in the 1960s with the main thrust coming through the Colombo plan. Further efforts by Dr. KA Dinshaw, who returned to India after training in the UK, gave a thrust to the development of this specialty, as it separated from Radiology.

 

Teletherapy (EBRT)

Brachytherapy

Early decades (1941-1965)

 

  Deep X-Ray Therapy 220KV (2)

Radon seeds

    Superficial X-ray unit: 85kV & contact therapy unit  
    Electrotherapy unit: ultra short wave  & ultra violet  
    Deep X-Ray Therapy 200KV (Maximar) (3)  
    Deep X-Ray Therapy 250KV (2)  
    TelecobaltTheratron Junior   Preloaded Caesium/Cobalt-60 Capsules
    Deep X-Ray Therapy 300KV   Gold-192 Grains
     

Beginning of a new era (1965 – 1975)

    Telecobalt Theratron-60  
    Telecobalt Janus
   Caesium-137 Gammatron
  Manual Afterloading: cobalt-60
     

1976 - 1985

      Caesium-13 tubes (BARC)
    Telecobaltgammarex-R   Caesium-13 tubes/needles (Amersham)
    Linear Accelerator Mevatron-12  
    TPS TP-11 computer
  Mould room facility
  Slectron-LDR/MDR: Caesium-137
  Manual Interstitial: Iridium-192 wires
    Simulator (Therasim 750)
  Linear Accelerator Clinac-6
 
    TPS Somados computer  
    TelecobaltAlcyon
  Telecobalt Theratron-780
 
     

1986 - 1995

    Telecobalt Theratron-780C   MicroSelectron-LDR/MDR
    Simulator C-arm  
    Dual Energy LA Clinac-2100C   MicroSelectron-HDR
  TPS-Plato
     

1996 - 2005

    TMS-Helax Planning computer  
    Simulator (Ximatron)  
    TPS Cadplan and Helios, Body Frame   MicroSelectron-HDR upgradation
  PLATO upgradation
 

  Brainlab Micro-multileaf system SRS/SRT
  IMRT (Helios). Varis Networking

 
    Telecobalt (Elite 80)  
    CT simulator (Emotion)
  Virtual simulation (Coherence dosimetrist)
  Simulator accessory (Ximavision)
  Linear accelerator (ClinaceEx)
  Millenium MLC
  BrainLab upgradation
  RFA Blue phantom
   MicroSelectron HDR control console upgradation
   C-arm simulator in the OT
    ECLIPSE radiotherapy TPS
  In-vivo real time multi channel dosimeter
  TLD dosimeter Rexon
   MRI compatible intracavitary applicators
  3D Image based brachytherapy treatment planning
     

2006 onwards

     PET based planning (ADVANTAGE Sim)
   Telecobalt unit (Equinox)
  Digitally networked C-arm
    IGRT suite (Tomotherapy, NovalisTx, Trilogy, 2nd HDR Brachytherapy unit)  
     

2016 onwards

    Unique  

The current facilities offer modern sophisticated, state-of-the-art treatments like 3-D conformal radiotherapy (3-D CRT), intensity modulated radiotherapy with image guidance & radiosurgery (IMRT & IMRS, with IGRT), Stereotactic radiotherapy/ radiosurgery (SRS, SRT) with appropriate motion management, in addition to 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.

The expertise and experience of the motivated faculty renders us with the ability to deliver high precision, conformal radiotherapy with state of the art facilities. We have the experience to deliver complex radiotherapy procedures like TSET (Total Skin Electron Therapy), TBI and Adaptive radiotherapy. In addition, the physicians are specialized by disease site in the body and form an integral part of the disease management groups (DMGs).

The department can boast of being an active brachytherapy facility with experience in practically all sites of the body. The proof of this reputation lies in the fact that 6-8 fellows/ observers visit the department annually for training in brachytherapy procedures. The efforts are aided by modern treatment planning systems.

A stringent quality assurance (QA) program and features like the "Online Portal Imaging and online CT imaging (both KVCT AND MVCT)" ensure efficient and accurate radiotherapy treatment delivery and verification. With the newer Linear Accelerators, this is possible.

The objective of the department of Radiation Oncology at the Tata Memorial Centre is directed towards delivering optimal radiotherapy and comprehensive patient care.

Intensity Modulated Radiotherapy (IMRT)

Intensity-modulated radiation therapy (IMRT) is an advanced form of three-dimensional conformal radiotherapy (3DCRT). It uses sophisticated software and hardware to vary the shape and intensity of radiation delivered to different parts of the treatment area. It is one of the most precise forms of external beam radiation therapy available. Currently, IMRT is used to treat select patients with prostate cancer, head and neck cancer, gynaecologic cancers, some brain tumors, pediatric and bone & soft tissue tumors. In IMRT, the physician designates specific doses of radiation (constraints) that the tumor and normal surrounding tissues should receive. The physics team then uses a sophisticated computer program to develop an individualized plan to meet the constraints. This process is termed "inverse treatment planning". The treatment plan is then evaluated and finalized before the precise implementation and delivery of the planned radiation using sophisticated linear accelerators under strict quality assurance. Optimal delivery of IMRT is a team effort that includes the radiation oncologist, medical radiation physicist and radiation therapy technologist.

