The document discusses the use of radiotherapy to preserve organs during cancer treatment. It describes how radiotherapy techniques like brachytherapy can be used to treat cancers of the breast, prostate, cervix and other organs while avoiding invasive surgery and preserving organ function. The document outlines various radiotherapy procedures and provides examples of how radiotherapy has been used to preserve organs and improve patient outcomes and quality of life for different cancer types.

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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?