INTRODUCTION

DEPARTMENT OF RADIATION ONCOLOGY

The Department of Radiation Oncology is now headed by Prof. B.Thejaswini. M.D., Dr.V.Lokesh.MD has taken over the charge  Director, KMIO from 17.10.2022. Dr.B.Thejaswini Professor & HOU RO-II is given the Incharge of HOD from 07.11.2022. We provide Radiation Oncology services using high energy X-rays to many cancer patients. The Department has many advanced equipment i.e, treatment units ranging from external beam radiation (Teletherapy) with newer, technologically-advanced options to various advanced Brachytherapy options. Radiation Oncology service at Kidwai Memorial Institute of Oncology has been upgraded with advanced machines like Linear Accelerator (seven), HDR Brachy therapy (three),   Ultrasound guided and MRI based Brachytherapy, including Permanent Implant Brachytherapy, we also have dedicated mould room integrated with wide bored CT simulators with 5 moving lasers and C/Linac matched carbon fiber couch to improve quality of our radiation treatment. We have also introduced latest Radiotherapy techniques for our cancer patients are being introduced like IGRT, VMAT, SRS/SRT, Total skin electrons, Total body irradiation for BMT, Respiratory gating, Tumor motion management/Symmetry/Adaptive RT etc. 

We have a highly experienced team and many of our senior Radiation Oncologists are nationally recognized for excellence and leadership in the field of Radiation Oncology. We have developed a standardized operating model that enables our treatment centre to deliver high-quality, cost-effective patient care. On the academic and research side, Radiation Oncology faculty members continued the academic and research activities with great enthusiasm. the whole team strived to effectively integrate human and machine for quality and radiation safety,   many SOPs were established to improve quality of patient care in the radiation oncology. Improving efficiency, reducing patient waiting period and establishing quality standards of radiotherapy in the department have heightened our teams  sprit to achieve higher target in terms of better cure and quality of life of a cancer patient. We continue to serve the patients with utmost care and humanitarian approach.

 All the staff in Radiation Oncology have worked bravely to meet the demands of the ongoing pandemic. We improvised and innovated safe way to continuously deliver radiation care to our patients even during lockdown. We also established an effective pre-radiation treatment protocol for COVID-19 testing patients undergoing radiation therapy, which received positive responses from patients and also modified radiation plans as per international guidelines, in the radiation premises mask, hand sanitization and social distancing norms were strictly followed.

With the establishment of SCI block we also mentor and coordinate the activities of other Institutes in the state dealing with the tertiary care of cancer. SCI will emerge as the main repository of knowledge, expertise and capacity vis-à-vis cancer within the State. Below Poverty Line (BPL) patients are to receive treatment free of charge. A minimum number of beds should ie available for this category. For poor patients who may not be BPL, the user charges are expected to be reasonable; purpose of enhancing these facilities is to provide affordable treatment for cancer.

Services provided by the department of Radiation Oncology:

• Clinical services: Out-patient and in-patient treatment of emergent and non-emergent patients of all malignancies.
• Diagnostic services in clinic: Physical examination of the patient, Indirect laryngoscopy, per vaginal examination and biopsy of amenable lesions.
• Brachytherapy services which include- Intracavitary brachytherapy, Interstitial brachytherapy, Mould therapy, intraluminal brachytherapy and permanent interstitial implant.
• Teletherapy techniques: 2 Dimensional Conventional Radiotherapy, 3-Dimensional Conformal Radiotherapy,Intensity Modulated Radiotherapy,Volumetric Modulated Arc Therapy, dynamic conformal arc therapy, Stereotactic Radio Surgery Stereotactic Radiotherapy, Stereotactic Body Radiotherapy,Image Guided Radiotherapy.
• Diagnostic/ therapeutic imaging: Simulation usingPhilips Wide BoreComputed Tomography Simualtor Machine including 4 dimensional computed tomography using Bellows, Cone Beam Computed Tomograph ( CBCT) with on-board imaging.
• Special radiotherapy techniques: Active Breathing Coordinator- Respirator Motion Management Elekta system , Deep Inspiration Breath Hold Radiotherapy, Total Body Irradiation and Total Skin Electron Treatment, 5 Moving Laser with tumour lock system, 6 Degree Couch Rotation Hexa Pod couch.
• Complete physics planning team: treatment planning of cases on Eclipse and Monaco TPS with contouring and image fusion facilities. Also available is MIM Maestro data storage and contourig station.
• Ongoing follow up with specialised reaction clinics twice in a week and subsequent patient follow ups post treatment.
• Additional: Stepper’s Rectal Ultrasound for Prostate.
• Academic services: ongoing post-graduate teaching program inclusive of clinical teaching, case discussions and presentations, multidisciplinary seminars, student seminars, faculty teaching programmes, journal clubs, ward rounds, demonstrations, clinico pathological conferences.
• Research: various research activities are carried out with approval from scientific and ethical committee clearance.

