Nuclear Medicine Oncology and Radiotherapy Institute (NORI)

Oncology & Radiotherapy Department

The Oncology and Radiotherapy Department of NORI is the main referral center for treatment of cancer in this region. The objective is to provide modern, state-of-the-art, multidisciplinary cancer patient care.

In the Oncology Section, consultant oncologists do the initial evaluation of the referred patients, their investigations and decisions about management of these patients are taken. The treatment of a cancer generally comprises of medicinal treatment including 'chemotherapy' and/or 'hormonal therapy', and treatment with radiation termed as 'radiotherapy'.

CHEMOTHERAPY

The term implies use of cytotoxic (killing rapidly dividing cells) medicinal preparations for treatment of cancers that may have spread or have tendency to spread in different parts of the body from their original site. Since these drugs are to be handled and administered carefully, highly trained personnel dispense and give these drugs to the patients in the medical wards of NORI.

RADIOTHERAPY

In treatment with radiation, very high-energy gamma rays, x-rays and particles are utilized to kill caner cells. These rays are invisible and painless and produced by highly sophisticated machines. Radiotherapy kills cancerous cells more avidly and effectively than normal tissue cells.
Before being treated with radiation, a patient has to undergo several steps after necessary investigations. These include:

1. SIMULATION: This event is the planning session, which is done jointly by an oncologist and a radiation physicist. The procedure is highly technical and is done on a simulator. The simulator is a fluoroscopic X-ray machine that simulates the conditions on the treatment machine. With the help of this machine, accurate localization of tumor in a region of the body is done, which prevents the neighboring normal tissues from unwanted effects of radiations.

SIMULATOR

2. TREATMENT PLANNING: After simulation a team of health physicists decides about the amount and intensity of radiation to be delivered to the tumor in concordance with radiation dose suggested by the consultant.

3. RADIOTHERAPY: After the initial two phases, a cancer patient is then given the prescribed dose of radiation in several fractions on the radiotherapy machines, either 60Co Teletherapy Units or Linear Accelerator.

COBALT-60 UNIT


LINEAR ACCELERATOR

BRACHYTHERAPY

This is a specialized form of radiotherapy in which gynecological tumors are irradiated from within the cavity of the gynecological structures. This intracavitary treatment is carried out with the help of a high-dose-rate remote after loading machine using Iridium-192 source.

BRACHYTHERAPY EQUIPMENT

EQUIPMENT IN ONCOLOGY & RADIOTHERAPY 

The Radiotherapy department is equipped with modern and state-of-the-art equipment for radiation treatment and we are also planning to replace the old equipment with most modern and sophisticated ones in the near future.

1. Cadplan BT Treatment Planning System (1996)

2. Ximatron Simulator (1985) - Under replacement

3. Phoenix Cobalt 60 Unit (2001): This unit has Cobalt-60 radioactive source, which provides gamma ray beam having average energy of 1.25 MeV

4. Monogil Deep X-Ray Therapy Unit (1984): It is used for the radiotherapy of patients with lesions less than 2-3 centimeters deep. It produces x-rays at potentials ranging from 160-230 KV and 10 mA.

5. Neoderma Superficial X-Ray Therapy Unit (1984): It is commonly used for superficial skin lesions. It produces x-rays at potentials ranging from 50-100 KV at 4 mA.

6. Saturne 41 High Energy Linear Accelerator (1996): It is a dual energy linear accelerator with both electrons and photons options. It has photon energy of 6 and 10 MeV and electron energies of 4.5, 6, 7.5, 9, 12, 15 MeV.

7. Clinac 6/100 Single Energy Linear Accelerator: It has single photon energy of 6 MV.

8. Varisource Ir-192 High Dose Rate After Loader: This brachytherapy unit is loaded with Iridium-192 radioisotope. So far the facility is limited for the treatment of gynecological malignancies.

9. Curietron Cs-137 Low Dose Rate After Loader: Remote after loader used for the brachytherapy of gynecological cancers. It is loaded with Cesium-137 radioactive source.