Patients from Małopolska have now access to stereotactic therapy in Amethyst’s Krakow center

20 October 2015

Patients from Małopolska have now access to stereotactic therapy in Amethyst’s Krakow center.

Krakow’s Amethyst Radiotherapy Centre is currently the only centre in Małopolska which offers stereotactic radiotherapy a method unavailable in the region for some time. This breakthrough technique, often referred to as radio-surgery, has already been applied to treat a dozen or so patients and more are being prepared for the treatment.

The idea of stereotactic radiotherapy is to administer relatively high radiation doses on a very limited and precisely identified affected area. The point is to focus the radiation where it is necessary whilst sparing the healthy tissue around the tumour. A major advantage is also that the duration of radiotherapy is shortened and the patient is given higher comfort, primarily in psychological terms. Whilst the ‘classical’ radiotherapy usually takes 5-6 weeks and the patient undergoes radiation sessions daily, stereotactic therapy requires only 4-6 sessions.

Stereotactic therapy often gives effects comparable to surgical treatment and can be applied, at the same time, when a surgery is impossible due to the location of the tumour or associated disorders, says Dr n. med. Marcin Hetnał, Director of Amethyst Radiotherapy Centre in Kraków. This method is applied at our Centre to treat lesions located in internal organs, such as lungs or liver, and within the spine, he adds.

Super-precise beam

The Amethyst Radiotherapy Center at the Ludwik Rydygier Specialist Hospital in Kraków is currently the only centre in Małopolska where patients can receive stereotactic treatment. This procedure is done with state-of-the-art Elekta linear accelerators using conical collimators and multi-leaf micro-collimators.

What does the treatment look like? The data about the shape and size of the field to be radiated are transmitted to the accelerator via a computer network. Here, in the collimator, leaf diaphragms, which operate like the diaphragm in a photo camera, are set following the preprogrammed pattern. Thus, the radiation beam is released very precisely and in line with the effect the doctors wish to achieve. Precision is of key importance. Because of that, an essential condition for the treatment is the prior, exceptionally precise, imaging of the area of lesions, often with the use of PET, magnetic resonance and CT images, and the possibility of verifying the image once the patient is already on the therapeutic table, says Dr Hetnał. The accelerators used in our centre, are state-of-the-art devices. Each of them can verify the patient’s position using X-ray and CT images, analyse the patient’s breathing phase to make sure that everything goes as planned. The more precise we are “carving” the field to be radiated, the better the results.

Chance to heal rather than risk

Stereotactic radiotherapy is applied at the Amethyst Radiotherapy Krakow Centre both to radical treatment (for single neoplasms – original or metastatic, located at places inaccessible for surgical intervention – or where a surgery involves too heavy a risk of complications), and in palliative care to alleviate the consequences of cancer. It may be used where repeated radiation is required or cancer recurrence after earlier radiotherapy. A basic problem then is the tolerance of healthy tissues which have already „received” a radiation dose before. In such a situation, the risk involved in the application of classical radiotherapy is too high, stresses Dr Marcin Hetnał. And stereotactic radiotherapy makes it possible to define the tumour area very precisely and concentrate a relatively high dose in it thus generating a high gradient that is drop in the dose on the border of the area.

Such therapy is available to patients who contact the Radiotherapy Clinic at the L. Rydygier Specialist Hospital or who are consulted at other hospitals in Małopolska.
Thanks to the cooperation with the John Paul II Specialist Hospital, many patients have qualified to undergo stereotactic therapy. One of them is a 74-year old patient with numerous accompanying diseases and a single neoplasm in his lung. The patient was consulted earlier on by a multi-discipline medical team and because of a considerable risk involved in a surgery, stereotactic therapy was offered to him. Thanks to the application of stereotactic therapy, we were able to apply the treatment quickly and safely and the patient stands a high chance of getting better, says Dr Marcin Hetnał.