Specialized service provided by the department of Radiation Oncology:

• Electron Therapy
• 2 Dimensional Conventional Radiotherapy
• 3-Dimensional Conformal Radiotherapy,
• Intensity Modulated Radiotherapy,
• Volumetric Modulated Arc Therapy, Dynamic conformal arc therapy
• Stereotactic Radio Surgery
• Stereotactic Radiotherapy
• Stereotactic Body Radiotherapy,
• Image Guided Radiotherapy
• Deep Inspiration Breath Hold Radiotherapy
• Total Body Irradiation and Total Skin Electron Therapy
• Close follow up with specialised reaction clinics twice in a week

       Radiation Oncology: Patient Service is arranged as per workflow and Radiation safety

STATISTICS

Radiation Oncology Out patient services:

Inpatients April-2022 to March-2023

 PV room / minor ot Procedures OPD basis:

Patient positioning and mould room work and CT simulation is integral part of RT planning:

 Radiation Therapy delivered on daily basis

BRACHYTHERAPY

STAFF DETAILS

Radiotherapy technologists

Radiotherapy technologists (Contract basis)

Staff Nurses:

ASWO

Rt office

Attenders

 RESEARCH PUBLICATIONS

Palled S, Ramachandra Reddy J, Chavan P, et al. Intra-operative interstitial brachytherapy in a novel infra-zygomatic approach for partially resectable head and neck cancers around the base of skull: A technical note. Journal of Contemporary Brachytherapy. 2023;15(2):148-153. doi:10.5114/jcb.2023.126861.

Viswanath L, Palled S, Venugopal B, Vijay CR, Srinivasan D, Nishchith VD. Building capacity for cancer care infrastructure in Karnataka - the present and the future. Klin Onkol. 2023 Winter;36(1):35-44. English. doi: 10.48095/ccko202335. PMID: 36868831.

Palled SR, Venugopal BK, Nihanthy DS, Khanum H, Vijay CR, Viswanath L, Ramachandra C. Clinical profile and outcomes in cervical cancer: An audit from a tertiary cancer center. Indian J Cancer. 2022 Sep 5. doi: 10.4103/ijc.IJC_211_19. Epub ahead of print. PMID: 36861703. 

Shivananjappa.R,Mandal SK, Vishwanth.B, Geeta SN, An experience with simultaneous integrated boost-definitive treatment of Head & Neck cancer: An Indian date J can Res Ther.-2023Jan-March; 19(2):283-288.

Raghunath S, Tiwari R, Rashmi.S, Geeta SN, Sulthana R, Madebhavi I impact of radical dose calculation  by  enclolunial  Brachytherrapy  and  inductor Chemotherapy  in the definitive treatment  of locally  advanced esophageal cancer  A  retrospective study . J cans Res Ther 2022; 18:S280-4.

Palled SR, Saminathan S, Pasha T, Naveen T, Ganesh KM, Lokesh V. Prostate permanent implant brachytherapy with BARC I-125 Ocu-Prosta seeds. J Cancer Res Ther. 2021 Jun;17(2):340–7.

Das J, Radhakrishna N, K G, A Badhe B. Malignant melanoma of urethra in a young female - Case report and Literature review. Gulf J Oncolog. 2021 Jan 1;1(35):92–5.

Radhakrishna N, Sudha SP, Kalayarasan R, Penumadu P. Does Radiation Dose to Gastric Fundus during Neoadjuvant Chemoradiotherapy for Esophageal Carcinoma Have an Impact on Postoperative Anastomotic Leak? GastrointestTumors. 2021;8(3):121–7.