Stereotactic Radiosurgery (SRS)

It is a highly precise technique used to treat brain tumors and other intracranial cancers. Stereotactic radiosurgery involves a single, high-dose application of radiation to the tumor, instead of the many smaller doses given in standard radiation treatment. This technique, which is accurate to one millimeter or less, does not require surgery. Stereotactic radiosurgery includes the participation of the radiation oncology, radiology and surgical team who work together to evaluate and treat each patient. Radiosurgery is limited to lesions that are well-defined and no larger than three to four centimeters. The location of the lesion is also important. For example, lesions too close to radiosensitive structures, such as the optic nerve, are not good targets for radiosurgery. Through the use of three-dimensional computer-aided planning and the high degree of immobilization, the treatment can minimize the amount of radiation to healthy brain tissue. Stereotactic radiosurgery is routinely used for brain tumors and lesions. It may be the primary treatment; utilized where a tumor is inaccessible by surgical means; or as a boost or adjunct to other treatments. Stereotactic radiosurgery is an important treatment option for many patients with abnormal blood vessels in the brain (for example, arterio-venous malformations), solitary metastatic brain tumors, meningiomas and other special tumors of the head and neck regions, such as acoustic schwannomas. Radiation is delivered using a framed system. Several radiation beams are precisely aimed to converge upon a small tumor. The patient lies on a couch that rotates 180 degrees for maximum targeting, without harming surrounding tissues.

Stereotactic Radiotherapy (SRT)

SRT accurately delivers lower doses of radiation over a series of treatment sessions. The overall total dose is higher than with an SRS treatment. Each treatment is called a "fraction" therefore this type of therapy is sometimes called "fractionated" therapy. SRT combines the advanced precision of radiosurgery with fractionated radiation and hence improves delivery compared to standard radiation therapy. Fractionated therapy can be particularly important when the tumor is adjacent to or involving vital neurological structures such as the optic nerve. It can be used in situations where single dose radiosurgery cannot be applied safely. Patients who have larger lesions that are not appropriate for radiosurgery may benefit from the advanced precision and focal radiation applied with SRT. SRT also has ideal application for pediatric patients because compared to conventional radiation it treats a much smaller area of a normal brain. Children are more sensitive to many of the side effects from radiation. SRT utilizes a frame system with a mouth bite which is a painless dental impression that fixes to the upper teeth. . This allows the patient to be precisely positioned on a repeat basis.

Stereotactic Body Frame (SBF) Radiotherapy

Stereotactic body radiotherapy is also called as extra-cranial stereotaxy. This specialized technique of radiotherapy allows very precise delivery of radiation doses to relatively small target volumes situated at sites outside the cranium. Owing to the high degree of precision in radiation delivery and the small volumes of tissue generally treated, it is possible to deliver higher doses of radiation per sitting and thus resulting in shorter duration of total treatment time. For accurate delivery and reproducibility of patients' treatment position, a special device called the stereotactic body frame is used for positioning and immobilizing the patient. The treatment is completely non-invasive requiring no needle sticks or anesthesia for treatment. It is an out-patient procedure requiring no hospitalization. It is also convenient in that it is usually delivered in one to five treatments sessions.

Total Body Irradiation ( TBI )

Conventionally radiation therapy is considered to be a form of localized treatment with the radiation beam directed to the diseased area sparing the surrounding normal tissues as far as possible. In certain conditions like low grade lymphomas radiation can also be delivered to the entire body in low doses either used alone or in combination with chemotherapy to achieve disease control. Low and high dose total body irradiation is also used as a part of the conditioning regimen for bone marrow transplant.

Total Skin Electron Beam Therapy (TSET)

Disease conditions like Mycosis Fungoides primarily involve the skin all over the body. As mycosis fungoides responds very well to radiation, radiotherapy remains the mainstay of treatment of this disease. Total skin electron beam therapy is a specialized technique of radiotherapy which allows the delivery of a relatively uniform dose of radiation (electrons) to the skin all over the body while sparing the underlying structures.

Electron Arc Therapy

This specialized technique of radiation therapy allows delivery of the radiation to flat or curved superficial surface structures like skin, chest wall, abdominal wall, and scalp/ skull while minimizing radiation doses to the underlying structures.

Tomotherapy

TomoTherapy, or Helical TomoTherapy, is a new way to deliver radiation treatment for cancer, and is the latest in radiation therapy delivery systems. TomoTherapy literally means "slice therapy," and gets its name from tomography, or cross-sectional imaging. The TomoTherapy Hi·Art System delivers a very sophisticated form of intensity-modulated radiotherapy (IMRT), and combines treatment planning, CT image-guided patient positioning, and treatment delivery into one integrated system. The equipment used for TomoTherapy looks much like a CT scanner. The patient lies on a couch that moves continuously through a rotating ring gantry. The gantry houses a small megavoltage linear accelerator, which delivers radiation in the shape of a fan beam as the ring is turning. With the couch moving at the same time the gantry is rotating, the radiation beam makes a spiral (or helical) pattern around the patient, targeting tumors with optimal levels of radiation while minimizing the dose to healthy normal organs and tissues in the region.

The advantage of TomoTherapy is having a radiation treatment beam projected into the tumor continuously as it rotates, rather than having a limited number of fixed beams, each providing only a fraction of the dose necessary to irradiate the tumor. With the TomoTherapy Hi·Art System, it is now possible to adjust the size, shape, and intensity of the radiation beam to target the radiation to the size, shape, and location of the patient's tumor.

Additionally, this unit provides the opportunity to obtain CT images of the body in the treatment setup position, and is hence one of the first devices capable of providing modern image-guided radiation therapy (IGRT). These CT scan images also can be used to precisely place the radiation beam and allow the operator to modify the treatment should the patient’s anatomy change due to weight loss or tumor shrinkage (adaptive radiotherapy).

