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Department of Radiation Oncology 

Head of the Department:

Dr. Geetha M, Associate Professor, Radiation Oncology

The Department of Radiation Oncology of Malabar Cancer Center is equipped with the latest technological advances in the field of Radiation Oncology so as to provide the patients with the comprehensive cancer care meeting international standards. The Departments of Radiation Oncology and Diagnostic Radiology are committed to achieving excellence in the treatment and diagnosis of cancer. Radiation Oncology saw the inauguration of the dual energy linear accelerator towards the end of the year 2011. March 2012 saw the first patient being treated with Rapidarc Intensity Modulated Radiotherapy. Over the next three months significant experience was gained in Rapidarc IMRT planning and the technique of Rapidarc Simultaneous Integrated Boost was fine tuned for head neck cancers. Presently about 65 - 70% of the patients on Linear accelerator are treated with Rapidarc. The statistics related to the treatment as well as the early results of treatment in selected sites were presented in various national conferences. In February 2013 the department also organized the first national conference of the Young Radiation Oncologists Wing (YROW) of the Association of Radiation Oncologists of India (AROI). Professor Ramesh Bilimagga also inaugurated the Young Radiation Oncologist Wing of the AROI in the same conference. 

In addition to delivering radiation treatment the doctors of the department also treat patients with systemic chemotherapy for solid malignancies. Various solid tumors have been treated with various forms of chemotherapy over the last year. With increasing burden of patients the department in association with the department of nursing and cancer palliative medicine regular training has been conducted for health services nurses from various medical colleges. The aim is to ensure that patients presenting from far off places can receive palliative chemotherapy in local centres in the near future after the doctors and nurses have been trained. In order to facilitate the same the department has prepared information sheets for common palliative chemotherapy regimens. It is expected that over the next few months more patients will benefit from this as they don't have to travel long distances to Malabar Cancer Center to get palliative chemotherapy. In addition the burden on the day chemotherapy ward of the hospital will be also reduced.
The Department of diagnostic radiology has also seen a large increase in the number of diagnostic imaging performed. The new 1.5 Tesla MRI was installed and started operating since January. With the induction of a one full-time diagnostic radiologist the number of cases undergoing imaging for various indications as well intervention in the form of guided biopsies has increased substantially. This has also reduced the burden on the surgical oncology department. The Picture Archival and Communication System (PACS) was commissioned during this period and has ensured continued availability of high quality diagnostic imaging for all patients imaged in the hospital without relying on films. It is expected that the system will be integrated with Hospital Information System (HIS) once it is commissioned in the recent future.
Over the next year we plan to commission the 4D CT Simulator, MRI compatible Image guided Brachytherapy system and Radiobiology Laboratory (in conjunction with the molecular oncology laboratory). In addition we are planning to acquire a new Linear Accelerator for catering to the increased load of patients in the hospital. Tenders have been called for supply of a Thermoluminescent dosimetry system, MRI compatible Intracavitary Brachytherapy applicator, Martinez Universal Perineal Template (MUPIT) Interstitial Brachytherapy system and an anthropomorphic phantom to set-up the Radiobiology Laboratory. The ongoing research projects, publications and other academic activities are detailed in the report below. The focus of the departments will remain on providing affordable international standard evidence and guideline based management (diagnostic and therapeutic) for all patients seen.

The Department is equipped with the following equipment:

  1. Linear Accelerator (Varian Clinac iX): This dual energy high end Linear Accelerator is a complete and integrated platform for delivering state of the art Radiation Therapy treatments e.g. 3DCRT/IMRT/RapidArc/IGRT/SBRT/SRS. The system is capable of treatment with 2 Photon Beam Energies and 6 Electron Energies. It is equipped with On Board Imaging System capable of KV Xrays, Online Fluroscopy and Cone Beam CT images for online treatment verification and adaptive radiotherapy. The machine treats about 65 - 70 patients daily with 65 - 70% being treated with RapidArc IMRT. This machine has successfully treated over 700 patients since its commissioning in November 2011. 
  2. Nucletron 16 Channel HDR Brachytherapy: The system is capable of delivering brachytherapy treatment to various sites. The Centre practices Intracavitary, Interestitial, Intraluminal and Surface Mould Brachytherapy. The centre is in the process of acquiring a MUPIT applicator for interestitial brachytherapy in pelvic malignancies as well as Fletcher Suite CT/MRI compatible applicator. In addition the treatment planning system is being upgraded to the latest ONCENTRA brachytherapy treatment planning. A dedicated Brachytherapy OT is situated beside the brachytherapy vault.
  3. Tele Cobalt 60: The workhorse of the treatment machine treats about 40 - 50 patients per day. The machine is intergrated with the CMS XiO treatment planning system. Compensator based treatment is offered for all radically treated head and neck cancer patients.
  4. Treatment Planning System: The department has the l;atest ARIA Oncology Information System along with the ECLIPSE treatment planning system. In addition it has the ADVANTAGE Sim, PLATO and CMS XiO treatment planning systems. The PLATO treatment planning system is being upgraded to the latest ONCENTRA BRACHY treatment planning system.
  5. CT Simulator: The department is in the process of acquiring the latest 16 slice CT Simulator capable of 4D image acquisition. The CT simulator will be exclusively available for the department of radiation oncology and will reduce the waiting list for the advanced treatment substantially. The present CT simulation is being performed on the 4 slice GE CT machine.
  6. Conventional Simulator: The department has a  Conventional Simulix Simulator in which all patients are simulated. The images can be fluroscopically transferred to the treatment planning systems.
  7. Mould Room: The department has a well equipped mould room with facility to make custom thermoplastic immobilization masks, vaccum cushions, compensators, Electron cutouts etc.
  8. X-ray: GE DX 525 X-Ray Unit was commissioned in 2005 along with Automatic Film Processing Unit. A GE Genius Portable X-Ray machine is also available in the Department.
  9. Mammography: Has one of the best mammography machine- Hologic Selenia Dimension with 3D mammography, stereotaxic and mammotome biopsy facility. Unit also has CAD facility.
  10. Ultrasound Scan: Three Ultrasound Scanners available in the Department.
    GE LOGIQ 200 Ultrasound Machine
    Portable Ultrasound Scanner MUS 602
    A new Color Doppler Ultrasound Scanner (Hitachi EUB) installed on 30/09/2010.
    Major services includes routine abdominal scans, doppler, USG guided biopsies, drainage, pigtail insertion and brachytherapy planning.
  11. CT Scanner: The GE Lightspeed Multi slice CT scanner with GE Advantage Sim Virtual simulation workstations was commissioned in 2007.The major activity includes routine spiral CT scan, CT Angiography, Multi phase studies, guided biopsies, drainage procedures, pigtail insertion and radiotherapy treatment planning.
  12. MRI Scanner: HDxT 1.5T Signa 16 Channel GE MRI scan was commissioned in January 2013. The machine has capability for routine imaging, whole body imaging, whole body DWI, endorectal coils for prostate, rectal and cervix imaging with prostate spectroscopy, dedicated breast coils and non contrast whole body angiography.
  13. RFA Machine and Maxio Robotic arm.
  14. PACS:Has GE Centricity PACS.

In addition to the above the Department also takes care of the solid tumor chemotherapy in the hospital. The department also conducts a 3 year combined BSc MRT course for training Medical Radiation Technologists in the area. It is also proposed to start a new MSc Medical Physics Course in the department. In addition the department is planning to start a Radiobiology Laboratory in cooperation with the Molecular Oncology Division of the hospital. In this regard it is planned to procure an Anthropomorphic phantom and TLD dosimetry system in the first stage along with mathematical modelling software. The Department has the following Divisions;

  1. Radiation Oncology Division
  2. Medical Physics Division
  3. Imageology Division

Faculties

  1. Dr. Geetha.M, Associate Professor
  2. Dr. Vinin N.V, Assistant Professor
  3. Dr. Greeshma.K.E, Lecturer
  4. Dr. Joneetha James, Assistant Professor
  5. Dr. Satheesh Babu T.V., Assistant Professor
  6. Dr. Sarath K.E, Lecturer

 

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