Stereotactic Radiosurgery (SRS) is a radiotherapy technique that uses extreme precision and a single dose of radiation to ablate tissue. This technique requires the use of a head ring, computed tomography often in conjunction with magnetic resonance imaging or angiography, 3D simulation and computerized dosimetry as well as treatment using a linear accelerator. SRS combines small fields and high doses of radiation to treat small lesions including some benign conditions including arteriovenous malformations. We are also developing the capability to perform extra-cranial stereotactic radiosurgery
Stereotactic Radiotherapy is a treatment technique that is similar to stereotactic radiosurgery with the exception the radiotherapy is delivered in numerous fractions on a daily basis. For some tumors and tumor locations there are advantages to this technique. As a result, we are able to take advantage of the precision of stereotaxis and combine it with the radiobiologic advantages of fractionation.
Intensity Modulation is a new technique that allows more precise shaping of the radiation field. This extends the ability of the radiation oncologist to avoid radiosensitive structures near the treatment field. This tool is extremely effective in the treatment of tumors near radiosensitive structures incluing the eyes, optic nerves, spinal cord and brain stem.
Hyperthermia (HT) is a treatment technique that utilizes microwaves to heat tumor cells. Heating of the tumor cells damages the cell membrane in some cases destroying the cell and in other making the cell more susceptible to radiation. As a result, HT is always used in combination with radiotherapy. The use of HT is limited to tumors that do not respond well to radiotherapy alone; examples include: chest wall recurrances and large head and neck tumors.
Three Dimensional Treatment Planning and Non-coplanar Therapy (3D) is a technique that has significantly improved the delivery of radiation therapy for a significant percentage of patients. This technique takes advantage of computed tomography to create images for treatment planning purposes. This technique also allows the delivery of radiation in more than one plane. In many cases 3D allow the radiation oncologist to reduce the dose to radiosensitive structures or increase the dose to the tumor to reduce complications or improve local control.
Total Skin Irradiation (TSI) is a technique used to treat the entire skin of a patient using low energy electrons. This technique is useful in the treatment of mycosis fungoides.
Prostate Implants are performed on an outpatient basis using radioactive seeds. This technique is useful for many patients with prostate cancer and has the advantage of being accomplished in a single day.
Brachytherapy is the use of radioactive implants to treat tumors. A wide variety of brachytherapy procedures, both temporary and permanent, are performed using a number of radioactive sources. Commons implant sites include the cervix, endometrium, prostate, neck, tongue and brain; although, most areas can be implanted if necessary and appropriate. Radioactive materials used include iodine, cesium, chromic phosphate, iridium and palladium.
Multidisciplinary care is conducted in a number of areas including neuro-oncology, mycosis fungoides and thoracic oncology while interdepartmental care is coordinated in a number of other areas. This provides a number of advantages to the patient. First, it provides the patient with an opportunity to consult with multiple oncologists with a single visit. Most multidisciplinary clinics include from the medical, surgical and radiation oncology specialties. These clinics also allow the oncologists to confer in a real time basis to develop the most appropriate course of treatment.
Immobilization Devices can be very important in radiotherapy. A number of immobilization techniques are utilized when appropriate to assure the accurate delivery of radiation. Immobilization methods include cellulose-acetate-buterate (CAB) molds, rapid foaming agents and aquaplast.
Superficial radiation can be very effective for the treatment of skin cancer as well as other conditions of the skin including recurrent keloids. Superficial capabilities include grenz rays for the non-surgical treatment of lentigo maligna.
Pediatric radiotherapy is accomplished through a relationship with Children's Hospital Medical Center in Cincinnati, Ohio.
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