the future of radiation therapy lies in better understanding tumour metabolism and in integrating different imaging modalities into our current approaches to radiation treatment. PrOF PAuL vAn HOutte, Head of the radiation Oncology Department
Main areas Intensity-modulated radiotherapy
Image-guided radiotherapy, Radiosurgery Brachytherapy Intraoperative radiotherapy
Combined modalities exist with chemotherapy, targeted biologi- cal therapies and surgery.
aPPlieD research image-guided radiotherapy Radiotherapy treatment often takes 6 to 7 weeks. An important aspect is the integra- tion of PET-CT into treatment planning. PET-CT is a highly sensitive technique. While the CT component is commonly used to perform planning, the PET component has the advantage of being able to more accurately delineate the limits of a tumour. Planning logically precedes treatment; however, some unpredictable changes may occur due to the way a tumour responds. Thus, there are great beneﬁts to be gained from repeated adaptation of planning, and adjustments to treatment are continually made in accordance with tumour response.
The main goal of modern radiation techniques is to focus the radiation exposure on the tumour while preserving the surrounding healthy tissue as much as possible. For example, IMRT used in the management of head and neck cancers makes it possible to preserve the salivary glands, which in turn spares patients the side effect of dry mouth syndrome. It is also possible to reduce the risk of irradiating healthy tissue by taking into account the patient’s breathing motion through what is known as a “gating” technique.
Partial breast irradiation Partial breast irradiation is an area under development, using different approaches. As well as external radiation, the department has a long history of preoperative implants for breast cancer. The latest technique to be implemented is intraoperative electron beam irradiation (the Veronesi approach), enabling full radiation treatment to be delivered at the time of surgery.
individualised treatment The ultimate aim of radiation oncologists is to individualise treatment not only according to the physical and anatomical aspects of a patient’s tumour, but also in relation to its radiobiological characteristics (degree of oxy- genation, proliferation rate, intrinsic radiosen- sitivity). PET-CT using new tracers may make it possible to clearly deﬁne such biological maps. These can then be monitored throughout the course of treatment in order to provide per- manent, accurate tailoring of the radiation re- quired for each individual patient.
1,800 new treatments per year 4 radiation units and 2 afterloaders 45 staff members