Joseph B, Bhaskar N, K R N, R S, V L. Hypofraction... Revisited: The emerging role of shorter treatment schedules for locally advanced cancers during the COVID-19 pandemic. J Med Sci Clin Res. 2021 Feb 8;09(02).

Pasha T, Channabasavaraju M, Venugopal B, Chandraraj V, Bondel S, Boraiah G, et al. A Dosimetric Comparison of Two Techniques of Brachytherapy in Carcinoma Cervix in Patients with a Difficult Application. Indian J Gynecol Oncol. 2021 Jan 12;19(1):10.

Radhakrishna N, Palled SR, Pasha T, Buchapudi RR, Govardhan HB, Thimmaiah N, et al. Estimation of dose-volume parameters of female urethra as organ-at-risk during interstitial brachytherapy in gynecological malignancies. J Contemp Brachytherapy. 2021 Oct;13(5):519–25.

Evaluation of dosimetric impact of inter-application and intra-application variations in fractionated high-dose-rate intra-cavitary brachytherapy of cervical cancer [Internet]. [Katke A, Nanda R, Thejaswini B, Pasha T, Giri GV, Babu G, et al. Weekly vs. tri-weekly cisplatin based chemoradiation in carcinoma cervix: a prospective randomized study of toxicity and compliance. Rep Pract Oncol Radiother J Gt Cancer Cent Poznan Pol Soc Radiat Oncol. 2021;26(6):948–54.

Dr, Ajay G.V, Sambit Swarup Nanda Dr, Ajay Kumar Choubey Dr, Ashutosh Mukherji Dr, Satyajit Pradhan Dr and Ashalatha D Dr. “radiation in a palliative setting during covid-19 era. An indian tertiary cancer care prospective – risks, benefits. ”  international journal of scientific research (2021)

Palled SR, Tanvirpasha CAR, Naveen T, Sathiyan S, Kadirampatti G, Lokesh V. Magnetic resonance image-based 3D volume interstitial brachytherapy using polyether ether ketone catheters in advanced cervical cancer - a feasibility study. J Contemp brachytherapy. 2019 Aug 1;11(4):307–11.

Nanda R, KatkeA,Suneetha N, Thejaswini B, Pasha T, Jagannath KP, et al. A prospective randomized study comparing concurrent chemoradiation with weekly and 3 weekly cisplatin in locally advanced oropharyngeal carcinoma. South Asian J Cancer. 2019;8(3):178–82.

Joseph B, Kumar R, Champaka G, Shenoy A, Sabitha K, Lokesh V, et al. Biological tailoring of adjuvant radiotherapy in head and neck and oral malignancies; The potential role of p53 and eIF4E as predictive parameters. Indian J Cancer. 2019 Oct 1;56(4):330–4. 

Joseph B, Ikkurthi V, Farooq N, Nithin K, Vijay CR, Ramesh C, et al. Breast-Conserving Radiotherapy with Simultaneous Integrated Boost—A Dosimetric Comparison of 3DCRT, VMAT and IMRT: Do We Really have a Better Plan? Indian Journal of Gynecologic Oncology [Internet]. 2019 [cited 2019];17(2):43. 

Joseph B, Kumar R V, Champaka G, Shenoy A, Sabitha K. S, The eukaryotic initiation factor 4E (eIF4E) as a predictive biomarker in the negative margins of resected head and neck and oral cancers: Is there a role for tailoring adjuvant radiotherapy. Indian J Pathol Oncol 2019;6(1):47-51. 

Jalali R, Maitre M, Gupta T, Goda JS, Shah N, Krishna U, et al. Dose-Constraint Model to Predict Neuroendocrine Dysfunction in Young Patients With Brain Tumors: Data From a Prospective Study. Vol. 9, Practical Radiation Oncology. Elsevier BV; 2019. p. e362–71. 

Krishna DU. Veda M, Jagannath KP, Naveen, Long term outcomes of Radiotherapy by two different fractionation regimens for IDH negative Glioblastoma in elderly- A Non Randomised Prospective Study. Vol. 7, Journal of Medical Science And clinical Research. Valley International; 2019. 

