Radiotherapy

Ospedale San Raffaele

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CLINICAL SERVICES:

  • Robotic Stereotactic Radiosurgery/Radiotherapy (SRS/SRT)
  • Adaptive Radiotherapy
    • IMRT (Intensity Modulated Radiotherapy) - IGRT (Image Guided Radiotherapy) treatments
    • Helical TomoTherapy
  • Low-Dose Rate Brachytherapy for Prostate Cancer
  • Total Body Irradiation (TBI)
  • Total Marrow Irradiation (TMI)

PROCEDURES PERFORMED PER YEAR:

2.000 treatments of External Beam Radiotherapy (EBRT)

Radiotherapy is a discipline based on the use of ionizing radiation that currently represents one of the most important types of cancer treatment. It is not invasive, it does not require anaesthesia or special medications, and is carried out in a short amount of time. For this reason, it is also suitable for patients who are inoperable or who cannot tolerate chemotherapy. Used individually (exclusive radiotherapy) or in combination with other therapeutic modalities (surgery and / or chemotherapy) it can have curative or palliative intent. It is often a valid alternative to surgery.

 

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treatmentS

Robotic Stereotactic Radiosurgery/ Radiotherapy

The Radiotherapy Unit of Ospedale San Raffaele delivers Robotic Stereotactic Radiosurgery/Radiotherapy (SRS/SRT) treatments for the Central Nervous System and for Body tumours (SBRT) with an M6 CyberKnife® System. SBRT involves the delivery of a single fraction or a few fractionated (usually up to 5 fractions) high dose radiation treatments, and CyberKnife is the first robotic radiosurgery system that offers highly precise treatments, with sub-millimetre accuracy, due to the dynamic motion compensation and the unique capability of real-time tracking and adjustment to moving targets.

Adaptive Radiotherapy

Another cutting-edge treatment is the Adaptive Radiotherapy which adjusts the treatment field to the changes in the tumour and near critical organs during the course of treatment.  
The Radiotherapy Unit has a wide experience in IMRT (Intensity Modulated Radiotherapy) - IGRT (Image Guided Radiotherapy) treatments.

The Helical TomoTherapy® machine, the first of its kind in Europe, was installed here in 2004. The Helical TomoTherapy System is the first IMRT - IGRT built-in machine that used integrated imaging to enhance treatment accuracy. The unique helical treatment delivery minimizes the exposure of healthy tissues at high doses, mitigating the side effects, and thus, enabling treatment for a wide range of patients and tumour types.  

LDR (Low-Dose Rate) Brachytherapy for Prostate Cancer

Prostate LDR Brachytherapy, performed in collaboration with the Urology Unit for over 20 years, is a technique that when added to hypofractionated or stereotactic treatments for prostate carcinoma, allows to tailor the treatment according to the patient’s needs, with an excellent biochemical control of over 90% at 5 years, even in high risk patients.

Total Body Irradiation (TBI) and Total Marrow Irradiation (TMI)

Total Body Irradiation (TBI) and Total Marrow Irradiation (TMI) with Image-Guided Helical TomoTherapy® are performed as an important part of bone marrow transplantation conditioning regimens.

Main Pathologies Treated:

  • Breast Cancer, mainly with a hypofractionated schedule, in 3 weeks fractions
  • Central Nervous System Tumours, ensuring a low probability of side effects due to daily IGRT-IMRT treatments
  • Gastrointestinal Tract Tumours, with an active Adaptive Neoadjuvant Treatment for Rectal Cancer, SBRT for liver lesions
  • Gynaecological Tumours, with low toxicity despite the concomitant chemotherapy  
  • Head & Neck Cancers with PET/CT simulation
  • Lymphoma
  • Thoracic Cancers, with Robotic SBRT for lung metastases but also extended fields with low contralateral lung doses needed for Malignant Pleural Mesothelioma
  • Prostate Cancer and other Urological Tumours
  • Oligometastasis
  • Re-irradiations   

Top Procedures:

  • Stereotactic Brain and Body Radiosurgery and Radiotherapy with M6 CyberKnife system and, in collaboration with Neurosurgery Unit, with Gamma Knife for Brain Tumours
  • Hypofractionated Helical Tomotherapy with SIB (Simultaneous Integrated Boost) available, according to the prescription, for all tumour sites
  • TomoDirect for Breast Cancer
  • VMAT (Volumetric Modulated Arc Therapy)

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT

  • CyberKnife M6 System, for SRS/SBRT treatments
  • Helical Tomotherapy systems:
    • Tomotherapy H,
    • Tomotherapy HD,
    • Tomotherapy Hi Art II
  • Clinac iX2300 RapidArc® that allows IGRT-IMRT treatments for all tumour sites
  • Gamma Knife® Perfexion™ for SRS treatments on CNS, in collaboration with the Neurosurgery Unit
  • MRI and PET/CT (FDG, Choline, FAZA) simulations for a precise localization of the tumour