Radiation Oncology

Question 1

Interstitial Brachytherapy

Answer

With interstitial brachytherapy, radioactive sources (for example, radioactive seeds) are put directly into the tissues, such as the prostate. These may be left in place permanently or only temporarily, depending upon the cancer and the treatment plan.

Question 2

High-dose Rate Brachytherapy

Answer

UChicago Medicine's team uses advanced techniques of high-dose rate (HDR) radiation to deliver internal radiation therapy using temporary radioactive implants placed close to, or inside, the tumor(s). Because cancer can often impact organs and other essential structures, it is important for radiation treatment to be tightly focused on tumors to minimize serious side effects. This technique ensures the maximum radiation dose is given to cancerous tissues, while minimizing exposure to the surrounding healthy tissue.

Question 3

Intra-operative Radiotherapy (IORT)

Answer

Intra-operative radiotherapy is offered in our state-of-the-art operating room that was built to accommodate high-dose rate brachytherapy treatments. For select patients for whom further surgery at the tumor site is not possible, delivering targeted radiation reduces the risk of local recurrence while minimizing dose to non-cancerous organs. This highly complex procedure involves coordination among surgeons from several specialties, the radiation oncologist and the physics team. The entire treatment workflow is optimized to quickly deliver the radiation so our patients can spend less time in the operating room.

Question 4

Stereotactic Radiosurgery (SRS)

Answer

Our radiation oncologists and physicists work closely with the neurologists and surgeons to determine the best treatment option for patients with malignant or benign conditions in their brain. Whether it is a single-fraction framed radiosurgery or a fractionated frameless procedure, our team meticulously designs the radiation plan, tailoring it to each patient’s needs. During the treatment, we use the state-of-art imaging techniques and computerized cranial position controls to align and focus the radiation beams to the targets within sub-millimeter precision.

Question 5

Stereotactic Body Radiation Therapy (SBRT) for Metastasis Treatment

Answer

Stereotactic body radiation therapy (SBRT) uses the most advanced treatment planning and image-guided targeting techniques to precisely target the tumor while minimizing toxicity to healthy organs.

SBRT delivers very high doses of radiation, thus also known as ablative radiotherapy, in five or fewer days depending on the type and location of the tumor. The best candidates for this procedure are patients with small, well-defined tumors who cannot tolerate surgery. For some patients, SBRT may be able to replace surgery as a primary cancer treatment.

SBRT is currently being used for early-stage non-small cell lung tumors, pancreatic and liver cancers, and metastatic tumors. UChicago Medicine's radiation oncology team offers the most advanced, personalized SBRT treatments to patients whose diseases range from the relatively common to the most complex and rare.

Our unique personalized image and biology-guided SBRT program pioneered the successful use of SBRT in the management of patients with limited metastatic disease, commonly referred to as oligometastases. Most recently, our multidisciplinary team has demonstrated that the combination of immunotherapy with SBRT treatment can improve overall survival and quality of life in patients with advanced metastatic cancer.

Question 6

Total Body Irradiation (TBI) & Total Marrow Irradiation (TMI)

Answer

Total body irradiation is a widely used form of radiotherapy as a preparative procedure prior to stem cell transplants. For those patients with unique needs, we also provide volumetric-modulated arc therapy (VMAT)-based total marrow irradiation, where the radiation doses are conformed to the bone marrow. Doses to non-cancerous organs, such as the brain, lungs, kidneys and liver can be significantly lowered to reduce toxicity while increasing therapeutic intensity of treatment.

Question 7

Total Skin Electron Therapy

Answer

In order to treat skin lymphoma (cancer of the lymph nodes), our radiation oncologists may deliver radiation to all the lymph nodes in the body to destroy cells that may have spread. In total skin electron therapy, the radiation is applied to the entire surface of the skin.

Question 8

Radioisotope Source Implants

Answer

Radiation given inside the body is a form of internal radiation therapy known as brachytherapy. The radioactive material is delivered through implants that are placed in or near a tumor, killing the cancer cells by destroying their DNA. Over time these implants will lose their radioactivity and are safe to be left in the body. The advantage of brachytherapy is delivering a high dose of radiation in a targeted area over a shorter period of time than external radiation therapy.

Question 9

Prostate Seed Implants

Answer

We offer permanent seed implant (I-125) as an alternative to external beam radiotherapy for prostate cancer patients. Working together with the patient’s primary urologist, our radiation oncologist will carefully implant dozens of rice grain-sized radioactive seeds in the patient’s prostate gland. The physicists will assist in the procedure to optimize the strength and location of implantation according to each patient’s anatomy.

Question 10

Superficial X-ray Therapy

Answer

Superficial X-ray therapy is a form of radiation therapy used to treat skin cancers and benign conditions and is often an alternative to surgery. It works by deploying a radiation beam that destroys cancer cells close to the skin surface — within a few millimeters deep. Because of the limited treatment area, other organs and normal tissues are spared from radiation.

Question 11

Deep Inspiration Breath Hold Breast Radiotherapy (DIBH)

Answer

Patients receiving radiation for left-sided breast tumors while in the supine position (lying chest up) are at greater risk for radiation exposure to the heart. Women can minimize this risk by breathing deeply and briefly holding their breath during treatment, which moves the heart and lungs away from breast tissue. To make DIBH easier for the patient, our experts use a state-of-the-art system that relies on 3D surface imaging to detect the breast's position for accurate treatment. This highly sensitive technology delivers radiation only during optimal positioning, and shuts off automatically when the patient coughs or exhales. Unlike older DIBH technology, this system is non-invasive and does not require the patient to breathe into a device during treatment.

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