The success of current cancer treatment requires a multidisciplinary approach that includes not only radiation oncology, medical oncology, radiology, nuclear medicine, pathology, surgical branches, and supportive therapy departments, but also all other branches specific to the disease. The effectiveness of the treatment is directly related to the discussion of individual patient and tumor characteristics in tumor boards with the participation of relevant experts, the decisions made in light of current scientific data, and the provision of treatment by expert teams with advanced technological equipment and patient comfort.
In our department of radiation oncology, treatments carried out with technologically advanced radiotherapy devices by doctors and radiation physics experts offer patients a high quality of life with similar high tumor control rates and low side effects achieved in internationally prestigious cancer centers.
The Elekta Axesse Linear Accelerator treatment device, which was first installed in our hospital in Turkey, is a highly prestigious device capable of performing intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), stereotactic radiotherapy (SRT), and stereotactic radiosurgery (SRS), which are accepted as the current standard treatment methods for many tumor groups. The Axesse technology, which can be used in the treatment of all cancer types, offers the possibility of minimizing the side effects that may occur in healthy tissues while maximizing treatment accuracy and tumor efficacy, thanks to its superior technology that allows the localization of the tumor to be controlled by taking a tomography (Cone-beam computed tomography) before treatment and monitoring the tumor and healthy tissue during treatment with image guidance. Therefore, it offers patients a high chance of tumor recovery while providing a more comfortable treatment period and post-treatment period by reducing side effects.
The Monaco Treatment Planning System, which was first used in our hospital in Turkey, is considered the best among planning systems by all relevant experts worldwide, as it uses the Montecarlo Dose Calculation System, which can simulate real treatment conditions. It offers the chance to calculate the most realistic and accurate dose distribution possible.
The Varian Varisource Brachytherapy Device is used for brachytherapy applications, where the radioactive source is placed inside or near the tumor tissue or risk areas through suitable catheters, and radiation is given for therapeutic purposes for a predetermined duration. This treatment option can be applied curatively in uterine and cervical tumors, prostate, breast, and soft tissue tumors, and palliatively in lung, esophagus, bile duct obstructions, or advanced-stage bleeding uterine and cervical cancers to improve existing symptoms. Nowadays, brachytherapy is generally used to complement the dose of externally applied radiotherapy. In our department, brachytherapy for the uterus, cervix, lung, esophagus, and bile ducts has been performed since 2007, and breast brachytherapy will be started shortly. Especially with computerized planning, brachytherapy can deliver high doses to the tumor tissue while protecting surrounding organs, resulting in more effects and fewer side effects. Conformal brachytherapy performed with the guidance of computed tomography has been standard practice in our clinic since 2008.
PET-CT-based radiotherapy planning is a significant imaging system for accurately determining the size of the primary tumor and revealing additional tumor foci that cannot be seen with other imaging methods in many tumor types. PET-CT is also crucial for assessing treatment response and distinguishing between treatment-related side effects and recurrent disease. Our clinic is one of the advanced centers that routinely use PET-CT imaging for disease staging, treatment planning, and distinguishing between side effects and recurrent disease in suitable patients.
Elekta Axesse and Gamma knife stereotactic radiotherapy and radiosurgery are used for delivering high doses of radiation to the tumor tissue in 1 to 5 fractions, considering the tumor type, location, and characteristics. This treatment creates a surgical-like effect on the diseased tissue. The procedure is painless and bloodless, and patients can often go home the same day. Gamma knife is used exclusively for intracranial tumors, pituitary adenomas, functional diseases, and arteriovenous malformations in collaboration with the neurosurgery department. The Elekta Axesse device can treat tumors located anywhere in the body, in addition to intracranial tumors. SRT and SRS, whether used as primary treatment or as an additional dose after external radiotherapy, increase disease control without compromising patient comfort. For example, more than 50% of pancreatic cancers locally recur after conventional radiotherapy and chemotherapy, while this rate drops below 10% with SRS. Similarly, SRT or SRS is a good alternative for early-stage lung cancer patients who cannot undergo surgery for various reasons, offering tumor control rates similar to surgery.