Image Guided Radiation Therapy

IGRT, or Image Guided Radiation Therapy, is currently one of the most sophisticated methods of radiation therapy delivery in the world. IGRT is the process of frequent two and three-dimensional imaging, during a course of radiation treatment, used to direct radiation therapy utilizing the imaging coordinates of the actual radiation treatment plan. An example of Three-dimensional (3D) IGRT would include localization of a cone-beam computed tomography (CBCT) dataset with the planning computed tomography (CT) dataset from planning. Similarly Two-dimensional (2D) IGRT would include matching planar kilovoltage (kV) radiographs fluoroscopy or megavoltage (MV) images with digital reconstructed radiographs (DRRs) from the planning CT.

Tata Memorial Hospital has just recently acquired the state-of-art Varian Trilogy 3D IGRT system. This linear accelerator has an on-board kv imager that obtains cone beam CT (CBCT) images of the patient daily, at the time of treatment set-up and positioning. This integrated imaging system allows the radiation technologists to verify the position of the tumor before each treatment session, so adjustments can be made online and on the spot to make sure that radiation is delivered exactly where it should be. CBCT based IGRT can result in sub-millimeter accuracy in treatment delivery, and this allows doctors to safely reduce the treatment margins thus increasing dose to the tumor and at the same time significantly reducing radaition dose to critical normal organs near the tumor. Pediatric malignancies, Lung cancer, head and neck tumors, breast cancer, prostate cancer, stereotactic radiosurgery and stereotactic body radiotherapy are just some examples of the treatments commonly performed using IGRT.

 

The department has a structured comprehensive training program for students pursuing MD in Radiation Oncology under the Homi Bhabha National Institute. Since 1981 the department has registered more than 115 students for DMRT & MD in Radiation Oncology. Currently 10 faculty members are recognized as teachers for MD in Radiation Oncology under MUHS/ HBNI. For the last 3 years the department has initiated a 2 year "Fellowship in Image Guided Radiation Therapy". The departments of radiation oncology & medical physics have also been conducting a formal "Training Course for Radiation Therapy Technologists" recognized by the Maharashtra State Board for Technical Education (MSBTE). Till date more than 140 technologists have received their diploma in radiation therapy technology at TMH. As an initiative towards dissemination of knowledge & hands-on training on various aspects of radiation therapy (advanced techniques like IMRT/ IGRT, Brachytherapy, Quality assurance etc), the department organizes a "Radiation Oncology Practicum" once yearly. The department has also been instrumental in initiating a teaching course for radiation oncology residents under the aegis of the Indian College of Radiation Oncology (ICRO). The department also receives a number of visitors from within the country and abroad who come on short & long term visits/ training programs. In 2013 the department had 30 national and 7 international visitors. Many of the staff members have been invited as experts by organizations like the ICMR, IAEA & WHO for expert advice on development of radiation oncology facilities in various parts of the world & related projects.

Approximately, 2/3rd of all cancer patients require radiation therapy as treatment during the management of their cancer, either by itself or in combination with surgery or anticancer drugs (Chemotherapy). Radiotherapy plays a very important role in curing early stage cancer, as an attempt to cure in intermediate stage disease, in combination with surgery and chemotherapy and is effective in relieving symptoms for patients with advanced cancers.

RESEARCH

Several research projects are being carried out in the department. Majority of these are investigator initiated and some of them are multicentric.

PROJECTS

 

Title of Project and investigators

Date of Starting

Funding body

Ongoing Projects

1

Concomitant chemoradiotherapy versus accelerated radiotherapy versus conventional radiotherapy in the management of advanced carcinoma of the head and neck. S. (Ghosh) Laskar, JP Agarwal, TK Saikia, KA Dinshaw

2000

TMH/ CSIR

2

Randomized multicentric study of 5 v/s 6 weekly fractions of radiotherapy in the treatment of squamous cell carcinoma of head & neck. JP Agarwal, SK Shrivastava, S (Ghosh) Laskar, KA Dinshaw

2000

IAEA/TMH

3

Intraoperative Iridium - 192 tumor bed implant alone in early breast cancer. Sarin R, Jalali R, Budrukkar AN, Badwe R, Parmar V, Nadkarni M, Chinoy R, Shet T, Shrivastava SK, Deshpande DD, Dinshaw KA

2001

Nil

4

HDR Brachytherapy Of Internal Mammary Nodal Chain In Breast Cancer With Intra-Operative Catheter Placement In The Internal Mammary Vessels. Sarin R, Badwe R, Jalali R, Mahantshetty U, Budrukkar A, Parmar V, Nadkarni M, Deshpande DD

2001

Nil

5

Feasibility study to evaluate and correlate between clinical & sonographic responses in cervical node metastases in head & neck carcinoma following radical radiotherapy. S (Ghosh) Laskar, JP Agarwal, S Arya, T Pandey, P Corea

2002

TMH

6

Concomitant chemoradiation in advance stage carcinoma cervix- A phase III Randomised trial. SK Shrivastava, HB Tongaonkar, S Gupta, R Kerkar, A Maheshwari, S (Ghosh) Laskar, KA Dinshaw

2003

TMH/ ICMR

7

Concomitant chemoradiation versus neo-adjuvant chemotherapy and surgery in the management stage II carcinoma cervix- A phase III Randomised trial, S Gupta, HB Tongaonkar,SK Shrivastava, eshwari, S (Ghosh) Laskar, KA Dinshaw

