Centre d'Oncologie des Eaux-Vives has technical facilities that are fully equipped with the latest-generation equipment in order to keep up with the demands of modern technology.
Treatment planning system
The Philips Brilliance Big Bore CT (computed tomography) scanner is specifically designed to meet the needs of radiation oncology. Radiotherapy treatment plans are developed using the Pinnacle³ IMRT server designed by Philips. This also provides image acquisition and processing via the AcQSim³ workstation.
The Clinac 21EX linear accelerator by Varian produces 6 and 15 MV photon beams and electron energies ranging between 6 and 20 MeV. This device features a high-resolution multi-leaf collimator and is controlled by the 4D Integrated Treatment Console. The computer networking technology between the treatment planning and radiotherapy systems, and the various clinical and administrative components, is provided using Varian’s VARiS Vision radiation oncology management software.
The cancer centre’s radiotherapy unit is therefore equipped with technology that makes it possible to deliver external radiation doses to our patients with a high level of precision. We have a wide range of state-of-the-art equipment to be able to offer such advanced treatment, the main devices include:
Image-guided radiotherapy (IGRT)
Image-guided radiotherapy (IGRT) involves collecting images before delivering external beam radiotherapy treatment, enabling the patient’s positioning to be monitored and corrected daily and improving treatment reproducibility. During each radiotherapy session, these techniques aim to adjust the position of the radiotherapy beams depending on the position of the tumour to be treated and the surrounding healthy organs that need to be avoided.
Intensity-modulated radiotherapy (IMRT)
Technology available at the centre also includes the option to adjust the intensity of the beams using intensity-modulated radiotherapy (IMRT), this optimises the dose distribution, delivering a maximum radiation dose to the tumour tissue while minimising the dose to the surrounding normal tissue.
On-board imaging (OBI)
On-board imaging (OBI) techniques and cone beam computed tomography (CBCT) enable technicians to ensure the reproducibility of radiation doses from one session to the next.
Volumetric modulated arc therapy (VMAT)
This innovative technique delivers radiation doses that are even more focused than that of IMRT. During a VMAT session, radiation is delivered continuously by a single arc or dual arc around the target volume. The tumour is eradicated with extreme precision while minimising the damage to the healthy tissue as much as possible. A key benefit of this technique is the short treatment time. The level of precision achieved by the VMAT technique means that high doses can be delivered. This therefore improves the chances of killing cancer cells while helping to improve the patient’s quality of life by reducing the risk of long-term effects to the surrounding normal tissue and healthy organs.
With its high level of precision, stereotactic radiosurgery can target tumours and deliver radiation doses with millimetre precision, therefore protecting the healthy organs and significantly reducing treatment times for the patient. In carefully selected patients, stereotactic radiosurgery can treat tumours growing in the brain, using intracranial stereotactic radiosurgery, as well as cancers diagnosed in other parts of the body, using extracranial stereotactic radiosurgery. In both cases, the aim of radiotherapy is to increase the localised radiation dose without increasing the dose to the surrounding healthy organs.
• Intracranial stereotactic radiosurgery
Fractionated intracranial stereotactic radiosurgery precisely targets the tumour to within a millimetre. Intracranial stereotactic radiosurgery is mainly used to treat small, malignant and benign primary brain tumours as well as brain metastases.
• Extracranial stereotactic radiosurgery
Fractionated extracranial stereotactic radiosurgery is based on the same concept and is used in numerous tumours, for example some lung and liver lesions where surgery is not, or is no longer, a feasible option. Stereotactic radiosurgery can also be used in combination with chemotherapy or when all lines of chemotherapy have failed.
Deep inspiration breath hold technique
This technique requires the patient to wear a pair of video-assisted goggles and use a spirometry to copy the visual display in the goggles and hold their breath for a few seconds. This technique is available in several centres and meets the objective of radiotherapy although this type of breathing affects the lung volume of patients during treatment. For patients who are receiving radiotherapy for breast cancer, the deep inspiration breath hold technique helps to prevent radiation-sensitive organs, such as the heart and superficial lung tissue, from being exposed to radiation beams and therefore reduce any delayed side effects, such as pulmonary fibrosis or heart failure, on these two organs.
Intraoperative radiotherapy for breast cancer involves a single session of radiation delivered during the operation to surgically remove the tumour in the breast (lumpectomy). This technique, known as IORT, is an innovative treatment approach. However, its usage must be carefully standardised depending on the risk factors presented by the patient at the time of diagnosis. Centre d'Oncologie des Eaux-Vives can provide patients with access to this innovative technique, as IORT is a treatment option offered by Centre du Sein GSMN at Clinique Générale-Beaulieu and Clinique de Genolier, Swiss Medical Network members