Trilogy: A Stereotactic Radiosurgery Guide for Patients

Currently, there are just 32 Trilogy linear accelerators in the world. Only 15 are situated in the U.S. Washington Hospital Center is the first in D.C. to add this exciting and new treatment innovation.

If you or a loved one has been diagnosed with cancer, there’s one thing you know for sure — you want the best treatment available.

The best treatment combines expert care and advanced technology. At the Washington Cancer Institute at Washington Hospital Center, you will receive quality medical care from an experienced staff of medical professionals using the latest equipment. That’s why Washington Hospital Center is the first hospital in D.C. to add the world’s most sophisticated radiation treatment device to its cancer treatment services.

The Trilogy linear accelerator can treat cancer anywhere in the body. Quite simply, it targets tumors more precisely, delivers a higher dose of radiation and requires fewer treatment sessions.

How cancer is treated

There are three main components to cancer treatment, which are used alone or in combination, depending on the tumor size, type and location.

• Surgery removes many kinds of tumors.
• Chemotherapy medications, taken orally or intravenously, travel through the body to kill cancer cells.
• Radiation therapy uses targeted radiation beams delivered from outside the body to the tumor site to kill cancer cells. For almost 60% of cancer patients, treatment includes radiation therapy.

What radiation therapy does

Radiation is pure energy delivered in beams. It works by damaging the DNA of cancer cells so they can no longer reproduce. Because cancer is characterized by rapid reproduction, this stops cancer from growing and spreading.

A radiation oncologist is a physician who is trained to use radiation for cancer treatment. This specialist determines the correct amount, or dose, of radiation, and the right method for administering it to achieve the best results. A medical physicist helps calculate the dosage to make sure your tumor gets the proper amount of radiation. Using state-of-the-art computers, they develop a variety of treatment plans that most effectively destroy the tumor while sparing normal tissue. Also, the treatment team uses imaging tests — CT scans, PET scans and MRIs — to plan where to aim the radiation.

Why technology is important

A linear accelerator is the machine most often used to deliver external beam radiation. Stereotactic radiation therapy is the most precise method of external radiation. For some years now, stereotactic therapy has been used to treat vascular abnormalities and brain tumors. Recent advances in imaging, patient positioning and targeting now make this approach useful for other cancers, too.

Intensity modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) are also important cancer treating technologies. IMRT is a three-dimensional radiation therapy treatment that allows radiation oncologists to optimize the planning and delivery of high doses of radiation to targeted areas, while minimizing radiation to healthy tissue. IGRT enhances the accuracy of IMRT by using detailed images to target diseases.

Precise targeting — What makes stereotactic therapy different is that it delivers beams from many different angles to target the tumor more exactly. This precise targeting can destroy tumors very effectively. It even allows treatment of some tumors that surgeons can’t reach. For some patients, radiation therapy can serve as an alternative to surgery and sometimes chemotherapy.

Higher doses — Because of this precise targeting, radiation oncologists can deliver higher doses of radiation. The radiation goes only to the cancer cells, sparing the healthy cells surrounding the tumor site.

Fewer treatment sessions — You’ve probably heard that radiation treatments are scheduled multiple times each week, sometimes for many weeks. Because the stereotactic approach uses higher and more targeted doses of radiation, fewer sessions are necessary.

Radiosurgery — Neurosurgeons and radiation oncologists also use stereotactic equipment to target brain and spine abnormalities. It provides a noninvasive alternative to surgery, allowing treatment of tumors that otherwise may be inoperable. Radiosurgery can be performed in a single session.

What makes the Trilogy Linear Accelerator Special

Even in the highly specialized world of radiation, the Trilogy linear accelerator stands out.
It offers an enhanced cancer treatment option.

Flexibility — The team of experienced medical professionals can customize treatment to target many different types of cancers, in many different locations.

Accuracy — Radiation beams match the three-dimensional shape of the tumor with a high degree of accuracy. It also can treat smaller lesions, which allows for treatment at earlier stages when cancer is most curable.

Precision — IGRT and On-board Imager (OBI) help medical professionals synchronize treatment with the patient’s breathing cycles. This helps to target tumors more precisely, while sparing healthy tissue.

Speed — The Trilogy delivers radiation at a rate that is 60% faster than traditional linear accelerators, which enhances the patient’s comfort.

Power — The highest dose rates can be delivered, so treatments take less time and fewer treatment sessions are needed.

Fewer side effects — Because of the precision of the radiation, healthy tissue is spared, which results in fewer side effects.

VIDEO: A Patients Guide - Stereotactic Radiosurgery

TrilogyTM Linear Accelerator: Stereotactic Radiosurgery at Washington Hospital Center.

What to expect during treatment

Most often, radiation therapy is an outpatient procedure. The first visit takes about an hour, because there is a lot of preparation involved. Each subsequent visit takes just 15 to 30 minutes. Patients return home after the treatment and resume normal activities. The team of experienced medical professionals designs unique treatment plans for each patient. That plan may include treatment with the Trilogy technology or with other advanced radiation therapy equipment better suited for that tumor type, size or location.

Initial visit— The patient meets with a radiation oncologist to discuss treatment options.

Positioning — Accurate, reproducible positioning and rigid fixation are important factors for precise dose delivery. The radiation therapist fits the patient with an immobilization device thermoplastic mask, which softens in warm water and forms a rigid yet comfortable “cast” of the patient’s anatomical contours as it cools and hardens about 4-5 minutes).

Imaging — The patient lies on a CT scan couch and undergoes an imaging procedure to create a treatment plan and ensure correct positioning.

Treatment planning — Using a sophisticated computer program, the team designs a customized treatment plan, based on information gathered during positioning and imaging.

Treatment delivery — The patient lies on a treatment couch while the machine moves around the bed and painlessly delivers invisible radiation. Sometimes the couch moves, too. The patient is alone in the room but the radiation therapist is right outside, available to observe and talk with the patient during treatment.

Follow-up — The treatment team monitors the patient’s progress with imaging tests, X-rays and blood tests. They work closely with the patient’s referring physician to manage care.

How to choose a cancer center

After a diagnosis of cancer, your doctor will tell you if radiation therapy is a recommended treatment for your cancer. Understanding your treatment options and how to choose a cancer center will help you make well-informed health care decisions.

Look for a cancer center that meets these criteria:

Experts — You want experienced, compassionate professionals to manage your care. The Washington Cancer Institute’s radiation oncology team includes four of the most experienced, respected radiation oncologists in the area, five radiation physicists and a caring, highly skilled group of radiation therapists and nurses.

Facility — A comfortable, well-equipped facility can ease your treatment. Our radiation oncology suite is located on the ground floor of the Cancer Institute at Washington Hospital Center. The suite is designed to provide quality cancer care in a patient-first and comfortable, healing environment. A parking garage with free parking for radiation therapy patients is right next door. Valet parking also is available.

Technology — The most advanced treatment technology can improve outcomes. The Washington Cancer Institute houses three state-of-the-art linear accelerators, plus a sophisticated three-dimensional CT simulator, treatment planning system and verification system.

Patient focus — You deserve comprehensive and compassionate care to help you fight your cancer. In addition to effective treatment options, the Cancer Institute offers the services of a nutritionist, social worker and pastoral counselor, along with patient education resources and support programs.

Every year, more than 1,000 patients choose the Washington Cancer Institute at Washington Hospital Center for radiation treatment. That’s more than any other cancer center in the area. Our patients consistently give us very high patient satisfaction scores, praising our ability to deliver exceptional patient care.

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