The Shelia K. Riggs Radiation Oncology Department offers 3D conformal radiation therapy, intensity modulated radiation therapy (IMRT), image-guided radiation therapy (IGRT), stereotactic radiosurgery (SRS), low-dose rate brachytherapy including transperinal prostate implants, high-dose rate brachytherapy, radioimmunotherapy, and Quadramet therapy. The Shelia K. Riggs radiation oncology department was one of the first radiation oncology departments in Maryland to offer IMRT. These treatments are designed and delivered using state of the art technology. The department is equipped with 3 linear accelerators (LINACs), a high-dose rate (HDR) unit, a conventional simulator, CT simulator, and three-dimensional (3-D) computer dosimetry.
With 3D conformal radiation therapy, the treatment volume conforms to the shape of the cancer tumor or region. This conformal treatment reduces the amount of radiation to surrounding normal tissue and organs and increases the amount of radiation to the target volume. 3D conformal radiation therapy is given by directing high-energy photons beams to the cancer tumor. These high-energy photons are generated and conformed to the shape of the cancer tumor by a linear accelerator (LINAC). The LINAC delivers the high-energy photons from different angles around the patient.
IMRT, a more advanced 3D conformal radiation therapy, conforms the high-energy photon beam to the shape of the cancer tumor and modulates the radiation intensity across the photon beam. By modulating the intensity of the high-energy photon beam, radiation dose is delivered more precisely to the cancer tumor and normal tissue sparing is greatly increased. IMRT is able to treat cancer tumors wrapped around sensitive structures such as the spinal cord. As a result, IMRT is often the choice for head and neck cancers.
IGRT delivers 3D conformal radiation therapy using real-time computed tomography (CT) imaging to maximize cancer tumor localization. IGRT accounts for the daily motion of the cancer tumor and normal tissues. CT images are acquired with the patient on the LINAC table prior to treatment. This CT study is compared with the reference CT study taken to generate the treatment plan. Appropriate position adjustments are made if the two CT studies are not aligned.
Brachytherapy uses sealed radioactive sources to deliver radiation to the cancer tumor. These sources are placed in or around the tumor using special applicators. Brachytherapy can be permanent or temporary. In permanent bracytherapy, the sources are inserted directly into the tissue. Whereas in temporary brachytherapy, the sources are removed after the desired dose has been delivered. Brachytherapy can be delivered at a low dose rate (LDR) or a high-dose rate (HDR).
LDR brachytherapy is used for permanent brachytherapy, often called seed implantation. Transperineal prostate implant is a common LDR brachytherapy procedure. In transperineal prostate implant, radioactive sources are implanted throughout the prostate using needles and transrectal ultrasound. Transperineal prostate implants are often an outpatient procedure. LDR brachytherapy can be used to treat head and neck cancer, genito-urinary cancer, breast cancer, and cancers affecting superficial areas of the body. These LDR brachytherapy treatments usually require overnight stays in the hospital.
HDR brachytherapy uses a single high activity iridium-192 source for temporary implants. HDR systems are capable of optimizing the dose distribution beyond what is possible with manual afterloading. Unlike LDR brachytherapy, HDR brachytherapy takes only minutes. As a result, HDR brachytherapy is usually an outpatient treatment. HDR brachytherapy can be a treatment option for treat head and neck cancer, genito-urinary cancer, breast cancer, and cancers affecting superficial areas of the body.
Radioimmunotherapy is offered as a treatment option for relapsed or refactory B cell lymphoma. The radiommunotherapy agent used is Zevalin. Radioimmunotherapy uses anti-bodies tagged with a radioisotope to treat cancer cells. The radioisotope used in Zevalin is yttrium-90. In most cases, Zevalin therapy is an outpatient treatment.
Systemic radioisotope therapy is offered to treat bone pain resulting from cancer spreading to the bone. The radioisotope used is Quadramet. Quadramet is an intravenous treatment that treats bone metastasis throughout the whole body. In most cases, Quadramet therapy is an outpatient treatment.