Radiation Therapy

External Beam Therapy includes the use of a linear accelerator as part of the cancer treatment to control or kill malignant cells. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery (for example, early stages of breast cancer). Radiation therapy is often used along with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers.

• Intensity Modulated Therapy - Intensity Modulated Radiation Therapy uses a computer to control the linear accelerator allowing precise delivery of the radiation dose to the malignant tumor. Treatment is carefully planned using computed tomography (CT) or magnetic resonance (MRI) scans. 3D images of the patient are used in conjunction with computerized dose calculations to determine the dose intensity pattern that best conforms to the patient’s tumor size and shape. This custom-tailored radiation dose maximizes tumor dose while minimizing dose to adjacent normal tissue. 
• SBRT: Stereotactic Body Radiation Therapy also SRT Stereotactic Radiation Therapy - Type of external beam radiation therapy typically given to very small tumors.  Special devices are used to keep the patient entirely still.   The treatment is given with tremendous accuracy minimizing dose to surrounding tissue.  The treatment is given in high doses over the course of 1-5 treatments.  
• SRS: Stereotactic Radio Surgery - Type of external beam radiation therapy typically given to very small tumors in a single treatment.  Patients are placed in specialized immobilization devices allowing for a very precise, high dose of radiation treatment given to the brain or spinal cord. 
• 3D Conformal Therapy- Therapy which uses 3D images (CT, MRI, etc) to shape the beam to match the shape of the tumor minimizing dose to normal tissue and maximizing it to the tumor area.  

Image-guided radiation therapy is special imaging technology that allows the Radiation Therapists to image the tumor immediately before the radiation is delivered, while the patient is positioned on the treatment table. These images are taken using an On-Board Imager and then evaluated by the doctor using specialized software and compared to the reference images taken during simulation. Any necessary adjustments are then made to the patient's position and/or radiation beams to more precisely target radiation at the tumor.

• Optical Surface Monitoring System (OSMS) – Specifically designed non-invasive, non-ionizing real-time 3D imaging technology producing high resolution and accurate 3D surface data that detects even slight patient motion while mapping the 3D external surface of the patient. Allows for instantaneous beam gating so clinicians can reduce uncertainty margins throughout treatment and is fully compatible with non-coplanar treatments and monitoring, allowing optimization of motion in all six degrees of freedom.
  
• DIBH: Deep Inspiration Breath Hold - Treatment for breast cancer that minimizes radiation to the heart by having the patient take a deep breath which expands the lungs pushing breast tissue away from the heart.
• Respiratory Gating - Respiratory Gating is used when there is a concern that the tumor may move during treatment due to normal patient breathing patterns. This system allows the radiation beam to be “gaited” or turned on and off in response to tumor motion.

Brachytherapy, also referred to as “internal radiotherapy”, “intra-cavitary radiotherapy”, “interstitial brachytherapy”, “seed therapy”, or “implantation”; places a radiation source directly into or near the treatment area so that fewer surrounding healthy cells are exposed to the radiation.  By using internal radiation therapy, the clinician can give a higher total dose of radiation to the target area in a shorter time than is possible with external treatment. These implanted sources can either be left in permanently or removed once the dose has been delivered, and can be used in conjunction with external beam radiation therapy. Brachytherapy is used to treat cancers of the prostate, cervix, endometrium, breast, skin, bronchus, esophagus, and head and neck, as well as soft tissue sarcomas and several other types of cancer.

• High Dose Rate (HDR) Brachytherapy - This very specialized treatment involves the placement of a very small highly radioactive source of Iridium near the area of interest.  The procedure involves the placement of a small catheter or applicator that will guide the radioactive source during the treatment delivery.  After treatment the delivery device(s) are removed.  Patients may receive this form of treatment several times. 
  • Gynecologic HDR – Commonly treated using a cylinder, tandem & ovoid, or tandem & ring applicator.  Patients commonly receive 3-6 applications with this technique.
  • Breast HDR (MammoSite, Savi) – This technique for administering partial breast irradiation delivers dose via a special catheter/applicator that is placed into the lumpectomy site minimizing exposure to the heart and lungs.
  • Lung HDR – This procedure involves the placement of a temporary bronchial catheter into the lung.
  • Esophageal HDR - – This procedure involves the placement of a temporary esophageal catheter into the esophagus.
• Prostate Low Dose Rate (LDR) Brachytherapy – outpatient cancer treatment that consists of permanent implantation of radioactive seeds into the prostate gland through the perineum for early stage prostate cancer.  

Radiopharmaceuticals transport targeted doses of radiation directly to the tumors and its metastases, thereby sparing normal healthy tissue. 

• Xofigo (Radium Ra 223 dichloride) Used to treat hormone resistant prostate cancer that has spread to the bone.
• Samarium (Sm-153 Lexidronam Pentasodium) -. Samarium is given to help reduce pain in a person whose cancer has spread to the bones

Optune - a wearable, portable treatment used to treat adult patients with recurrent glioblastoma multiforme (GBM).

Beyond its critical role in cancer treatment, modern radiation therapy also offers significant relief for certain non-cancerous (benign) conditions. Utilizing precisely targeted, low doses of radiation, this approach works to reduce inflammation, alleviate pain, and manage benign cell overgrowth, rather than destroying tissue.

This innovative treatment may be an option for persistent conditions unresponsive to conventional therapies, including:

• Benign tissue overgrowth, such as vestibular schwannoma or keloids
• Inflammatory conditions, including Grave's ophthalmopathy and gynecomastia
• Musculoskeletal conditions like osteoarthritis, Dupuytren’s contracture, and plantar fasciitis

Benefits often include long-lasting pain relief, reduced inflammation, and improved quality of life with minimal side effects.

If you are suffering from a chronic benign condition, discuss with your provider if low-dose radiation therapy could be a solution for you. LDRT is offered at CHI Health St. Elizabeth and CHI Health St. Francis. We'll assess your individual case to determine if this targeted healing approach is appropriate.