Radiation Oncology

Apollo Cancer Centres' Radiation Oncology program represents the cutting edge of cancer treatment technology. Our comprehensive suite of radiation therapy options allows us to provide precisely targeted treatments while maximizing healthy tissue preservation.

Key advantages include:

Precise tumor targeting
Minimal damage to healthy tissue
Reduced side effects
Better quality of life during treatment
Improved outcomes for complex cases

All the advanced radiation therapy systems at Apollo Cancer Centres are supported by:

Expert radiation oncology teams
Specialized medical physicists
Dedicated therapy technologists
Comprehensive quality assurance programs
Regular system upgrades and maintenance

The comprehensive suite of radiation therapy technologies enables us to provide personalized treatment approaches for each patient, ensuring optimal outcomes while minimizing side effects and maintaining quality of life during treatment.

Advanced Radiation Technologies

Proton Therapy

As South Asia's pioneer in proton therapy, Apollo offers this sophisticated form of radiation treatment that represents the pinnacle of precision in cancer care. Proton therapy uses high-energy proton beams to target tumors with unprecedented accuracy.

Key Technological Features:

Pencil beam scanning technology- a highly precise method to deliver radiation, minimizing exposure to healthy tissues
Advanced treatment planning systems-sophisticated software that designs personalised radiation treatment plans based on tumor size, shape and location
Real-time imaging guidance-Ensures radiation is accurately delivered by continuously monitoring tumor movement during treatment .
Adaptive therapy capabilities-adjusts treatment plan dynamically to account for changes for changes in tumor position or size.
Comprehensive motion management-Handles tumor movement caused by breathing or pther body functions to maintain accuracy .

Distinctive advantages include:

Superior dose distribution with Bragg’s peak utilization [delivers maximum radiation dose precisely to the tumor]
Significant reduction in radiation to healthy tissues
Particularly beneficial for pediatric cases
Optimal for treating complex tumor locations
Enhanced quality of life during and after treatment

TrueBeam STx with Velocity

The TrueBeam STx with Velocity represents a revolutionary advancement in radiation therapy technology, engineered to deliver powerful cancer treatments with unprecedented speed and precision. This sophisticated system combines advanced imaging, beam delivery, and motion management capabilities to effectively target tumors while protecting surrounding healthy tissues.The system's high-precision beam delivery capability makes it particularly effective for treating complex and challenging cancers of the brain, spine, lung, liver, and prostate. Using intelligent automation and control systems, it can synchronize imaging, patient positioning, motion management, and treatment delivery with extraordinary precision.

Key features include:

High-precision beam delivery
Advanced imaging integration
Sophisticated motion management
Real-time tracking capabilities
Rapid treatment delivery

Particularly effective for treating:

Brain tumors
Spinal tumors
Lung cancer
Liver cancer
Prostate cancer

Key Technological Features:

Volumetric RapidArc® technology for faster treatments
High-definition beam shaping for precise dose delivery
Advanced motion management system for moving targets
Real-time imaging during treatment delivery
Integrated patient positioning system

Clinical Benefits:

Treatment times reduced to minutes instead of hours
Enhanced protection of healthy tissues
Higher dose delivery accuracy
Improved patient comfort during treatment
Better clinical outcomes for complex cases

Novalis Tx

Novalis Tx represents the pinnacle of radiation oncology technology, offering hope to patients with conditions once considered untreatable. This advanced system combines a powerful linear accelerator with sophisticated image guidance and motion management tools, enabling precise treatment delivery from virtually any angle around the patient.

The system's advanced imaging capabilities provide clinicians with detailed real-time information about tumor shape, size, and position, ensuring accurate patient setup and treatment delivery. The integration of multiple technologies allows for highly precise stereotactic radiosurgery and radiation therapy.

Advanced Features:

ExacTrac® X-ray monitoring system
6D robotic couch for precise patient positioning
HD120™ MLC for precise beam shaping
Integrated imaging solutions
Advanced treatment planning capabilities

Treatment Applications:

Complex brain and spine tumors
Moving tumors in the lung and liver
Small targets near critical structures
Previously inoperable tumors
Multiple metastases treatment

Stereotactic Radiosurgery (SRS)

SRS delivers precise, high-dose radiation for specific conditions such as tumors in the brain. SRS is a non surgical procedure that delivers a high dose radiation to a specific target with extreme precision. Advanced imaging techniques like MRI, CT or PET are used to create a detailed 3D map of the target area . The patient is fitted with a head frame or immobilization device to ensure no movement of the target .High dose radiation is then delivered from multiple angles.