2003

TMH/ ICMR

8

Intraluminal HDR brachytherapy alone versus Intraluminal HDR brachytherapy and External Beam Radiotherapy in the Palliation of Advanced Oesophageal Carcinoma. KA Dinshaw, S Ghosh Laskar, SK Shrivastava, DD Deshpande, RA Kinnhikar

2003

IAEA/TMH

9

Two vs four cycles of abvd chemotherapy and low dose radiation therapy in early stage favourable prognosis hodgkin's disease: a randomised clinical trial.M.A.Muckaden, .S. Laskar, T.K.Saikia, S.K.Pai, K.Naresh, S.Gupta

2003

TMH

10

Hereditary Cancer Consortium. R Sarin, SS Agarwal, KA Dinshaw K Mohandas, P Kurkure, R Badwe, H Tangaoankar, A Puri, R Chinoy, R Mulherkar, P Kadam

2002

TMH

11

Accelerated Tumor Bed Irradiation in Early breast cancer with IMRT: A Feasibility and dosimetric study. R Sarin S Chopra, D Kumar, SS Narayanan, R Kamble, R Jalali, SK Shrivastava, DD Deshpande, K A Dinshaw

2003

TMH

12

Efficacy of stereotactic conformal radiotherapy (SCRT) compared to conventional radiotherapy in minimising late sequelae in children and young adults with brain tumours: a randomised clinical trial (SCRT trial). R Sarin, R Jalali, N Merchant, S Goswami, N Shah, KA Dinshaw, et al

2001

Terry Fox Foundation

13

To prospectively compare tumour control, late sequalae and quality of life in patients with non-functioning pituitary adenomas treated with surgery alone versus surgery followed by radiotherapy: a randomised trial (pituitary trial). R Jalali, A Goel, R Sarin, et al

2002

TMH

14

Radioprotective effect of ocimum sanctum (Tulsi) in patients undergoing hemibody irradiation: A double blind randomised trial R Sarin, R Jalali, SK Shrivastava, MA Muckaden, M Ghatge, AS Raste, KA Dinshaw

2002

ICMR grant

15

Prevalence and spectrum of BRCA1 and BRCA2 mutations in familial breast ovarian cancers. R Sarin, SS Agarwal, R A Badwe, HB Tangaoankar, K.A Dinshaw

2004

TMH

16

Prospective neurological function, quality of life and Barthel's assessment in adult patients with primary brain tumours. R Jalali, A Bud, R Sar, R Kamble, S Parab, R Hawaldar

2004

TMH

17

Feasibility of concomitant electron boost (on Saturdays) in patients with locally advanced breast cancer treated with radiotherapy R Jalali, R Malde, A Budrukkar, R Sarin

2004

TMH

18

Para-aortic Lymph Node Staging and Evaluation of Treatment Outcome by 18F-fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in Advanced Cancer Cervix. KA Dinshaw, SK Shrivastava, A Samuel, HB Tongaonkar, R Kerkar, A Maheshwari, S (Ghosh) Laskar.

2004

TMH

19

Elective versus Therapeutic Neck Dissection in the Treatment of Early Node Negative Squamous Cell Carcinoma of the Oral Cavity, AK D'cruz, D Chaukar, KA Pathak, M Deshpande, P Chaturvedi, P Pai, RL Bhalawat, S. (Ghosh) Laskar, JP Agarwal, KA Dinshaw

2004

TMH

20

Randomized Clinical trial to compare results of Concurrent chemo-radiation with surgery and post-operative radiotherapy. KA Pathak, M Deshpande, AK D'cruz, D Chaukar, P Chaturvedi, P Pai, RL Bhalawat, S. (Ghosh) Laskar, JP Agarwal, PM Parikh, VR Pai, KA Dinshaw

2004

TMH

21

A phase II trial of IRESSA in advanced Head & Neck cancers. D'cruz, D Chaukar, S. (Ghosh) Laskar, JP Agarwal, KA Dinshaw

2004

Multicentric: ASTRA-ZENECA

22

Radiotherapy Dose Escalation for Inoperable Ewing's Sarcoma/ PNET (EFT 2001 RT). S.Laskar, C.N.Nair, M.A.Muckaden, A.Puri, M.G.Agarwal, S.Gujral, S.Gupta, S.Banavali,P.Kurkure, S.K.Pai, S.Juvekar, N.Nair,D.D.Deshpande, S.K.Shrivastava, S.Basu.

2004

DAE/ CTC

23

Intensified Vincristine, Ifosfamide, Etoposide with Adriamycin, Cyclophosphamide, and Actinomycin D in the Treatment of Non-Metastatic Ewing's Family of Tumors. C.N.Nair, M.A.Muckaden, S.Gupta, S.Banavali, S.K.Pai, P.A.Kurkure, S.Laskar, A.Puri, M.G.Agarwal, S.Juvekar, T.Shet, M.Ramadwar, S.Desai, S.Agarwal, N.Nair, R.Havaldar.

2004

TMH

24

Intensive versus Routine follow-up for Soft Tissue Sarcomas. A.Puri, M.G.Agarwal, R.Badwe, R.Hawaldar, R.Mistry, C.S.Pramesh, S.Laskar, S.Gupta, N.Jambhekar, M.A.Muckaden, S.Juvekar.

