Organ preservation by radiotherapy

1. ORGAN PRESERVATION BY RADIOTHERAPY
Dr.KANHU CHARAN PATRO
MD, DNB[RADIATION ONCOLOGY] MBA, PDCR, CEPC

2. • Cancer is the second leading cause of death.
• Globally, By 2020, there will be 20 million new cancer patients each
year.
• In the U.S., there are 1.25 million new cancer cases annually
 198,100 prostate  192,200 breast
 169,500 lung  135,400 colorectal
• In 2001, U.S. cancer mortality will be about 553,400 --over 1,500
people a day.
• In the US, men have about a one in two lifetime risk of developing
cancer; for women the risk is about one in three.
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Cancer Facts

3. ? ?
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7. Oncologist
Diagnosis
Treatment
Radiologist
Cytopathologist
Surgeon
HistopathologistMolecular
Pathologist
Geneticist
psychiatrist
Nursing
And
Support staff
Audit

8. Evolution of
radiotherapy
treatment
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Radiation –Part of life

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Wilhelm Conrad Rontgen

11. History - radiation
1896 – Becquerel - Radioactivity
1898 – Madam Curie / Pierre Curie - Radium
1903 – Nobel Prize for Curie’s & Becquerel
1903 – First successful case of malignancy basal
cell carcinoma of face
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12. GOALS
 High dose to tumor tissue-Tumor control
 Normal tissue sparing
 Minimize long and short term toxicities
 Better Quality of life
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13. • COSMETIC DEFECT
• FUNCTIONAL DEFECT
• IMPAIRED QUALITY OF LIFE
SURGERY
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14. RADIOTHERAPY

15. • CONVENTIONAL
• 3DCRT
• IMRT
• IGRT
• VMAT/RAPIDARC
• PET GUIDED RADIOTHERAPY

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BRACHYTHERAPY

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24. PROCEDURE
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25. IMAGING AND PLANNING
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26. ISODOSE

27. TREATMENT DELIVERY

28. • HEAD AND NECK CANCERS
• BREAST CANCERS
• ESOPHAGUS CANCERS
• PENILE CANCER
• SOFT TISSUE SARCOMA
• BLADDER CANCERS
• CANAL CANCERS
ORGAN PRESERVATION
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29. ORGAN PRESERVATION FOR
BONE TUMORS
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33. ORGAN PRESERVATION FOR
BREAST CANCERS
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Intra- operative Brachytherapy
procedure

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Intra- operative Brachytherapy
procedure

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Intra- operative Brachytherapy
procedure

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Intra- operative Brachytherapy
procedure

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3D Brachytherapy Planning
CT Loading Dose distribution

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Dose prescription and Treatment
delivery
• Dose: 34Gy in 10 fraction bid
• Dose per fraction: 340cGy

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PENILE CANCERS
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45. ORGAN PRESERVATION FOR
SARCOMAS
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51. ORGAN PRESERVATION FOR
CANCER CERVIX [STAGE
0,EARLY 1]
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54. ICA HDR application
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57. ORGAN PRESERVATION FOR
CANCER ANAL CANAL
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58. APR
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59. ANAL CANAL BRACHYTHERAPY
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60. ORGAN PRESERVATION FOR
CANCER TONGUE
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62. TONGUE IMPLANT IN PROGRESS
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63. TONGUE IMPLANT IN PROGRESS
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ORGAN PRESERVATION FORCANCER LIP

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68. Applicator in situ with IOP

69. Complete response –towards healing
hypo-pigmentation

70. Recent

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73. KELOIDS
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74. CANCER ESOPHAGUS
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75. ESOPHAGEAL BRACHYTHERAPY
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ILRT-dosimetry

77. BASE OF TONGUE
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78. PROSTATE CANCER
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82. OCULAR MELANOMA
RETINOBLASTOMA
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94. • GOOD COSMETIC
• FUNCTIONAL PRESERVATION
• GOOD QUALITY OF LIFE
• ESTABLISHED PROCEDURE
• EXPERTISE REQUIRED
• AVAILABLE LITERATURES
• LESS TOXIC
FACTS
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95. SMART THINKING
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98. Just “Doing It” is not good enough !
You must know “what” to do and “where” to do it !
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Whenever not
possible,
make friends

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104. Guess
•What next

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?