Technical capabilities:

Precise target localization
High-dose delivery
Real-time imaging
Motion management
Multiple delivery systems

Optimal for treating:

Brain tumors
Spine tumors
Functional disorders
Vascular malformations
Selected metastases
Can also be used to treat tumors of the lungs, liver, pancreas or prostate .

Technologies Used in SRS

1. Gamma Knife:

A specialized machine designed exclusively for brain and head treatments.

2. CyberKnife:

A robotic system that allows for precise targeting of tumors anywhere in the body, including moving targets like the lungs.

3. Linear Accelerator (LINAC):

Uses advanced imaging and radiation delivery to treat tumors in the brain and body.

CyberKnife Technology

CyberKnife represents a groundbreaking approach to radiosurgery, combining robotics with advanced imaging and treatment delivery. This unique system uses a lightweight linear accelerator mounted on a highly articulated robotic arm, enabling treatment delivery from potentially thousands of angles with sub-millimeter accuracy.

The system's advanced tracking capabilities allow for real-time tumor tracking and beam adjustment, making it particularly effective for treating moving tumors without the need for traditional immobilization devices. This technology has revolutionized the treatment of inoperable tumors and complex cases.

System Capabilities:

Robotic arm delivery with 6 degrees of freedom- the arm can move in 6 directions allowing precise delivery of radiation from multiple angles .
Real-time tumor tracking with sub-millimeter accuracy-tracks the tumor’s movement during treatment and adjusts the radiation beam in real time to ensure accuracy.
Synchrony® Respiratory Tracking-specifically designed to manage tumor motion caused by breathing .
Advanced treatment planning software-customises treatment plans for each patient based on size,location and movement patterns .
Multi-modality imaging integration-combines imaging data from multiple sources [ex-CT ,MRI] for precise tumor visualization and planning.

Clinical Applications:

Intracranial tumors and lesions
Spine tumors
Early-stage lung cancers
Selected liver tumors
Complex prostate cases

Unique Advantages:

Treatment of previously inoperable tumors
Comfort during treatment delivery
Fewer treatment sessions required
Minimal recovery time
Excellent clinical outcomes

Tomotherapy

Tomotherapy at Apollo combines the precision of IMRT [Intensity modulated Radiotherapy ] with the accuracy of CT imaging, offering unique advantages in treatment delivery. This innovative system delivers radiation therapy slice by slice, similar to how a CT scanner operates, allowing for highly precise and uniform dose delivery to complex tumor shapes while minimizing exposure to healthy tissues.

The system performs a CT scan before each treatment, ensuring precise patient positioning and enabling adaptive planning based on daily anatomical changes. This daily imaging capability, combined with dynamic delivery, provides unprecedented accuracy in treatment delivery.

Clinical Benefits:

Superior dose conformity
Reduced side effects
Treatment adaptation capabilities
Improved outcomes for complex cases
Enhanced patient comfort

Advanced Features:

Helical treatment delivery- delivers radiation in a helical or spiral pattern, allowing for highly precise treatment .
Built in CT imaging for precise positioning and alignment before each treatment session.
Adaptive planning capabilities- can adjust treatment plans dynamically based on changes in tumor size and patient anatomy during the course of treatment .
TomoHelical™ [ which delivers radiation ina continuous spiral pattern for highly conformal treatment of complex tumor shapes] and TomoDirect™ [delivers radiation in fixed linear beam paths ] delivery options.
Advanced dose calculation algorithms
Dynamic jaw technology-improves delivery of the dose shaping radiation beam to the contours of the tumour.
Advanced dose calculation algorithms

Benefits include:

Seamless treatment of multiple targets
Superior dose conformity and precision
Reduced side effects
Improved treatment outcomes
Enhanced patient comfort

Three-Dimensional Conformal Radiation Therapy (3D-CRT)

Our 3D-CRT technology provides precise radiation delivery through advanced imaging and planning:

Key components:

CT-based treatment planning where a detailed 3D map of the tumor and surrounding structures
Multi-angle beam delivery
Shape-optimized radiation fields-shaped to match the contour of the tumour
Protection of vital organs reducing long term complications
Adaptive planning capabilities- can adjust treatment plans dynamically based on changes in tumor size and patient anatomy during the course of treatment .

