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Clinical Services
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External Beam Treatment
One of the most common forms of treatment for cancer involves External Beam Therapy (EBRT). EBRT is a method of delivering a dose of radiation to a specific target within the patient’s body using high energy radiation beams. The beams of radiation (photons and/or electrons) are generated by a linear accelerator and are focused at on the cancerous lesion. The treatment only lasts for a few minutes and is as painless as any other x-ray (a chest x-ray or dental x-ray for example).
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PET CT Simulation
PET/CT imaging provides the radiation oncologist with an invaluable tool to determine areas of active cancer versus normal structures for use in conjunction with Intensity Modulated Radiotherapy and Image Guided Radiotherapy. One of the greatest advantages that PET/CT holds is the potential to increase the radiation dose to small areas that are at greatest risk, without incurring a penalty in terms of toxicity.
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MR Simulation
As MRI continues to grow in the areas of anatomical, spectroscopic, and functional imaging in oncology. the Department of Radiation Oncology is positioned to advance the growth of this technology in the area of radiation therapy treatment planning of many body sites. Clinical trials utilizing the strengths of MRI are being developed in the areas of brain cancers, breast cancers, and paraspinal tumors. Other body sites are sure to follow. Investigations of these types are the link to the future of radiation therapy treatment planning.
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Image Guided Radiotherapy (IGRT)
Image-guided radiotherapy (IGRT) is the use of real-time imaging to improve the delivery of therapeutic radiation. Radiation oncologists at the Comprehensive Cancer Center of Wake Forest University (CCCWFU) have been using the ACCULOC© IGRT prostate localization system since February of 2006. This system allows for patients to be shifted such that the prostate is aligned to the isocenter for each treatment fraction. Since the precise location of the prostate is known, escalated doses of delivered radiation can be directed to the intended target using a conformal targeting method called intensity modulated radiotherapy (IMRT).
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Gamma Knife
The Gamma Knife uses radiation with pinpoint accuracy to destroy tumors, vascular malformations and to create brain lesions in overactive regions that cause trigeminal neuralgia and tremor. For example, the Gamma Knife has changed the outlook for patients with brain metastases providing local control rates as high as 90%. It is also often the tretment of choice for inoperable brain arteriovenous malformations (AVMs). Recently it has become the treatment of choice for trigeminal neuralgia because it relieves the intense pain of this condition without surgery and without the numbness caused by other treatments.
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Brachytherapy
The Comprehensive Cancer Center at Wake Forest University Baptist Medical Center recently opened an Integrated Brachytherapy Unit (IBU) – one of only five such units in North America. The IBU concept integrates all aspects of brachtherapy (radiation source in contact with the tumor) treatment. Patient preparation, applicator insertion, imaging, treatment planning, delivery and verification are now all possible in a single, shielded room - offering real-time savings while implant quality is improved. The integrated procedure with the IBU ensures a stable conformal geometry for the complete process and drastically reduces the overall treatment time for each patient.
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