Better treatment for cancer in PGI pipeline
The Post-Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, is offering advanced radiotherapy treatments to deal with at least 12 new cases of cancer that come every day.
According to data provided by the PGIMER, more than 4,000 new cancer cases receive radiotherapy every year in the department of radiotherapy alone. The department also offers treatment to almost 300 patients every day.
“Radiotherapy has been practiced using conventional techniques for more than 100 years, in which not only the cancer, but also a large amount of normal tissues of the body receive radiation.
This technique gave good control of the cancer but, was also associated with radiation morbidity, as a large amount of normal tissue was also included in the radiation field,” said Dr SC Sharma, head, department of radiotherapy.
With technological advances in the field of radiation using methods of immobilisation, 3-dimentional treatment planning computer systems and machines with multi-leaf collimator, it is possible to use highly sophisticated radiotherapy techniques, which delivers high dose to the tumour but, with little or no dose to the surrounding normal tissues, and hence reduces the late radiation morbidity, he said.
According to PGIMER, Intensity Modulated Radiation Therapy (IMRT), which is being used in the institute for more than 10 years, “It has led to increase in the control rate of cancer and has drastically reduced the late radiation morbidity.
Volumetric Modulated Arc Therapy (VMAT) is a special technique of IMRT,” said Dr Sharma.
According to experts, the internal organ movements due to respiration or organ filling, between or during a treatment still remains a problem, as it may move the tumour out of the radiation treatment field due to the tight margins that are taken for treatment planning. “There are day to day set-up errors also which can creep in during the treatment.
New techniques are now developed to control these uncertainties using Image Guided Radiation Therapy (IGRT), where real-time imaging combined with real-time adjustments of the beam are possible,” said Dr Feroza Patel, professor, department of radiotherapy, PGIMER.
According to experts, IGRT, IMRT and VMAT techniques deliver curative radiation over a period of six to eight weeks, which is a long interval and patients have to come every day to the hospital for treatment.
This increases the economical, emotional and social problems for the patients, hence new techniques are being devised, to reduce the overall treatment time of radiation.
INSTALLING A HIGH ENERGY LINEAR ACCELERATOR
The department of Radiotherapy at PGIMER, Chandigarh, is in the process of installing a high energy linear accelerator at the cost of ` 25 crores with facilities for IMRT, IGRT, VMAT and SBRT.
North of Delhi this will probably be the only facility in a government hospital, thereby providing affordable cancer treatment to all those patients who need it.
It will help to escalate the dose of radiation to the cancer affected area while significantly reducing the dose to the normal tissues and hence, lead to better tumour control and survival and at the same time significantly reducing the late term radiation toxicity.
Significantly, the PGI was designated as regional cancer centre in 2005 under National Cancer Control Programme, union health ministry.
The institute will strengthen its cancer care facilities by adding 90 additional beds.