2004

TMH

25

The Treatment and Characterization of Acute Lymphoblastic Leukemia in Children, Adolescents and Young Adults (INCTR 02-04). S.Banavali, P.Kurkure, C.N.Nair, P.M.Parikh,S.K.Pai, S.Gujral, M.A.Muckaden, S.Laskar, N.Merchant, S.Goswami, P.Amre, A.Paes, B.Kolhatkar, R.Hawaldar, N.Thomas.

2004

TMH/ INCTR

26

Concomitant and adjuvant Temozolomide with radical radiotherapy in children with brain stem glioma (brain stem glioma study). R.Jalali, P.Kurkure, R.Sarin, N.Merchant, T.Gupta

2004

Hospital Intramural grant

27

IMRT for Craniospinal irradiation (CSI) - will have preclinical component of dosimetric/modelling work followed by implementation and feasibility in 5 patients (IMRT-CSI study). R.Jalali, D.Sharma, R.Sarin, T.Gupta, Reena.P, S.K.Shrivastava, K.A.Dinshaw

2004

DAE/CTC

28

A phase II randomized trial Comparing IMRT with conventional radiation therapy in Stage IIB Carcinoma Cervix.SK Shrivastava, U Mahantshetty, DD Deshpande, S (Ghosh) Laskar, KA Dinshaw, RA Kinhikar, Sherly Saju, SV Jemima, HB Tongaonkar, S Gupta.

2004

Varian Medical Systems LTD.USA

29

Phase II study of 3-Dimentional Conformal Radiotherapy (3D-CRT) versus Intensity Modulated Radiotherapy (IMRT) for Squamous Cell Carcinoma of the Head & Neck (HNSCC).SG Laskar, T Gupta, JP Agarwal, SK Shrivastava, KA Dinshaw, PM Parikh, VR Pai, Reena Devi, S Deshpande, DD Deshpande.

2005

Varian Ltd, USA

30

Phase II study of 3-Dimentional Conformal Radiotherapy (3D-CRT) versus Intensity Modulated Radiotherapy (IMRT) for Squamous Cell Carcinoma of the Head & Neck (HNSCC).Gupta T, Laskar SG, Agarwal JP, Shrivastava SK, Dinshaw KA, Parikh PM, Pai VR, Reena Devi, Deshpande S, Deshpande DD.

2005

Siemens Ltd., USA

31

Para-aortic Lymph Node Staging and Evaluation of Treatment Outcome by 18F-fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in Advanced Cancer Cervix. Dinshaw KA, Shrivastava SK, Samual A, Mahantshetty U, Laskar SG, Merchant NH, Gupta S, Tongaonkar HB, Rangrajan V, Purandare N.

2005

DAE/CTC

32

Comparative evaluation of different detectors for IMRT dosimetry. Deshpande DD, Kinhikar RA, Saju Sherley, Narayana SS, Sharma D, Shrivastava SK, Dinshaw KA.

2005

Intramural / ACTREC

33

Phase III Trial of Surgery followed by conventional radiotherapy (5#/Wk) versus concurrent chemoradiotherapy versus Accelerated radiotherapy (6#/Wk) in high risk, locally advanced, stage III & IVa, resectable, squamous cell carcinoma of oral cavity. Deshpande Mandar, D'Cruz AK, Pathak KA, Chaukar DA, Chaturvedi P, Pai P, Dinshaw KA, Bhalavat RL, Agarwal JP, Ghosh S, Pai VR, Mohandas K, Kane SV

2005

DAE-CTC

34

Temozolomide versus PCV in recurrent high grade gliomas (BR 12 Trial). A MRC conducted multicenter randomised trial -R Jalali (Collaborator from TMH).

2005

MRC/ TMH

35

Timing of systemic chemotherapy in patients with isolated locoregional recurrence of breast cancer. Nair R, Gupta S, Badwe R, Parmar V, Nadkarni M, Sarin R, Jalali R, Budrukkar AN, Hawaldar R

2005

36

A phase III trial evaluating the role of chemotherapy as an adjuvant therapy for premenopausal women with endocrine responsive breast cancer who receive endocrine therapy (PERCHE trial). Parmar V, Badwe R, Nadkarni M, Nair R, Gupta S, Sarin R, Jalali R, Budrukkar AN, Hawaldar R

2005

IBCSG

37

A phase III trial evaluating the role of exemestrane plus GnRH analogue as an adjuvant therapy for premneopusal women with endocrine responsive breast cancer (TEXT trial) Parmar V, Badwe R, Nadkarni M, Nair R, Gupta S, Sarin R, Jalali R, Budrukkar AN, Hawaldar R

2005

IBCSG

 

 

PUBLICATIONS ( 2004 & 2005 )

 

International Journal (Article)

1

Laskar S, Gupta T, Vimal S, Muckaden MA, Saikia TK, Pai SK, Naresh KN, Dinshaw KA . "Consolidation Radiation after Complete Remission in Hodgkin's Disease following Six Cycles of Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine Chemotherapy: Is There a Need?". J Clin Oncol; Vol 22, No.1, pp.62-68, Jan 2004.

2

Laskar S, Vimal S, Muckaden MA, Laskar S (Ghosh), Bhalla V, Banavali S, Kurkure P, Nair CN, Dinshaw KA . "Nasopharyngeal Carcinoma In Children: Ten Years Experience At The Tata Memorial Hospital, Mumbai". Int. J of Radiat Oncol Biol Phys; Vol 58, No.1, pp.189-195, 2004.

3

Gupta T, Agarwal J, Laskar SG. Nonsurgical treatment of laryngeal cancer. N Engl J Med 2004; 350(10):1049-1053.

