At the Moncrief Radiation Oncology Center, skilled radiation oncologists provide consultation, treatment and follow-up care for patients with cancer and other conditions. Standard techniques as well as advanced radiation therapies are available, including:

Brachytherapy: Treating Head & Neck Cancers and Gynecological Cancer
High and Low Dose Brachytherapy:  An Intense Delivery of Radioactivity by Seeds
Brachytherapy is a form of radiation therapy in which a higher dose of radiation is delivered via  radioactive seeds or very small wires placed either in the tumor ("interstitial implant") or near the tumor ("intracavitary therapy"). 

Thus, the radiation is emitted outward from the affected area rather than from an external source across normal tissue. Depending on the individual case, brachytherapy may be given with low-dose sources where treatment takes place over several days in the hospital or with a high-dose-rate (HDR) device that allows for treatment on an outpatient basis.

High dose rate (HDR) brachytherapy is also utilized for the same types of cancers.  The treatment is usually given in 2 to 3 outpatient visits.  A device or holder is placed into the area to be treated.  The device is then connected to the HDR machine and a small but intense radiation source is loaded into it.  The dose is delivered in approximately 5 to 10 minutes.  Once the treatment session is complete, the radiation source is withdrawn back into the machine and the device is removed from the treatment area.  The patient is discharged to return a week or two later for additional treatments.
For more information regarding our brachytherapy program or to refer a patient for consultation with a physician, please call (214) 645-8525.

CyberKnife: Treating Brain Tumors, Head & Neck Cancers, Prostate Cancer, and Other Sites
Stereotactic Radiosurgery and Stereotactic Radiotherapy at Our CyberKnife Center
Stereotactic radiosurgery is a non-invasive treatment in which high doses of radiation beams are delivered to a tumor in a concentrated, precise manner.  Because the beams enter the body from different angles and intersect at the tumor or lesion, the surrounding healthy cells are often spared.

UT Southwestern is one of five institutions in the United States utilizing the CyberKnife system to perform single or multiple (fractionated) stereotactic radiotherapy.  The CyberKnife is a device that utilizes a linear accelerator mounted on a robotic arm to locate the position of the tumor and focus the beams of radiation on the tumor. Currently, the CyberKnife is being used to treat primary or metastatic brain tumors.  It is also used to treat other tumors of the head and neck, base of skull and cervical spine.  Investigational protocols are being developed for treatment in other body sites such as the pancreas and prostate.

Both radiosurgery and radiotherapy are preformed on an outpatient basis at the CyberKnife facility at Zale Lipshy University Hospital.  The patient is scheduled to receive an initial consultation with the radiation oncologist and neurosurgeon.  During that visit, a CT scan is performed.  A CT scan is an x-ray in which a three dimensional image of the tumor site is constructed by a computer.  This 3-D image allows the physicians to see all sides of the tumor and can plan for the radiation beams to be precisely focused on the unique shape of the lesion. Once the CT scan is obtained, the physicians and medical physicists utilize the computerized planning system to create the treatment plan.  This usually takes one day or less.  The patient returns for the first treatment the next day.  The number of treatments required depends on the location, size and shape of the tumor.
For more information about our stereotactic radiosurgery program or to refer a patient for consultation with a physician, please call (214) 645-8525.

Prostate: Treating Prostate Cancer with Radioactive Seed Implants
Radioactive seed implants for prostate cancer are also a form of brachytherapy.  The physician will place radioactive seeds (about the size of a grain of rice and containing either Iodine¹²⁵ or Palladium¹⁰³) into the prostate gland.  These seeds emit low energy x-rays that destroy the cancer cells while leaving the surrounding tissue relatively unharmed.  Iodine¹²⁵ and Palladium¹⁰³ give up about 90 percent of their radioactivity within a short time - six months and two months respectively.  By one year, the radioactivity can be considered gone.

Typically, the radiation oncologist will implant about 70 to 150 seeds into a patient's prostate gland.  The exact number depends on the actual size of the prostate.  Although the cancer may only be detectable in a portion of the prostate, there may be tiny amounts of cancer throughout the gland; therefore, the entire prostate is treated. Before the procedure is performed, the radiation oncologist and the urologist will make a map of the prostate gland, known as a volume study, from a prostate ultrasound scan.  The radiation oncologist and medical physicist will then utilize a computerized treatment planning system to determine the number and location of seeds needed to treat the cancer.

The implant procedure is performed at Zale Lipshy University Hospital on a day-surgery basis.  Spinal anesthesia is used to numb the patient from the waist down.  The physician inserts the seeds with a series of thin needles and uses an ultrasound monitor to accurately guide the seeds to their final position.  When each needle is in its correct position, the needles are slowly withdrawn while the individual seeds are deposited into the prostate gland.  The implant procedure usually lasts about 45 minutes to one hour, followed by a recovery period of two to three hours.  The patient is discharged on the same day, with instructions to return in two days for a follow-up visit and CT scan to assure the seeds are in position to deliver the correct radiation dose to the prostate.
For more information about our prostate seed implant program or to refer a patient for consultation with a physician, please call (214) 645-8525.

MammoSite Radiation Therapy System: Treating Breast Cancer
At the time of lumpectomy, or shortly thereafter, a deflated MammoSite balloon is inserted into the tumor resection cavity in the breast; the fluid injection site and radiation source port remain outside the breast. The balloon is filled and remains inflated for the entire duration of radiation therapy. During the treatment, the prescribed radiation dose is delivered to the breast via a high-dose rate (HDR) machine under precise computer control. By internally delivering radiation directly to the tissue surrounding the original tumor, the MammoSite RTS minimizes radiation exposure to healthy tissue while treating the area at highest risk for recurrence.

Intensity Modulated Radiation Therapy (IMRT): Treating Head & Neck Cancers, Breast Cancer, Prostate
This state-of-the-art treatment allows doctors to target multiple radiation beams directly on the tumor and spare more healthy tissue. Beam intensities vary, so that the highest possible doses can be used to destroy cancerous tissue. Proper positioning of the patient is crucial to the success of IMRT.

Stereotactic Radiosurgery (SRS) - Radiotherapy (SRT): Treating Brain Tumors and Other Intracranial Cancers
SRS-SRT involves a single, high-dose application of radiation to a tumor, instead of the many smaller doses given in standard radiation treatment. Several radiation beams are precisely aimed to converge upon a small tumor. The patient lies on a couch that rotates 180 degrees for maximum targeting, while minimizing radiation to the surrounding normal tissue. It is effective in treating brain tumors, some head and neck tumors, and abnormal blood vessels in the brain.

Three Dimensional Radiation Treatment Planning: CT Imaging
Moncrief Radiation Oncology Building uses a CT (computed tomography) scanner that simulates radiation treatments for each patient. The simulation, which allows doctors to visualize tumors, is used to test various treatment fields and immobilization devices used to position the patient during radiation therapy. With this picture, they can shape and mold multiple beams of radiation to fit the size and shape of a tumor and, thus, treat tumors with pinpoint accuracy.