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Jo Ann Chalal,
M.D.
Medical Director
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Sangeeta Tyerech,
M.D.
Associate Medical Director |
The Robert J. Moonan Department of Radiation Oncology is dedicated
and committed to the delivery of excellent care to the cancer
patient.
The latest technology
is available to treat patients including IMRT (intensity modulated
radiation therapy), 3DConformal treatment, and brachytherapy (the
insertion of radioactive material directly into the tumor). A sophisticated
treatment planning system is utilized by the physics staff to determine
the best delivery of the planned radiation dose to the targeted tissues.
IMRT is the most sophisticated external beam radiation
treatment available to appropriate patients to take full advantage
of the need to protect normal tissues while escalating doses to tumor
bearing tissues. Multimodality management is common with patients
receiving chemotherapy and/or surgery in conjunction with radiation.
The Department is fully accredited by
the American College of Radiology. This
accreditation is requested on a voluntary basis and involves a peer
review process of the practice of Radiation Oncology. Subjected to
a rigorous review of patient care standards, the Radiation Oncology
Department has always received its accreditation without qualification
and with the highest accolades, indicating that it provides high quality
radiation oncology care.
Preparing to treat a patient with radiation is an extremely complex
process. A consultation with a radiation oncologist leads to recommendations
for the appropriate course of treatment. Protocol eligibility is always
discussed at that time. If treatment is recommended, a series of steps
are followed in order for a patient to receive treatment:
Imaging:
appropriate imaging studies are obtained depending upon the area(s)
to be treated. These may include plain films, bone scans, CT scans,
MRIs. All are reviewed by the treating physician.
Simulation: to render treatment, the patient requires
marks on the skin overlying the anatomy to be treated. CT simulation
is generally performed. This is a CT taken through the relevant
anatomy to be treated with the patient in a specific treatment position.
Treatment Planning: utilizing the CT anatomy from
the CT simulation, the physicists and physicians consult together
to review the treatment goals, outline normal and tumor anatomy,
and to determine the best orientation of radiation beams to achieve
the desired effect of tumor cell kill while minimizing normal cell
damage. Computerized treatment plans and dose calculations are reviewed
prior to initiation of treatment.
Verification: prior to initiating treatment and
periodically during treatment, x-rays of the treated field are compared
with simulation x-rays or digitally reconstructed x-rays (DRR) to
ensure reproducibility of daily treatment.
Treatment Delivery: After the physician approves
verification films, treatment can start. Treatment times vary with
technique, sophistication of treatment delivery, as well as goal
of treatment (curative vs. palliative). Treatments are given 5 days
weekly, Monday – Friday, between 8 AM and 4 PM with scheduled
appointment times.
Physician Visits: patients are seen at least once
weekly by the physician and nurse for assessment of general medical
condition, response if any to treatment, evaluation of side effects
and blood counts. Treatment progress is also reviewed.
Quality Assurance: since radiation cannot be seen,
heard, or touched, our QA program involves weekly verification films
of all treated fields including patient position and review of prescription
and dose delivery.
