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Radiation Oncology Facility

External beam radiation therapy

The department of radiation oncology is equipped with five linear accelerators (3 Varian® and 2 Siemens®), a CT simulator with 4D capabilities, and a dedicated MRI simulator. External beam delivery options include intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and 3D conformal radiotherapy (3D-CRT). Image guided radiotherapy (IGRT) can be utilized for all of the delivery options, using kV and MV imaging, kV and MV cone beam CT (CBCT), and target tracking using implanted radiofrequency transponders (i.e. Calypso®). Additionally, one of the Siemens linear accelerators also equipped with a 16-slice CT-on-rails, with 4D capabilities. As of 2016, the newest additions to our department include a 45 MV racetrack microtron and a positron emission tomography magnetic resonance imaging (PET-MRI) unit.

The Buckingham satellite facility has a CT simulator with 4D capability, Varian Trilogy® linear accelerator, and a CyberKnife®. Patients are treated with 3D-CRT and IMRT, as well as the latest in image guided radiation therapy, SRS and SBRT.

Brachytherapy

The department maintains an active brachytherapy program offering interstitial low dose rate (LDR) prostate implants and high dose rate (HDR) implants for a multitude of clinical scenarios. All HDR treatments are delivered on a Varian VariSource iX® HDR unit in a dedicated HDR suite. The suite has access to the CT simulator, ultrasound and MRI for planning brachytherapy treatments, as well as anesthesia for prostate implants.

High intensity focused ultrasound

In addition to its simulation capabilities, the MRI unit is equipped with a high intensity-focused ultrasound (HIFU) unit used for the treatment of certain disease sites. There is ongoing research in the department utilizing focused ultrasound as well.

Radioembolization

The department collaborates with clinicians and physicists in interventional radiology and nuclear medicine in order to treat patients with primary and metastatic disease in the liver.

Unsealed sources

Residents rotate in nuclear medicine in order to obtain the necessary experience required in unsealed source prescription and administration.

Resident caseload

Fox Chase residents are among the best-trained in external beam radiation therapy and brachytherapy. For example, the Accreditation Council for Graduate Medical Education (ACGME) required case minimums, typical brachytherapy case numbers in the US, and typical resident case numbers are provided below:

 RT type

EBRT

BT, interstitial

BT, intracavitary

Pediatrics

SRS

SBRT

Unsealed sources

 ACGME minimum 450 5 15 21 20 10 6
 BT, median of US residents   20 36        
 Typical FCCC resident 550-700 30-50 40-80 25-40 25-40 20-50 6-20
Abbreviations: ACGME: Accreditation Council for Graduate Medical Education; BT: brachytherapy; EBRT: external beam radiation therapy; FCCC: Fox Chase Cancer Center; SBRT: stereotactic body radiation therapy; SRS: stereotactic radiosurgery