February 2, 2016

Service Spotlight: Radiation Oncology

Specialized technology for cancer treatment

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Radiation oncology is one of the major forms of cancer treatment at Cleveland Clinic. Our experience and expertise in innovative treatment approaches help provide patient-centered, multidisciplinary care focused on quality, outcomes, safety and patient experience. Specialized technologies target a variety of disease sites for individualized cancer treatments. In addition, we participate in a number of clinical studies, including the NRG cooperative group, and have an active translational research program focused on stem cells and genomics.

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INTENSITY MODULATED RADIATION THERAPY sculpts the radiation beams to the shape of the tumor while minimizing normal tissue side effects. Cleveland Clinic was one of the first institutions to offer this type of radiation delivery for cancers including prostate, brain, spine, and head and neck. In addition, intensity modulated arc therapy provides precise and speedy delivery of radiation. Various image guidance systems are used:

  • On-board X-ray, ultrasound, optical imaging or cone beam computed tomography is used to precisely target and deliver radiation therapy treatments.
  • The Calypso® 4D Localization System uses radiofrequency waves to function as a GPS for the body. Tiny seeds, the size of a grain of rice, are implanted. Beacon transponders within the seeds are activated by an electronic field to continuously track the treatment position target, allowing for tighter treatment margins.
  • VisionRT/Align RT utilizes optical surface tracking, allowing for assessment of patient setup prior to each treatment. The system monitors change in the patient’s body surface contour ensuring accurate targeting and delivery of radiation each day.

THE VARIAN EDGE™ linear accelerator uses ultrafast, precise radiation delivery for patients with prostate, liver, lung, spine, brain, and head and neck tumors via stereotactic body radiation therapy (SBRT). This machine fully integrates the Calypso system for real-time tumor tracking. A sophisticated treatment couch provides additional treatment precision. Cleveland Clinic was the second U.S. medical institution to use this innovative radiation delivery system.

BRACHYTHERAPY is the placement of radioactive sources in or around a tumor. Our prostate brachytherapy program is one of the busiest in the country, treating more than 4,700 patients. We also have an active, high-dose-rate brachytherapy program for esophageal and gynecological malignancies.

GAMMA KNIFE® RADIOSURGERY is a single session of high-dose, targeted radiation for malignant brain tumors, such as brain metastases, benign brain tumors, arteriovenous malformations and functional neurological disorders, including trigeminal neuralgia. Cleveland Clinic has performed more than 5,500 cases and is one of the few U.S. accredited training centers.

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INTRAOPERATIVE RADIATION THERAPY (IORT) efficiently delivers radiation in the operating room and minimizes radiation to normal tissues. IORT is used primarily for breast, colorectal and gynecologic cancers. Cleveland Clinic uses an Intrabeam unit for IORT.

HYPERTHERMIA noninvasively heats the surface of a tumor, increasing blood and oxygen flow to increase sensitivity to radiation treatments. We are Ohio’s only cancer program offering hyperthermia for select gynecologic malignancies, recurrent chest wall malignancies related to breast cancer, some sarcomas, and some head and neck cancers.

Select diseases treated

Cleveland Clinic offers several novel treatment approaches for common diseases that deliver superb disease control with minimal side effects:

  • Stereotactic body radiotherapy for early stage lung cancers is the standard for older and frailer patients in whom greater than 90 percent tumor control can be achieved in one to five treatment sessions. More than 1,400 patients were treated with fewer side effects compared with more traditional lung radiation therapy.
  • High-precision, high-dose SBRT prostate cancer external beam radiation therapy is delivered in only five treatments, compared with the typical 35 to 40 treatments.
  • Re-irradiation for patients with tumors that recur after prior radiation treatment – including lung, head and neck, brain, spine and pelvic tumors – provides aggressive treatment while sparing normal tissues.
  • Superficial, noninvasive radiation treatments for skin cancers (basal cell and squamous cell types) are targeted specifically for elderly and infirm patients, as well as any patient for whom surgery could compromise function or cosmesis of areas such as nose, external ear and eyelids.
  • Nonmalignant conditions treated with low-dose radiation therapy prevent disfiguring keloid formations and painful heterotopic bone formation around the hips, elbows and knees.

Radiation treatment delivery continually evolves in complexity secondary to technological advancements.

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Cleveland Clinic’s experienced team of radiation oncologists, medical physicists, dosimetrists, therapists, nurse practitioners and nurses work together to optimize patient safety, quality assurance and treatment delivery.

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