A State-of-The-Art Radiation Oncology Department at The JFK Comprehensive Cancer Institute
Radiation therapy has always been an important component in the integral management of cancer care. Modern technical advancement in instrumentation and cancer biology has made radiation therapy more effective than before for many types of cancers.
The JFK Comprehensive Cancer Institute has the most advanced modern radiation therapy equipment. Structured with the national standard of practice, it offers three major radiation treatment modalities to our patients:
- External beam radiation therapy
- Stereotactic Radiosurgery
External Beam Radiation Therapy Program
External beam radiation therapy treats the largest percentage of cancer patients. It is most commonly done using high energy x-rays and electron beams produced by linear accelerator (Linac). The most advanced forms of external beam radiation therapy include intensity-modulated techniques that are delivered either statically (IMRT) or dynamically (VMAT/RapidArc). In addition, a series of high precision technologies such as image-guided radiotherapy (IGRT) system and respiratory motion management are incorporated to assure accurate treatment delivery. The newly installed TrueBeam system by Varian Medical Corp. at the JFK Cancer Center is the most advanced digital linac that is integrated with the most comprehensive high tech components including RapidArc, OBI (On-board Imager) for IGRT, RPM (Real-time Position Management) for patient motion control and High-intensity mode for Radiosurgery, allowing our radiation oncologists to provide our patients with the latest external beam radiation therapy options with the highest precision and the least side-effects. The TrueBeam is also known for its highest radiation output rate in the industry, resulting in the shortest treatment time.
Brachytherapy is one of the highly effective radiation therapy modalities. It uses radioactive isotopes to deliver radiation dose to tumors directly, with minimal radiation damage to the surrounding normal tissues. Brachytherapy is suitable for many tumors, including breast, GYN, lung, esophagus, prostate, etc. The brachytherapy procedures at JFK are performed in a dedicated suite using a latest model of high-dose-rate (HDR) remote after-loader by Nucletron Corp.
Depending on the site being treated, this technique involves temporary placement of catheters (MAMMOSITE, SAVI) for breast cancer or tandem and ovoids for vaginal endometrial and cervical cancers.
For relatively small tumors and some benign conditions such as AVM, trigeminal neuralgia, meningioma, pituitary adenoma, and acoustic neuroma Stereotactic Radiosurgery (SRS) or stereotactic ablative body radiotherapy (SBRT) is often the most optimal choice of treatment. SRS or SBRT uses highly focused radiation beams to deliver markedly higher radiation dose to ablate tumors without damaging surrounding normal tissues. It can achieve comparable results to surgery without physical invasion. Such treatment requires extremely high precision and performance skills. Depending on each patient’s condition, SRS/SBRT at JFK can be delivered by two most advanced SRS/SBRT systems, the TrueBeam and the Cyberknife. The Cyberknife, manufactured by Accuray, Inc. is recognized as one of the most advanced instrumentation for Radiosurgery. It combines highly sophisticated image guiding technologies and robotic technologies to deliver Radiosurgery with un-paralleled precision. It was the first and remains the only system, capable of tracking and compensating for tumor motion in real-time while delivering radiation to eradicate tumors. The Cyberknife Center at JFK, with a team of internationally renowned experts, offers our patients this state of the art technology with supreme quality.
The CyberKnife® System is a viable, non-invasive alternative to surgery and is capable of treating tumors anywhere in the body. The treatment – which delivers high doses of radiation to tumors with extreme accuracy – offers new hope to patients who have inoperable or surgically complex tumors, or who may be looking for an alternative to surgery.
The CyberKnife® System uses image-guidance and computer controlled robotics to deliver multiple beams of high-energy radiation to the tumor from virtually any direction. Designed to treat tumors anywhere in the body with sub-millimeter accuracy, the CyberKnife System tracks the tumor’s position, detects any tumor or patient movement and automatically corrects the treatment delivery. This outpatient procedure does not require anesthesia or invasive stabilizing frames. Most patients experience minimal recovery time and can return to normal activities almost immediately.
Medical Imaging and Treatment Planning
Medical imaging technology plays crucial role in modern medicine. The level of treatment efficacy relies on the accurate determination of tumor or diseased regions as well as critical organs. In addition to a dedicated 16-slice large-bore CT scanner/simulator, capable of obtaining 4D images, multiple medical imaging modalities including MRI and PET-CT, are routinely used through deformable fusion to delineate tumor regions for treatment and critical organs that need protection. High-performance computers with highly sophisticated computation software are used to design and optimize treatment plans to assure highest rate of tumor control and minimal radiation damage to normal tissues.
When complicated advanced technologies are integrated for cancer treatments, they pose unprecedented high demand on accuracy and efficiency of information management. This is especially true in modern radiation therapy. The operation at the JFK radiation therapy department is configured on an integrated network platform, called “Inspiration”, developed by Varian Medical Corp. With this platform, all data associated with patient treatment from all equipment and hospital service departments are centrally controlled and flow seamlessly. Efficiency is maximized and errors are minimized.