Benefits include:

Improved tumor targeting
Reduced side effects
Better tissue preservation
Enhanced treatment outcomes
Shorter treatment times

Intensity-Modulated Radiation Therapy (IMRT)

IMRT represents an advanced form of 3D-CRT [3D Conformal Radiation therapy ] offering even greater precision in radiation delivery:

Advanced capabilities:

Variable radiation intensity so that higher doses are delivered to specific areas of the tumor
Precise dose modulation adjusted to match tumor contours
Complex tumor targeting-effective for treating tumors with irregular shapes or those that are located near critical structures.
Critical structure sparing-protects nearby organs and tissues from excessive radiation.
Adaptive planning- Adaptive planning capabilities- can adjust treatment plans dynamically based on changes in tumor size and patient anatomy during the course of treatment .

Clinical advantages:

Higher doses to tumors
Minimal exposure to healthy tissue
Reduced side effects
Better quality of life
Improved cure rates

Image-Guided Radiation Therapy (IGRT)

IGRT combines advanced imaging with precise radiation delivery:

Technology features:

Real-time imaging
Daily position verification
Adaptive planning
Motion management
Treatment optimization

Benefits include:

Enhanced accuracy
Reduced margins
Better tumor control
Fewer side effects
Improved outcomes

Key Differences in Use of IMRT and IGRT

IMRT focuses on shaping and controlling the radiation dose for maximum effectiveness and safety.IGRT focuses on guiding the delivery of radiation in real-time, ensuring that the radiation is accurately directed at the tumor.

IMRT and IGRT often work together in modern cancer treatment. IGRT ensures that the radiation beams from IMRT are accurately delivered to the tumor, making the combination a powerful tool for treating complex and hard-to-reach cancers with minimal side effects.

High Dose Rate Brachytherapy (HDR)

Brachytherapy is a form of internal radiation therapy where a radiation source is placed directly inside or near the tumor. It allows for precise delivery of radiation to cancer cells while minimizing exposure to surrounding healthy tissues.

How Brachytherapy Works

1. Radiation Source Placement:

• A radioactive material (e.g., seeds, wires, or pellets) is inserted into or near the tumor using applicators, catheters, or needles.

• Placement is guided by imaging techniques like CT, MRI, or ultrasound for accuracy.

2. Localized Treatment:

• The radiation affects the tumor while sparing nearby healthy tissues and organs.

3. Radiation Decay:

• The radioactive material releases high-dose radiation over a controlled period, targeting cancer cells and minimizing side effects.

Brachytherapy is commonly used for:

• Gynecological Cancers: Cervical, uterine, and vaginal cancers.

• Prostate Cancer: Effective for localized tumors.

• Breast Cancer: Used in partial breast irradiation.

• Skin Cancer: For superficial lesions.

• Head and Neck Cancers: Including oral cavity and nasopharyngeal cancers.

• Lung Cancer: In cases where external radiation is not suitable.

Benefits of Brachytherapy

1. Precision:

• Delivers radiation directly to the tumor with minimal impact on nearby healthy tissues.

2. Reduced Side Effects:

• Lower risk of damage to surrounding organs compared to external beam radiation therapy.

3. Shorter Treatment Time:

• Some treatments are completed in one or a few sessions.

4. Outpatient Procedure:

• Many forms of brachytherapy are performed on an outpatient basis, allowing quicker recovery.

5. Effective for Localized Tumors:

• Offers high success rates for treating tumors that have not spread.

Radionuclide Therapy (RNT)

RNT is a type of targeted internal radiation therapy where radioactive substances known as Radionuclides . Radionuclides are bound to molecules like antibodies, peptides or proteins that can locate and bind to specific receptors on cancer cells .

Treatment delivery is done through:

Intravenous administration
Direct tumor targeting
Systemic therapy
Local applications
Combination approaches

Particularly effective for:

Thyroid cancer
Neuroendocrine tumors
Prostate cancer
Liver cancer
Selected metastases