Naveen T, Krishna ASU, Santosh V, Arivazhagan A, Lokesh V. Subgroup stratification of adult diffuse gliomas and outcomes: an adaptation of the updated WHO classification in a resource-constrained environment. Journal of Radiotherapy in Practice. Cambridge University Press (CUP); 2019. p. 1–4. 

Ghosal N, Sivaraju L, Mahadevan A, Krishna AU, Rao S, Hegde A. Aggressive primary pediatric intracranial malignant melanoma: Sphinx of the tissue diagnosis. Vol. 14, Asian Journal of Neurosurgery. Medknow; 2019. p. 275. 

Ahmed K, Govardhan H, Roy M, Naveen T, Siddanna P, Sridhar P, et al. Cell-free circulating tumor DNA in patients with high-grade glioma as diagnostic biomarker; A guide to future directive. Indian Journal of Cancer . 2019 Jan 1 :56(1):65–9. 

Krishna U, Thimmarayappa A, Lokesh D, Chandraraj V. Optimization of radiation therapy in non-functioning pituitary adenoma based on temporal lobe dosimetry. 2019 Jun 22. 

Manjula M. V, Pawar Y. S. Treatment non-compliance and government aided health schemes : a boon or a curse. Int J Med Res Rev 2019;7(02):61-64.doi:10.17511/ ijmrr. 2019.i02.02.

Poornachandra Tejaswi, Jagannath KunigalPuttaswamy, Lokesh Vishwanath, Poojar Sridhar, Vijay Calmuge Raghu, Saritha Sunny Pullan. Evaluation of Carotid Artery and Carotid Sinus doses in Early stage Carcinoma Glottis with and without bolus. J Med Sci Clin Res. 2019 Apr 1;7. 

Poornachandra Tejaswi, Jagannath KunigalPuttaswamy, Lokesh Vishwanath, Poojar Sridhar, Vijay Calmuge Raghu, Saritha Sunny Pullan. Analysing the dose to lacrimal glands in Carcinoma Nasopharynx: Is there a need for Ophthalmic prophylaxis? J Med Sci Clin Res [Internet]. 2019 Apr 1;7. 

Shamsundar S.D, Jagannath K.P, Niveditha S, K. Aradhana, R. Nanda, B. Thejaswini. Prognostic significance of primary tumour volume in nasopharyngeal carcinoma– a single institute study. Int J Med Res Rev 2019;7(01):24-29. doi:10.17511/ijmrr.2019.i01.05. 

Pasha T, Palled S R, Loni R, Bondel S, Chavan P, et al. High Dose-Rate Brachytherapy in Recurrent High-Risk Head and Neck Cancer, Rep Radiother Oncol. 2019 ; 6(1):e98391. doi: 10.5812/rro.98391.

Poojar S, Loni R, H K KR ,Naveen T, Lokesh V. Impact of Short Versus Long Course Whole Brain Radiation Therapy on Memory Function in Brain Metastasis Patients, Rep Radiother Oncol.;2019; 6(1):e95524. doi: 10.5812/rro.95524. 

Viswanath L, Naveen T, Siddanna P, Chetana P, Geethasree M, Sridhar P, et al. Epidermal growth factor receptor (EGFR) overexpression in patients with advanced cervical cancer. J Clin Oncol [Internet]. 2014 May 20 ;32(15_suppl):e16538–e16538. 

Thimmaiah N, Kalavagunta S, Loni R, Pasha T, Poojar S, Viswanath L. Efficacy, Radiological Response and Local Toxicity in Locally Advanced Head and Neck Squamous Cell Carcinoma Patients (LAHNSCC) Treated with Hypofractionated Accelerated IMRT with Concomitant Simultaneous Integrated Boost (SIB). Reports Radiother Oncol. 2019 Aug 26. 

Joseph B, Ikkurthi V, Farooq N, Nithin K, Vijay CR, Ramesh C, et al. Breast-Conserving   Radiotherapy with Simultaneous Integrated Boost—A Dosimetric Comparison of 3DCRT, VMAT and IMRT: Do We Really have a Better Plan? Indian J Gynecol Oncol. 2019;17(2):43.