4

Gupta T, Laskar SG . Re: Cancers of the head and neck region in developing countries.Radiother Oncol 2004; 70(2):207-208.

5

Malde R, Laskar S, Muckaden MA, Desai S. "Primary, Multifocal Extranodal Lymphoma Presenting with Multiple Cranial Nerve Palsies: An Unusual Presentation of an Uncommon Entity". Leukemia & Lymphoma, Feb. Vol. 45(2), pp.389-391, 2004.

6

Gupta T, Laskar S. Commentary on the article titled "Clinical Effectiveness of Radiotherapy for Hodgkin's Lymphoma: A Summary". Cancer treatment reviews; 30, 215-219. (2004)

7

Laskar S, Muckaden MA, Gupta T, Dinshaw KA. Invited feature case study titled "Radiation Therapy for Advanced Hodgkin's disease: The Continuing Debate". The American Journal of Oncology Review Sept., Vol.3, No.9, P 547-552: 2004.

8

Jalali R, Budrukkar A, Sarin R, Sharma D. High precision conformal radiotherapy employing conservative margins for benign and low grade brain tumours. Radiotherapy & Oncology Vol. 2004 (Online Nov. ).

9

Sharma D, Jalali R, Tambe CM, Animesh, Deshpande DD. "Effect of tertiary multileaf collimator (MLC) on foetal dose during three-dimensional conformal radiation therapy (3DCRT) of a brain tumour during pregnancy." Radiotherapy & Oncology 2004; 70:49-54.

10

Correa PD, Arya S, Laskar SG, Shrivastava SK, Dinshaw KA, Gupta T, Agarwal JP . Ultrasonographic changes in malignant neck nodes during diotherapy in head & neck squamous carcinoma. Austral Radiol 2004 (in press).

11

Jalali R, Khatua S. Advances in the management of pediatric brain tumours.

Journal of Haematology and Oncology 2004 (in press).

12

Shrivastava SK, Engineer R, Rajyadksha S, Dinshaw KA. HIV Infection & invasive Cervical cancers. Treatment with radiation therapy, toxicity and outcome Radiotherapy Oncology (Online Dec).

13

Malde R, Jalali R, Muzumdar D, Kurkure P. Gliosarcoma occurring 8 years after treatment for a medulloblastoma Child's Nervous System 2004; 20:243-246.

14

Jhavar S, Sarin R, Mulherkar R, Benner A, Agarwal JP, Dinshaw KA.

Glutathione S-transferase M1 or T1 null genotype as a risk factor for developing multiple primary neoplasms in the upper aero-digestive tract, in Indian males using tobacco Oral Oncology, Vol 40(1); page 84-91, 2004

15

Sarin R. Letter to editor titled: Parachutes and medical interventions: An unfair comparison' in response to article in BMJ (327: 1459-1461, 2003).

British Medical Journal, Published on-line on 4th Feb. 2004.

16

Amare PS, Ghule P, Jose J, Bamne M, Kurkure P, Banavali S, Sarin R, Advani SH. Constitutional genomic instability, chromosome aberrations in tumour cells and retinoblastoma Cancer Genetics & Cytogenetics, Vol 150, page 33-43, 2004.

17

Gupta T, Sarin R. Palliative radiation therapy for painful vertebral metastases: a practice survey. Cancer; 101(12): page 2892-96, 2004.

18

Pathak KA, Bhalavat RL, Mistry RC, Deshpande MS, Bhalla V, Desai SB, Malpani BL. Upfront submandibular salivary gland transfer in pharyngeal cancers.

Oral Oncol. 2004 Oct; 40(9):960-3.

19

Laskar S, Gupta T, Muckaden MA. Radiotherapy in Advanced-Stage Hodgkin's Lymphoma; John M.M. Raemaekers, Berthe M.P. Aleman, and Michel Henry-Amar; JCO Jan 1 2005: 245-246. In Reply: Journal of Clinical Oncology Jan 1 2005: 246-247.

20

Pramesh CS, Mistry RC, Agarwal JP. Chest wall resection in patients with non-small cell lung cancer. Letter to the Editor European Journal of Cardio-thoracic Surgery; 726-735:2005.

21

Chopra S, Bahl G, Ramadwar M, Ramani S, Nair R, Muckaden MA, Laskar S. Synchronous mucosa-associated lymphoid tissue (MALT) lymphoma involving bilateral orbits and breasts: a rare clinical entity Leukemia & Lymphoma 46(8);1247-1250: 2005.

22

Yuvaraja BT, Mahantshetty UM, Ravichand SC, Srinivas GR, Tongaonkar HB. Management of Renal Cell Carcinoma with Solitary Metastasis: Results from a Single Institute Series World Journal of Surgical Oncology 2005, 3:48.

23

Kinhikar RA, Deshpande SS, Mahantshetty UM, Sarin R, Shrivastava SK, Deshpande DD. HDR Brachytherapy combined with 3D conformal versus IMRT in left-sided breast cancer patients including internal mammary chain: Comparative analysis of dosimetric and technical parameters Journal of applied Clinical Medical Physics, Vol 6 Number 3, 1-12: Summer 2005.

24

Gupta T, Dinshaw KA. Modified optimal fractionation for poor prognosis malignant gliomas: An elusive search. Acta Oncologica 44:105-113;2005.

25

Malde R, Agarwal JP, Laskar SG, Gupta T, Dinshaw KA.

