Lady Hardinge Medical College starts Radiation Therapy facility

New Delhi: Lady Hardinge Medical College (LHMC) marked a significant milestone with the inauguration of its Radiation Oncology Block on April 9, 2024, where the first radiation therapy treatment using advanced Brachytherapy equipment was administered to a cancer patient.

This state-of-the-art facility, equipped with high-dose-rate Brachytherapy and a CT-simulator unit, represents a monumental leap in LHMC's ability to provide cutting-edge radiotherapy services to cancer patients.

The department has been providing OPD and chemotherapy services for cancer patients until now.

The newly installed Brachytherapy system, utilizing the Iridium-192 radioactive source, offers internal radiation therapy for various cancers, including cervical, uterine, prostate, breast, and others. This treatment modality is highly effective in targeting cancer cells while minimizing damage to surrounding healthy tissue, offering renewed hope to patients.

According to ANI report, With newly installed high-dose rate Brachytherapy equipment on the ground floor and a CT simulator unit on the first floor of the block, LHMC will now be able to provide much-needed state-of-the-art radiotherapy services to cancer patients. Modern radiotherapy techniques require accurate information about the tumour as well as surrounding structures during radiation planning for targeting the cancers. The CT-Simulator machine is used for image-based planning of highly conformal radiotherapy treatment, which helps in targeting the tumour and sparing the normal structures.

The installation of this equipment, valued at approximately Rs 13 crore, holds particular significance for economically disadvantaged cancer patients who previously faced limited access to radiation therapy services. With long waiting times in government hospitals with radiation facilities, the timely availability of treatment is critical in managing cancer progression.

LHMC shortly plans to introduce a High Energy Linear Accelerator (LINAC) machine for External Beam Radiation Therapy (EBRT), expanding its treatment capabilities to a broader range of cancer types. This advanced technology, costing around Rs 22 crore, will deliver high-energy x-rays and electrons for deep tissue penetration while sparing superficial tissues, offering personalized treatment for conditions such as brain tumors, head and neck cancers, prostate cancer, and more.

X-ray and electron beams of different energies allow the radiation oncologist to customise the treatment based on the shape and location of the tumours. It will be particularly beneficial for patients with Brain tumours, Cancer that has spread to the brain or a recurrence of a brain tumour, cancer around the head and neck area, Spine, prostate, lung cancer, etc. The LINAC machine, whose order has been placed for approximately Rs 22 crore, will be shipped from the United Kingdom in a few weeks.

The External Beam Radiation Therapy treatment on LINAC would complement the internal radiation therapy treatment with HDR Brachytherapy, as some cancer sites are treated by external and some by internal radiation therapy and few by both. One example is cervical cancer, which is one of the most common cancers in females in our country and is generally treated with external beam radiation therapy first, followed by internal brachytherapy treatment.

There are many applicators by which brachytherapy treatment is delivered to tumours in different organs, such as the oral cavity, vaginal cavity, anal canal, breast, prostate, soft tissue, oesophagous and bronchus. Each of these applicators is unique in providing ease of placement of implant and according to the need for radiation dose distribution in a particular organ.

In early breast cancer cases for patients who want to retain their breast, following removal of the tumour by surgery, the remaining breast requires to be irradiated. In such scenarios, in selected cases, brachytherapy implants or balloon catheters can provide the treatment in a shorter span of time, producing equivalent results to external beam radiation treatment, which is longer and more time-consuming.

Early buccal mucosa, tongue and prostate cancer patients benefit from brachytherapy delivered by interstitial implants, either alone or in combination with external beam radiotherapy. Those patients who have a recurrence of disease in the pelvis arising from the cervix, endometrium, or other gynaecological sites and cannot undergo surgery to remove them can achieve benefit by undergoing brachytherapy with the help of interstitial implants.

Many brachytherapy procedures are performed under general or regional anaesthesia, especially the interstitial implant types, and hence require in-patient care both before and after the procedure. The treatment in these scenarios is delivered by several fractions spanning a few days in overall duration.

Some of these procedures are quite painless and application can be done on an OPD basis with or without mild sedation and pain control. Vaginal brachytherapy, oesophageal, and bronchial luminal brachytherapy are usually done with the help of special applicators without the requirement of anaesthesia.

One particularly interesting application of brachytherapy is in a few types of early skin cancer where specially designed catheters catering to individual tumour sites can be applied like an external appendage and brachytherapy is delivered painlessly, producing excellent results with patient convenience.

The complications associated with brachytherapy alone are relatively few. This modality of radiotherapy requires less time for actual treatment delivery, especially with the use of the high dose rate (HDR) remote afterloader machine, which has now become functional at LHMC.