Intensity Modulated Radiation Therapy
(IMRT) is an advanced mode of highprecision
radiotherapy that utilises
computer-controlled x-ray to deliver
radiation that conforms to the threedimensional
(3-D) shape of the tumour
by controlling the intensity of the
radiation beam. This allows a high
radiation dose to be delivered to the
tumour while minimising radiation
of the surrounding normal tissues.
IMRT also has the capability of ‘dosepainting’,
a technique where diff erent
doses can be delivered to diff erent
parts of the treated volume.
IMRT is especially useful in cases
where normal organs are in close
proximity to the tumour. In head and
neck cancers for example, tumours
often sit next to vital organs such as
nerves to the eyes, spinal cord and
salivary glands. IMRT allows radiation
oncologists to minimise dosage to
these critical organs while keeping
the dose to the tumour suffi ciently
high to ensure cure.
Radiosurgery refers to the use of small beamlets of ionising radiation to surgically remove intracranial lesions (brain injury/tumours) which were previously classified as ‘inoperable’ or as an alternative to open neurosurgery.
Radiosurgery offers a non-invasive alternative for many patients for whom traditional brain surgery is not an option and removes the physical trauma and majority of risks associated with conventional surgery.
This procedure has the advantage of requiring no hospitalisation or ICU stay, no general anaesthesia (except in young children), and reduced treatment mortality (from haemorrhage or infection) for most indications compared to conventional open neurosurgery.
Literally meaning slice treatment, this
machine looks similar to a CT scanner
but spew out thin slice high energy
x-rays. Like IMRT, this treatment allows
highly conformal radiation to be
delivered to the tumour, at the same
time sparing normal organs.
The added advantages of this
modality are the ability for imaging
to be done prior to each treatment
to ensure accurate positioning as
well as its ability to treat a large
area in one sitting.
It refers to a group of drugs that
specifically target cancer cells, leaving
the other cells unharmed; hence they
are regarded as ‘Magic Bullets’. Since
these drugs only target cancer cells,
they are usually thought to be free
of side eff ects. However, this is not
true. There are diff erent types of side
eff ects, depending on the kind of drug
taken. It is also important to note that
every individual’s experience with side
effects may differ.
This plays a large role in treating
hepatic (liver) malignancies that
cannot be removed. It is important
to stress that these treatments
are palliative, and not for curative
intent. There are two interventional
The first is transarterial
which combines hepatic artery
embolisation with simultaneous
infusion of a concentrated dose of
chemotherapeutic drugs. Embolisation
deprives the tumour of blood supply
and promotes tumour cell death.
The second is radiofrequency ablation
(RFA) of liver tumours. RFA uses the
principle of microwaves to generate
heat within the target tissue. It does
not distinguish between tumour
and normal tissue. The needle is
placed into the lesion under imaging
guidance. Both CT and ultrasound
work well for this technique.
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