High Dose rate Brachytherapy boost for primary nasopharyngeal carcinoma: preliminary results of an ongoing prospective study Bull Cancer 92 (7-8):E45-50; 2005.

26

Pramesh CS, Mistry RC, Agarwal JP, Arvind K.

Pulmonary Function May be Prognostic But Should Not Preclude Lobectomy for Lung Cancer. Letter to the Editor Ann Thorax Surg 2005; 79:2197-2204.

27

Correa PD, Arya S, Laskar SG, Shrivastava SK, Dinshaw KA, Gupta T, Agarwal JP. Ultrasonographic changes in malignant neck nodes during radiotherapy in head & neck squamous carcinoma Austral Radiol 49, Issue 2, 113, April 2005. (A).

28

Jhavar SG, Sarin R, Chopra S, Kotnis A, Mulherkar R, A'hern R, Agarwal JP, Shrivastava SK, Dinshaw KA. Females with paired occurrence of cancers in the UADT and genital region have a higher frequency of either Glutathione S-transferase M1/T1 null genotype. J Carcinog. 2005 Mar 24;4(1):6.

29

Chopra S. In regards to Dickler et al . Treatment volume and dose ptimization of mammosite breast brachytherapy applicator (Int J Radiat Oncol Biol Phys 2004;59:469-474). Int J Radiat Oncol Biol Phys. 2005 Feb 1; 61(2):630; author reply 630-1.

30

Chopra S, Agarwal JP. Letter to the editor Oral Oncol. 2005 Oct; 41(9):953-4. No abstract available.

31

KA Dinshaw, JP Agarwal, SG Laskar, T.Gupta. SK Shrivastava. A. D.cruz.

Head and Neck Squamous Cell Carcinoma: The role of Post-Operative Adjuvant Radiotherapy Journal of Surgical Oncology 2005;91:48-55

32

S.Chopra, JP Agarwal. In regards to Kaspert's et al Oral Oncology 2005; 41:225-243.

33

CS Pramesh, RC Mistry, JP Agarwal, K. Arvind. Pulmonary Function May be prognostic ut should not preclude lobectomy for lung cancer. Reply to Editor. Correspondence. The Society of Thoracic surgeons 79;2197-2198;2005

34

Rajiv Sarin . Partial -breast treatment for early breast cancer emergence of a new paradigm.Nature Clinical Practice Oncology Vol 2, No.1;40-47:2005.

35

PD Correa, S.Arya, SG Laskar, SK Shrivastava, KA Dinshaw, T. Gupta, JP Agarwal. Ultrasonographic changes in malignant neck Squamous carcinoma

Australasian Radiology Vol. 9 Issue 2;113: April 2005 (Abs).

36

Yuvaraja B Thyavihally, Umesh M Mahantshetty, Ravichand S Chamarajanagara, Srinivas G Raibhattanavar, Hemant B. Tongaonkar.

Management of Renal Cell Carcinoma with Solitary Metastasis: Results from a Single Institute Series. World Journal of Surgical Oncology 2005, 3:48.

37

Dinshaw KA, Budrukkar AN, Chinoy RF,Sarin R, Badwe RA, Hawakdar R, Shrivastava SK. Profile of prognostic factors in 1022 Indian women with early stage breast cancer treated with breast-conserving therapy. Int. J. Radiation Oncology BIOl.Phys., Vol.63, No.4. pp.1132-1141,2005.

38

Sarin R, Jalali R. "Optimizing the sequencing of adjuvant chemotherapy and radiotherapy for early breast cance." Nature Clinical Practice Oncology (2005) 2, 606-607.

39

Jain PN, Kavishkar N Jalali R. "Refractory headache in a patient with breast cancer and carcinomatous meningitis unresponsive to analgesics." J Pain Palliat Care Pharmacother. 2005;19(2):33-5.

40

S Khatua and R Jalali . "Recent advances in the management of childhood brain tumours." Pediatr Hematol Oncol. 2005 Jul-Aug;22(5):361-71.

41

Budrukkar A, Jalali R, Sarin R, Dinshaw KA. "Radiation therapy techniques in the management of breast cancer". Mammology 2005; 1(2): 1-9.

42

Jalali R, Budrukkar A, Sarin R and D Sharma. "High precision conformal radiotherapy employing conservative margins for benign and low grade brain tumours." Radiotherapy & Oncology 2005; 6(4): 176-81.

43

Jalali R, Budrukkar A. "Evolution and techniques of 3DCRT/SRT/SRS for brain tumours and their impact on management of intracranial lesions". J Int. Science Academy 2005; 18 (1): 29-35.

44

Jalali R, Goswami S, Sarin R, More N, Siddha M, Kamble R."Neuropsychological status in children and young adults with benign and low-grade brain tumours treated prospectively with focal stereotactic conformal radiotherapy." Int J of Radiat Oncol Biol Physics (In press).

45

Jalali R, Goswami S, More N, Sarin R, Siddha M, Kamble R, Parab S.

"Maintenance of neuropsychological function in children with benign and low grade brain tumours treated with high-precision focal conformal radiotherapy."

NeuroOncology 2005 (in press).

46

Gupta T, Laskar S, Gujral S, Muckaden MA. Brain metastases in soft tissue sarcomas: Case report and literature review. Sarcoma (in press).

47

Gupta T. Stereotactic radiosurgery for brain oligometastases: good for some, better for all? Ann Oncol 2005;16:1749-1754.

