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More comfort for seriously ill patients: MHH radiotherapy works with a rotating table
For people with leukaemia, a bone marrow or blood stem cell transplant is often the only chance of survival. Preparatory treatment is crucial for the success of such a transplant. This often includes whole-body radiotherapy, which is carried out at the Department of Radiotherapy and Special Oncology at Hannover Medical School (MHH). The team now offers patients an innovation in whole-body radiotherapy: lying on a rotating table, they do not need to change position during the entire process. This is a great advantage for people who are already very weak. Only a few clinics in Germany offer rotational radiotherapy for the whole body.
Important treatment before transplantation
Patients must be conditioned before a stem cell transplant. This means that not only all cancer cells, but also the patient's own haematopoietic system and immune system must be destroyed. ‘Complete elimination is a prerequisite for the donor cells to grow as well as possible,’ explains Professor Dr Hans Christiansen, Director of the Department of Radiotherapy and Special Oncology. ‘Those affected first receive high-dose chemotherapy. In many cases, this is then combined with whole-body radiotherapy,’ adds Associate Professor Dr Roland Merten. Patients include both adults and children. Professor Christiansen's team works closely with experts from the haematology departments for adults, children and adolescents at the MHH on whole-body radiotherapy. They are responsible for the overall treatment of the patient.
Whole body irradiation without changing position
Normally, only a limited area of the body is treated during radiotherapy, making it difficult to irradiate the entire body. Previously, patients had to lie down on a special mat on the floor so that the radiation from the linear accelerator could reach the entire body in sections.
This was an uncomfortable situation for the seriously ill patients, especially as they had to be repositioned during the treatment. The new solution is much more comfortable: the patients lie on a horizontal table top that can be rotated 360 degrees and can therefore be moved into any position required for the radiotherapy with millimetre precision. Repositioning is no longer necessary. During radiotherapy, the linear accelerator rotates around the body, delivering the radiation dose. ‘Thanks to the special table top, we realise rotational irradiation in sections for the entire body, from the top of the skull to the sole of the foot,’ explains medical physics expert Jens Bock. In technical jargon, rotational radiation is also known as VMAT (Volumetric Intensity Modulated Arc Therapy).
Precise therapy planning
The new system not only offers advantages for patients. The rotating table top also makes work easier for the treatment team - specialists from medicine, medical physics and medical-technical radiology - for example when determining the radiation dose to be delivered. A medical physicist calculates this a few days before the procedure with the help of planning computer tomography (CT), in which the patient lies in exactly the same position as during the subsequent radiotherapy using an individually modulated plastic shell and a head mask.
Irradiation in four to six sessions
Whole-body radiotherapy is the last treatment step before a bone marrow or blood stem cell transplant. It comprises four to six sessions. The first session lasts around one and a half hours, and the others between 30 and 40 minutes. ‘We are pleased that we can make treatment a little easier for this group of patients with the rotating table top,’ says Dana Loberenz, Head Medical Technologist for Radiology (MTR) at the clinic. The table top is made of carbon fibre. The purchase was made possible by a donation of 25,000 euros from the Rudolf Bartling Foundation.
For further information, please contact Professor Dr Hans Christiansen, christiansen.hans@mh-hannover.de.
At a linear accelerator with a rotating table top: Professor Dr Hans Christiansen, Privatdozent Dr R ...
Copyright: Karin Kaiser/MHH
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