URMC / Radiation Oncology / Patient Care / Treatment

Treatment

The University of Rochester Medical Center offers the widest range of radiation oncology treatments available in upstate New York. Here is a brief introduction to some of the most common treatments that are available here.

CT Simulator and Treatment Planning System with Image Fusion Capability

IMR Head and Neck

Individualized patient treatment plans begin with a simulation session, where a patient is placed into an appropriate position for treatment, and multiple CT images are acquired. The process is followed by a planning session when the customized radiation dose and physical design are made through high-end computer workstations by dosimetrists. During this process, other images (MRI, PET/CT, etc.) can be fused with our planning CT scans to precisely target the tumors and to avoid critical normal structures. When the final plan is approved by the radiation oncologists, it is transferred to the designated treatment machines for the delivery of radiation treatments.

Multidisciplinary Treatment

In many cases, the advanced radiation oncology treatments are provided in combination with surgery or chemotherapy. This is for brain tumors, lung cancer, gastrointestinal cancers, lymphomas, pediatric cancers, hepatobiliary cancers, breast cancer, head and neck tumors, prostate cancer, and other genitourinary cancers.

Respiratory Motion Management

We are constantly in motion – our breathing, hearts beating, and tummies rumbling all result in motion. We can monitor and even compensate for some of this motion using cutting-edge camera systems that track reflective markers that we place on your body, or optical or thermal image of your body surface during your initial CT simulation. You may be asked to hold your breath for short time intervals if you are able for some types of treatment, such as chest (e.g. for lymphomas), left breast, lung, or abdomen treatments. When you come back for your treatments, we will use those same reflective markers or body surface to make sure your breathing or breath-holding is the same as during your initial CT simulation.

Image-Guided Radiation Therapy (IGRT)

Precision radiation therapy requires that we know exactly how you are positioned every day. Image-guided radiation therapy allows us to visualize and align you to reproduce how you were positioned during your initial CT simulation so that we can be absolutely sure we are targeting the right area and sparing the nearby healthy tissues.

Ethos Adaptive Radiation Therapy (ART)

Intensity-Modulated Radiation Therapy and Image-Guided Radiation Therapy typically use a static image of what your body looked like during your initial simulation appointment to design your treatments and help position you for each treatment. However, our bodies change every day depending on what we ate or how much we drank, and the tumor may regress over the course of the radiation treatment. Adaptive radiation therapy allows us to customize how your radiation is delivered based on what your anatomy looks like every day during your treatment. Combining Image-Guided Radiation Therapy and high-powered computer automation, our institution is the only institution in all of upstate New York that can perform online adaptive radiation therapy to best target your cancer and spare the surrounding healthy tissue.

Stereotactic Radiosurgery (SRS)

A precise, single fraction of high-dose radiation is used to treat brain and spinal lesions. URMC has the greatest experience in the region in stereotactic radiosurgery and is considered a national leader in this technology. Employing state-of-the-art TrueBeam Edge machine with high-definition multileaf collimator and BrainLab ExacTrac Dynamic tracking system, a broad spectrum of conditions are treated at URMC using high-precision stereotactic radiosurgery from single benign or malignant lesion to multiple brain metastasis.

Stereotactic Body Radiation Therapy (SBRT)

High doses of radiation are delivered in a very precise fashion to a tumor in the body. This can help to eradicate certain types of tumors while protecting nearby normal tissue from damage. Treatments are completed over the course of about a week. This treatment is for primary tumors of the lung, liver, pancreas, prostate, or other organs or cancers that have metastasized to the brain, spine, lung, or liver. A number of cutting-edge respiratory motion management strategies are employed at URMC to mitigate tumor motion with breathing and ensure the accurate delivery of SBRT. URMC leads the upstate region in the employment of SBRT.

Brachytherapy

Brachytherapy is a type of internal radiation treatment. The doctor places a radioactive material, called source, inside of the body, either in cancer or close to it. Depending on the type of cancer, the source may be implanted temporarily or permanently. The low-dose-rate implant is a type of brachytherapy that often leaves sources inside the body. On the other hand, a high-dose-rate implant leaves the radioactive source inside the body for a brief period. The doctor takes out the source after treatment. Because the source is inside of cancer or close to it, brachytherapy can deliver very high dose radiation safely without exposing a large area of normal tissue, therefore it can be more effective at killing cancer cells but limiting the injury to the surrounding normal tissue. This treatment is for prostate cancer, gynecological cancers, breast cancer, and sometimes for sarcomas. URMC is nationally recognized for brachytherapy and is a national training site of the American Brachytherapy Society for prostate HDR brachytherapy.

Surface-Guided Radiation Therapy (SGRT)

Surface guided radiation therapy (SGRT) is a cutting-edge technology used to improve accuracy with radiation treatment. SGRT is used for treating nearly every cancer type, especially breast cancer, stereotactic radiosurgery, and thoracic and abdominal tumors. URMC utilizes state-of-the-art C-RAD Catalyst, BrainLab ExacTrac Dynamic, Varian Identify systems to deliver SGRT, such as treating left-sided breast cancer with deep-inspiration breath hold with SGRT to minimize heart toxicity.

Total Body Irradiation (TBI)

Total body irradiation (TBI) is a type of radiation therapy that is given to the entire body. It is often used in preparation for stem cell and bone marrow transplantation. TBI is used both for malignant conditions, such as leukemia, and benign conditions, such as aplastic anemia. TBI is planned in conjunction with chemotherapy prior to transplant. It is given either as a single treatment or in multiple sessions (up to eight treatments, twice a day) depending on the patient’s diagnosis and transplant treatment plan.

Theraspheres

A form of internal radiation, or brachytherapy, Theraspheres are used to treat primary liver cancer or other cancers that have metastasized to the liver. The Therasphere beads are injected into the tumor during a minimally invasive procedure. The radiation from the beads then works to kill the cancer cells while minimizing damage to the normal liver. This treatment is for liver cancer, bile duct cancer, and other cancer metastasis to the liver.

Lutathera/Peptide Receptor Radionucleotide Therapy (PRRT)

Lutathera, or Lutetium177 Dotatate, is a type of radiation medicine used to treat neuroendocrine or carcinoid tumors. The medicine consists of a radionuclide Lutetium 177 linked to a molecule called dotatate. The dotatate binds to receptors on the surface of neuroendocrine tumor cells. In this manner, the radioactive Lu177 enters the tumor cells and kills the tumor through internal radiation. The treatment is delivered via an intravenous (IV) injection.

Areas of Particular Expertise

Ethos Adaptive Radiation Therapy (ART)
Total Body Irradiation (TBI)
High dose rate brachytherapy (HDR)
Low dose rate brachytherapy (LDR)
Gynecologic implants
Prostate seed implants
Stereotactic Radiosurgery (SRS)
Stereotactic Body Radiation Therapy (SBRT)
Image-Guided Radiation Therapy (IGRT)
Surface-Guided Radiation Therapy (SGRT)
Conformal Radiation Therapy (CRT)
Intensity-Modulated Radiation Therapy (IMRT)
Breath-hold Radiation Therapy
Prophylactic hip irradiation
Radioembolization or Selective Internal Radiation Therapy for liver cancers
Radiation treatment for oligometastases and multiple metastasis
Accelerated partial breast radiotherapy using MammoSite or external beam
Intravascular brachytherapy for cardiac vessel stenosis
Surgically targeted radiation therapy (STarT) with Gamma-Tile
Eye plaque
Lutathera/Peptide Receptor Radionucleotide Therapy (PRRT) for neuroendocrine tumors