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Modern

radiotherapy techniques.

Our patients benefit from modern radiotherapy techniques.

IMRT (Intensity-Modulated Radiotherapy)

The radiation intensity is individually modulated from each direction in such a way that it adds up to an optimum dose distribution in the target volume. In the conventional IMRT method, a number of differently sized field segments shaped with a multileaf collimator are radiated sequentially ("step & shoot IMRT") for intensity modulation from the direction of each single beam.

The benefits for our patients: The high-dose range can be adapted precisely to the shape of the target volume, so that adjacent risk areas can be better protected. This makes it possible to increase the dose in the target volume without a higher load on these organs.

Areas of application: Step & shoot IMRT is used only in very few special cases, as VMAT is more suitable.

VMAT (Volumetric Modulated Arc Therapy)

The radiation device rotates continuously around the patient during radiotherapy. At the same time, the rotation speed, beam field shape and dose rate constantly change so that the optimum radiation intensity is irradiated from each direction.

Benefits for our patients: Equally high-dose adjustment to the target volume as with the step & shoot IMRT, in addition to an even more homogeneous dose distribution with significantly shorter irradiation times (only 1 to 3 min instead of 8 to 12 min).

Areas of application: All radiotherapy on prostate, bowel, head & neck, lung, brain and gynecological tumours, with simultaneous integrated boosts, as well as other suitable indicators in individual cases, such as left-sided breast cancer or bone metastases in the spine, if the patient would benefit from this.

IGRT (Image-Guided Radiotherapy)

Before a radiotherapy session, a 'Conebeam-CT' (computed tomography) is carried out directly by the radiotherapy device and compared with the planning CT. The correct positioning of the patient can be checked and, if necessary, corrected automatically to 1 mm. In addition, organ responses within the body can be recognised and taken into account.

Benefits for our patients: Significantly higher target accuracy and thus both better treatment possibilities and lower risk of side effects.

Areas of application: For all IMRT and VMAT radiation techniques as well as for all further indications, which require highly accurate patient positioning.

AgilityTM - Collimator

The currently fastest and most high-resolution large-field multileaf collimator in the world has 160 tungsten leaves with only 5 mm effective width. A ruby ​​reflector sits on each leaf, which reflects UV light to a CCD camera. Thus, the position of each leaf is constantly monitored optically with an accuracy of 0.1 mm. The leaves can be retracted and retracted independently at an extremely high speed of up to 6.5 cm per second. The collimator shields the radiation by more than 99.5%, which is higher than any other collimator on the market.

Benefits for our patients: Thanks to a high-precision adjustment of the radiation to the target area and the smallest amount of radiation absorption, healthy tissue is even better protected.

Areas of application: Where a high-precision beam field adjustment offers advantages for the patient. (Normally not for breast radiotherapy, palliative or non-malignant radiotherapy - our also very precise MLCi2 collimator is used here).

FFF (Flattening Filter Free – radiotherapy)

When applying FFF, the flattening filter is driven out of the radiating head, which otherwise ensures a dose-beam distribution balanced over the entire radiation field in the case of conventional irradiation. For IMRT, this is no longer absolutely necessary. Thanks to the omission of the flattening filter, less scattered radiation is produced. In addition, a higher dose can be deponated per minute.

Benefits for our patients: The radiation exposure outside the directly irradiated body area, as well as the risk of a second tumour, is reduced by 30 to 70%. The higher dose rate allows a shortening of the radiotherapy time with high single doses.

Areas of application: Small and medium-sized target volumes e.g. in stereotaxis of brain, lung or liver tumours, in very young patients, and in individual cases, e.g. in prostate patients.

Stereotactic Radiotherapy

By applying stereotactic radiotherapy, small volumes (for example, tumours in early stages) can be targeted highly accurately and irradiated with high single doses. For this purpose, e.g. the head is fixed with specially adapted thermoplastic masks to the exact millimetre. A rigid frame screwed to the skull is no longer required. Stereotaxis is always performed with IGRT, usually with VMAT and, if necessary, with FFF.

The benefits for our patients: This highly accurate radiotherapy can save the patient from having to go through a difficult operation, and is often the only possible therapy for inoperable tumours.

Areas of application: Small (inoperable) tumours or metastases in the brain, lung or liver, meningiomas, acoustic neuroma and pituitary adenomas.

SpaceOAR (TM) Hydrogel (Spacer Gel)

It is possible to inject a special spacer gel between the rectum and the prostate. This keeps the rectum away from the high dose area, and therefore helps to avoid side effects in the rectum. The gel is injected once under ultrasound control before the start of radiotherapy, and remains there for several weeks during the radiotherapy. Afterwards, it is completely decomposed by the body within a few months.

Benefits for our patients: Additional endocrine protection and thus reduced risk of side-effects.

Areas of application: In prostate patients with a particularly unfavourable anatomy, and at the request of the patient.

 
 
 
 
 
 
 

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Centre for Radiotherapy and Medical Genetics at Diakonie Hospital Stuttgart

+49 711 991 1460