48

Gupta T, Sarin R, Jalali R, Juvekar S. Posterior fossa ependymoma: Unusual extension into the internal auditory canal in a 32-year old woman J HK Coll Radiol 2005; 8:109-111.

49

Sastry J, Dedhia R, Laskar S, PA Shet T, Kurkure MA Muckaden.

Extra-renal Wilms' tumour-is it different? Pediatric Nephrology (In Press).

 

National Journal (Articles)

1

Jalali R, Budrukkar A.Evolution and techniques of 3DCRT/SRT/SRS for brain tumours and their impact on management of intracranial lesions.J of the Int. Science Academy 2004 (in press).

2

Jalali R. High precision radiotherapy techniques in the management of brain tumours - evolution and clinical experience.JK Science 2004, Vol6 (4), pp. 176-181.

3

T Gupta , Laskar SG, Thakur M, Desai S, Shrivastava SK, Dinshaw KA, Agarwal JP. Isolated prostatic metastasis from primary sigmoid colon carcinomaIndian J Gastroenterol 2004;23(3):114-115

4

D Prasad, R Jalali and T Shet . Intracranial subfrontal schwannoma treated with surgery and 3D conformal radiotherapy.Neurology India 2004:52 (2): 253-255.

5

Mahale N, Sarin R, Kerkar R.Ovarian Ablation as a Systemic Therapy in Breast Cancer: A review of Techniques and their EfficacyMammology Volume 1(Issue 2) 10-18,2005.

6

Chopra S, Varma, KC Nischal, Uday Khopkar, Chanda Baisane, Pratibha Amare (Kadam) . Darier's disease following radiotherapy for carcinoma of cervixIndian J Dermatol Venereol Leprol September-October 2004 Vol. 70 Issue 5.

7

A.Rustogi, A.Budrukkar, K.Dinshaw, R.Jalali. Management of locally advanced breast cancer: Evolution and current practice.J Cancer Res Ther - March 2005 Vol 1(1) 21-30.

8

Goel V, R.Sarin, SK Shrivastava, S. Desai, KA Dinshaw.Management dilemmas in radiation associated pelvic sarcomasJ Cancer Res Ther - March 2005 Vol 1(1) 57-59.

9

R.Sarin.Trends in Basic, translational, epidemiological and therapeutic research in cancer.J Cancer Res Ther - March 2005 Vol 1(1) 4-6.

10

Mishra S, Laskar S, MA Muckaden. MA P Mohindra, SK Shrivastava, KA Dinshaw."Monthly Palliative Pelvic Radiotherapy In Advanced Carcinoma Of Uterine Cervix"J Cancer Res Ther (In Press).

11

G Biswas, CN Nair, S Laskar, Banavali S .Desmoplastic Small Round Cell Tumor Indian Journal of Cancer (In Press).

 

In the year 2013, more than 5500 patients underwent radical or palliative radiotherapy at the TMH. There is increasing use of sophisticated state-of-the art treatment facilities for the patients. The judicious use of 3D-CRT, IMRT, IGRT and SRT/SRS, has been practiced for appropriate patients under protocol settings. Nearly 70% of the patients in the department receive treatment free of cost. In 2013, we treated 5562 patients with external beam radiation therapy & 696 patients underwent brachytherapy procedures. A total of 1105 patients were treated using specialized techniques such as IMRT/ IGRT, SRT, SRS, TSET, SBF and TBI. There are 38 beds for radiotherapy (including 11 beds for patients undergoing brachytherapy).

The faculty in the department has been actively involved in institutional/ multi-institutional national & international research protocols. As part of the research initiatives, faculty members have initiated a number of research projects as principal/ co-investigators that have been approved by the Institutional Review Board (IRB). From January 2008 till December 2013 faculty members from the department have been involved as PI's in 72 projects approved by the IRB. Majority of the projects have been investigator initiated projects. The research areas have ranged from clinical to basic research. There has also been a focus on Indigenous Technology Development & Technology Evaluation. Some of the achievements as part of the technology/ equipment development efforts have the indigenously built cobalt-60 teletherapy machine (Bhabhatron II), intracavitary brachytherapy applicators (BARC applicator, SHIVA), interstitial brachytherapy catheters, special fixation device for lung shields used for total body irradiation, & low density base plates for patient positioning & fixation. Most of the indigenously developed equipments are currently being used for patient treatment within the country & abroad (Bhabhatron). As part of the research outcomes there have been over 50 publications in peer reviewed journals in 2013. The publications have included full length original articles in peer reviewed international journals, full length original articles in peer reviewed national (indexed) journals, & in non-indexed Indian journals or case reports. The faculty of Radiation Oncology has also been involved in writing editorials & books chapters throughout the year. There have also been a number of publications as part of conference proceedings.

Phone: Department Office Number: +91-22-24177000 / Ext.No. 6791

Address: Department of Radiation Oncology, Ground Floor, Homi Bhabha Block,

TATA MEMORIAL HOSPITAL, Dr.E.Borges Road, Parel, Mumbai-400-012

Maharashtra, India

Fax: Hospital Fax Number: (+9122) 24146937

Email-id:Email-id: radonco@tmc.gov.in

Contact Us

TATA MEMORIAL HOSPITAL
Dr. E Borges Road, Parel, Mumbai - 400 012 India
Phone: +91-22- 24177000, 24146750 - 55
Fax: +91-22-24146937
E-mail : msoffice@tmc.gov.in (for patient care and queries) / hrd@tmc.gov.in(for administrative - HRD matters)

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