Radiation oncology
The Oncoradiology Department to the Health Centre of Kaposvár University has been founded in 2001 as a part of the leading institute in Somogy County, South Western Hungary and in the Pannon Region. From the beginning, our aim was to work out and operate a modern multidisciplinary radiation oncology center. To reach this goal “state of art” equipment and modalities had been used in the department from the very beginning. In 2015 new high technology VARIAN Radiotherapy system was installed. A strong collaboration with the Diagnostic Radiology Department, the PET Center (PET Mediscopus) and with the priority partner, the Teaching Hospital “Kaposi Mór”, as well as with other hospitals and health care institutions and private practitioners of the region, a high quality, complex patient care is provided since 2015 in a network model – “Onconetwork”.
Radiation oncology treatments are carried out according to strict international and national regulations and are based on a multidisciplinary team decision for the individual treatment plan of each patient. The number of examined and treated patients is growing continuously; in 2014 there were 2198 treated patients.
The appliance of modern diagnostic-therapeutic techniques, the employment of trained assistants, and the versatile qualification of our staff make it possible to deliver the whole spectrum of modern radiotherapy treatments as well for malignant diseases, as for non-tumor issues.
The Center has 28 medical doctors and 47 BSC qualified medical non doctors within a staff of 167 members.
Since 2003, our Health Centre has been engaged in graduate level training for the Kaposvár Training Centre of the University Medical School of Pécs, and the Postgraduate training of specialists.
The entire work of the center in providing the medical services is with accordance to the ISO-9001 and ISO 14001 quality management system requirements, and is standardized annually.
Outpatient schedules
At our three outpatient units applying complex oncological approach high quality medical treatment is provided from Monday to Friday between 08.00 and 15.00. Patients are expected to arrive after a telephone appointment usually with a specialist’s referral. After examination and consultation, when needed, we use the whole spectrum of the diagnostic abilities to get the upmost correct information needed for the correct therapeutic decision.
Owing to our Diagnostic Department, and PET capacity the most modern cross sectional imaging tests (MSCT, MR, MR spectroscopy, PET-CT PET-MR and others) can be applied within a short time.
Radiation therapy simulation is available from Monday to Friday between 06.00 and 16.00. Our linear accelerators work in two shifts on every working day /including Saturdays/ from 06.00 to 22.00. High dose rate brachytherapy treatments are applied from Monday to Friday between 08.00 and 16.00. There is no waiting list. As soon as we have the results of all the necessary diagnostic examinations, the treatment can be initiated within 7-10 working days after the first appearance of the patient at our Health Centre.
Treatment can be delivered on an outpatient basis, when patients arrive with their own transportation; with the assistance of contracted transport companies; from the private guesthouse of the Centre, as inpatients from our ward, or from surrounding hospitals.
External Radiotherapy
The well trained staff, the utilization of modern diagnostic-therapeutic methods, the adherence to strict international and national regulations made it possible to deliver the whole spectrum of modern radiotherapy treatments.
In our institution we treat the following groups of tumors:
Tumors in the central nerve system
Head-neck tumors
Lung cancer, tumors in the chest
Breast cancer
Abdominal cancer (pancreas, kidney, abdominal lymph node)
Urology tumors
Prostate cancer
Gynecological cancer (endometrial, cervix or vulvar cancer)
Rectum and anus cancer
Skin cancer
Hematologic cancer
Other malignant diseases
The treatment of our patients is discussed on a weekly basis with the Oncology Department of the Teaching Hospital “Kaposi Mór”. The Oncology Team comes up with a multidisciplinary decision regarding the individual treatment plan for each of our patients. If radiation therapy- combined with chemotherapy- is needed, the background for the chemotherapy is provided by the Oncology Department of the Teaching Hospital “Kaposi Mór”.
Internal Radiotherapy
Brachytherapy (brachy meaning ’short-distance’) also known as internal radiotherapy, is a form of radiotherapy where a catheter is placed inside or next to the area requiring treatment. The therapeutic radioisotope is precisely delivered to the neoplastic leasion through the above mentioned catheter, so that the tissue which requires destruction is chemically localized. This way the tumor can be treated with very high doses of localized radiation, whilst the probability of unnecessary damage to surrounding healthy tissue is reduced because of the rapid dose fall around the catheter.
Our institution is unique in the sense that we use CT and/or MR, PET/CT PET/MR cross-sectional imaging for the placement of catheters and the planning of the radiation therapy itself. The main advantage of this method is that both the catheter and the tumor, with its extension, and the healthy tissues are visible, unlike in the case of a traditional X-ray image. This way we can provide personalized treatment by achieving the highest dose rate possible, and at the same time protect the healthy tissues surrounding the tumor.
This modern brachyteraphy is mainly used as a so-called ’boost-therapy’ in order to complement the external radiation therapy. Typical tumor sites treated by brachytherapy are gynecological, skin, head and neck cancers. We apply the therapy for some benign tumors as well, for example, for the postoperative treatment of keloid scars.
Besides the routine interventions done at our institution, we are putting great emphasis on the development and application of new therapies as well:
· CT-MR based gynaecological brachytherapy (ESTRO cooperation)
· MR-directed prostate brachytherapy
· CT-MR, PET-CT, PET-CT-MR fusion-based radiation planning
· Combined chemoradiation therapy
· Treatments combined with biological therapy
· Intensity modulated radiation therapy in the case of head-neck tumour or abdominal-pelvic cancer
· Dynamic MR-based lung cancer radiation
· fMRI based CNS irradiation
· HDR-AL treatment of skin cancer based on personalised moulage kit
· HDR-AL treatment of keloid scars
· Intra-articular radiation treatment
· Total body irradiation
· Whole neuraxis irradiation
Equipment
Linear accelerators:
VARIAN TRUEBEAM 2.0
VARIAN CLINAC IX
The two dual energy linear accelerators are twin-machines (perfectly matching their technical data). This system allows the continuous treatment of our patients, since no treatment is cancelled because of technical problems or maintenance.
The CLINAC IX is one of the most reliable dual energy LINAC available. It is equipped with a 120 multi leaf collimator (MLC), with intensity modulated radiotherapy (IMRT) compatibility (both step and shoot and sliding window modes). It operates in 6 and 15 MV photon, and 6,9,12,15,18 MeV electron energy levels. A built in MV flat panel operates for treatment verifications.
The TRUEBEAM 2.0 is the most modern full digital LINAC. It is equipped with full range of imaging systems (KV, MV, cone beam CT) and it makes possible to deliver high precision stereotactic radiotherapy (SRT), stereotactic radiosurgery (SRS), RapidArc and image guided radiotherapy (IGRT) treatments.
The connection among the planning system, the simulator and the linear accelerators is secured by the VARIAN ARIA Oncology Information and communication system.
Planning systems, simulators, fastening systems:
For the planning of modern CT radiation treatment we apply the VARIAN ECLIPSE system. Most of our patients receive their therapy on the basis of a personalized 3D planning. In indicated treatment situations IMRT or RapidARC modalities are used. For the preparation of the patients and the planning of the treatment fields we use SIEMENS SIMVIEW NT® and SIEMENS 6 MULTISLICE CT® simulators.
Internal therapy:
At our institution we use high dose rate VARIAN GAMMAMED PLUS after-loading equipment with an integrated planning system (VARIAN BRACHYVISION).