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Batra Hospital & Medical Research Centre
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An advanced radiotherapy technique in Batra Hospital for treatment of limited metastatic cancer - Stereotactic Body Radiotherapy using implanted gold seed markers

31 May, 2019

A significant number of patients suffering from cancer harbour metastatic disease (cancer spread widely in the body) and their chances for achieving cure are limited with currently available treatment options. A recent advancement in radiotherapy has allowed targeting these metastatic sites with very high doses of radiation to destroy cancer cells, which is available in our institution known as Stereotactic Body Radiotherapy (SBRT). This is available in our hospital.

Figure 1: (A, B) Whole Body PET-CT images demonstrating the sites of metastatic disease (red arrows). (C, D) Images demonstrating the position of gold seeds in relation to both sites of metastatic disease (yellow arrows). Disease is seen in red outline on both images

A middle aged lady presented with metastatic cancer (arising from the kidney), and she had two sites of metastatic disease, one in the left anterior abdominal wall and another in the left chest wall, which were relatively small in size. Due to the movement of the abdomen and chest with breathing, she received training for Deep Inspiration Breath Hold (DIBH) on TM TM Varian RPM system at Batra Hospital. To facilitate accurate localisation and daily imaging verification [Image Guided Radiotherapy (IGRT)], three gold seeds each were implanted under local anaesthesia near both lesions. Treatment planning was performed on TM TM TM Varian Eclipse v13.5 system utilisingRapidArc and treatment delivery was performed on TM TM Varian TrueBeam v2.5 with DIBH gating at Batra Hospital. She received a dose of 45 Gray in 3 sessions for both sites. Two months after completing radiotherapy, she achieved a complete response and there was no evidence of disease anywhere in the body on PET-CT. The patient is cancer free for the last 6 months.

Figure 2: (A, B) Treatment planning images for both sites demonstrating the dose distribution.

This successfully treated case demonstrates that for some patients with limited metastatic cancer, SBRT can help them achieve a cure. This technique is not widely available in cancer departments across India and Batra Hospital has achieved tremendous success in carefully selected patients.

Categories >> Radiotherapy

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