Department of Radiation Oncology outlines accomplishments, goals for future

The following report is based on information presented by Dwight Heron, MD, professor and chairman, Department of Radiation Oncology, during a recent meeting of the UPMC Shadyside Medical Executive Committee.

A recent department accomplishment has been the introduction of TrueBeam™, one of the most powerful linear accelerators available. The TrueBeam STx with Novalis Radiosurgery allows clinicians to deliver more powerful doses of radiation faster and with enhanced precision. This advancement is possible because of the system’s ability to localize the tumor precisely using virtual real-time imaging. Improved speed and accuracy translates into not only shorter treatment times, but also a better patient experience.

TrueBeam offers greater patient comfort by shortening treatments and improving treatment precision, leaving less time for tumor motion during dose delivery. TrueBeam can be used for all forms of advanced external beam radiation therapy. However, its capabilities are realized to a greater degree when it is used for stereotactic radiosurgery (SRS) and stereotactic body radiosurgery therapy (SBRT). Tumors necessitating SRS or SBRT often require high-precision localization to avoid injury to nearby highly sensitive structures, such as the optic chiasm, brain stem, or spinal cord. The new system is housed at the Mary Hillman Jennings Radiation Oncology Center at
UPMC Shadyside.

Other recently deployed technology includes RapidArc®, which integrates advanced technologies for target localization, immobilization, and imaging and harnesses the power of the radiation beam to destroy tumors, including those in tight, confined spaces that may not be accessible with conventional surgical approaches. A more sophisticated image-guided, intensity-modulated radiation therapy (IMRT), RapidArc takes the same type of complex, highly precise tailored treatment, but delivers the entire dose in less than five minutes compared to 20 to 30 minutes with traditional IMRT. RapidArc also has the ability to rotate 360 degrees around the patient, which permits physicists and radiation oncologists to tailor the intensity of the beam from multiple angles throughout treatment and decrease radiation exposure to healthy surrounding tissue.

Other department updates were:

  • Deb Pollack, RN, MSN, recently was named department manager.
  • The department experienced extensive flooding during the severe storm on Friday, Aug. 19, 2011. Department staff and other hospital personnel worked numerous hours that weekend to ensure the department was back to working order by that Monday. Through these coordinated efforts, patient care was not interrupted, allowing for a seamless patient experience despite this unforeseen disaster.
  • Methods to improve immobilization for head and neck cancers continue to be evaluated.
  • Participation in investigator-initiated clinical trials, cooperative group/industry trials, and other classifications of trials continues to increase.
  • Patient safety initiatives focus on multiple areas. Weekly chart reviews for new patients are conducted in order to review and approve the plan of care. The department reviews, on average, 24 new start charts a week. Monitoring for compliance with hand hygiene practices and physician compliance for adhering to department clinical pathways are undertaken. Upward trends have been noted in hand hygiene. Compliance with using clinical pathways has exceeded the benchmark standard for multiple quarters.
  • Vigilance is exercised to avoid treatment-related events that must be reported to the Department of Environmental Protection. More than 15,000 treatments were delivered at UPMC Shadyside in Fiscal Year 2011. There were no reportable events during that time. A current patient safety initiative is to decrease the number of patient treatments delivered by solo radiation therapists.