Acibadem Maslak Hospital
Radiotherapy Center – Infrastructure and Systems
Rapidarc
Brachytherapy
Acibadem Healthcare Group Radiotherapy Centers
Acibadem Kozyatagi Hospital
Stereotactic Radiotherapy / Radiosurgery
Acibadem Bursa Hospital
Acibadem Adana Hospital
Acibadem Kayseri Hospital



Acibadem Maslak Hospital

At Acibadem Maslak Hospital, multidisciplinary approach to treatment of oncology is of utmost importance. Evidence based treatment plans that concur with international guidelines and standards are determined at the periodic, interdisciplinary disease councils.

The Center is equipped with state-of-the-art radiotherapy infrastructure. The Rapidarc device, which is only available at three locations in Europe and is the second trilogy device in our county (the first one is at Acibadem Bursa Hospital) can be considered as one of the significant features of Acibadem Maslak Hospital Radiotherapy Center. Furthermore, the existence of the Brachytherapy Unit, which is not present in many health institutions, enables integrated and seamless care. Top

Radiotherapy Center – Infrastructure and Systems

Trilogy
Trilogy is a linear accelerator that can perform all three radiotherapy modalities: IMRT, IGRT and SRT.

At Acibadem Maslak Radiotherapy Center, 3-dimensional conformal radiotherapy, which is the standard radiation oncology treatment, is provided using highly-advanced linear accelerators.

IMRT (Intensity Modulated Radiation Therapy), which is recently gaining popularity all around the world, is successfully used in appropriate cases. While in the United States about 90% of the radiotherapy centers offer IMRT, only 5% do so in Turkey.

IMRT is able to deliver 10-15% more radiation compared to conformal techniques, while minimizing the exposure to healthy tissues. IMRT renders immobilization of the patients critical due to rapid dose adjustments. Hence, despite best efforts to minimize patient mobility during treatment, conventional portal imaging for determination of target area is generally inadequate. At this point, IGRT (Image Guided Radio Therapy), which is offered first at our group in Turkey, steps in to bring down the ambiguities and insufficiencies that may be encountered in IMRT applications.

Today, the golden standard of radiation oncology has become IGRT-IMRT and treatment has become extremely safe for the medical team and the patients. IGRT is based on the principle of obtaining the kilo voltage (kV) images in one minute by using two robotic arms. IGRT images obtained post set-up are combined with the DRR images obtained during treatment planning and if need be, errors can be corrected without physically entering into the treatment room. In cases where kV images are not adequate, for example in prostate cancer patients, volumetric Cone Beam Computer Tomography (CBCT) images can be acquired thanks to the 360-degree rotation of the IGRT robotic arms. These images are evaluated 3-dimensionally prior to the commencement of treatment and computer tomography images obtained during planning are matched with the Cone Beam Computer Tomography images. CBCT imaging tracks not only the bone structures but also changes in soft tissues and organ movements. Thus, optimization of individual patient target planning volume is possible.

Real-Time Position Management System that enables respiratory gating is available in both devices in the unit. Since the images from the 4-dimensional Computer Tomography (CT) on radiology department are more advanced compared to conventional CT in terms of detecting tumor movement, more accurate tumor volume determination is possible. This leads to more targeted radiation and less irradiation of the healthy surrounding areas. Specifically, with the Respiratory Gating System, which is one of the three preferred methods in treatment of lung cancers, optimized delivery of radiation can be ensured.

Combined with IGRT, this method enables Stereotactic Radiotherapy using linear accelerators.

The Trilogy device at Acibadem Maslak Hospital is the second Trilogy in Turkey, after the first one at Acibadem Bursa Hospital in 2008. Top

Rapidarc
The 4th Rapidarc device in Europe is available at Acibadem Maslak Hospital and it has all the features and capabilities of Trilogy, except for SRT. Rapidarc offers one of the most advanced treatment methodologies of the recent years: Volumetric Arc Therapy.

Conventional IMRT treatments last between 10 and 20 minutes. Immobility for such duration may not be easy, especially for patients who suffer from treatment side effects or pains associated with the disease. Efforts to shorten the treatment times have led to creation of Volumetric Arc Therapy, which reduces treatment duration to 1-2 minutes. This is possible thanks to dosage and velocity modulations while the device rotates around the patient during treatment. At the same time, gantry rotation and multi-lead collimator (MLC) movements in this technology are faster than other linear accelerations. Compared to conventional IMRT, patient comfort is improved and the time available to spend with patient during set-up and treatment is increased.

The other point to keep in mind is that the average radiation dose delivered is lowered by 2-3 folds in comparison to conventional IMRT. This is especially critical in pediatric patients. As a result, Rapidarc allows us to perform the state-of-the art radiotherapies in the fastest, most effective and simplest manner. The Rapidarc in Acibadem Maslak Hospital is the first one in Turkey.Top

Brachytherapy
Brachytherapy can be used on its own or in conjunction with external radiotherapy, with the purpose of increasing local delivery of radiation to tumor/tumor region. Radioactive seeds are inserted into the tumor and the target tissues and exposure is limited to the area around the seeds. Brachytherapy is used in especially gynecological, head and neck, breast and lung cancers.Top

Acibadem Healthcare Group Radiotherapy Centers
The treatment planning modalities in all of the Acibadem Radiotherapy Centers are electronically connected. When needed, patients can be consulted online and treatment plans can be evaluated and approved centrally.Top

Acibadem Kozyatagi Hospital
Acibadem Kozyatagi Hospital is the first radiation oncology center of the group.” 3-dimensional conformal and brachytherapy” treatments are being offered with great success rates since 2004. The 3-dimentional physics-dosimetric planning system at the brachytherapy unit enables best protection of normal tissue.

The center has treated 2,064 patients from October 2004 to January 2009. Able to deliver IMRT since October 2005, the center has treated 331 patients with the modality so far. Gamma Knife, which is available since October 2005, has accepted 771 patients as of January 2009. Since March 2008, both linear accelerators at the center are able to perform IMRT and IGRT.Top

Stereotactic Radiotherapy / Radiosurgery
Gamma Knife, which can be used for Stereotactic surgery in intracranial lesions, is available at Acibadem Kozyatagi Hospital. The gold standard of treatment for brain tumors, Gamma Knife can be used in brain and brain base lesions. A highly qualified and experienced team of neurosurgeons, radiation oncologists, radiologists and pathologists have been treating neurological tumors for many years at Acibadem Kozyatagi Hospital.

The most important aspect of Stereotactic surgery is the precise target follow-up system. Since the entire radiation dose is delivered at once, this technology has become the pinnacle of IGRT. The treatment is appropriate not only for brain but also soft organ tumors.

Advancements in linear accelerator technology have enabled Stereotactic radiosurgery with linear accelerators. The most sophisticated example of such application is TRILOGY.

Stereotactic radiosurgery is widely used in brain tumors, brain metastases, head and neck tumors, lung cancers, prostate cancers, gynecological tumors, soft tissue tumors, pancreatic cancers, AVM, malignant melanomas and liver cancers.Top

Acibadem Bursa Hospital
Acibadem Bursa Hospital, which carries the high-quality health services that have been provided in Istanbul for years to Bursa, has become a regional reference center. Services in all medical and surgical specialties are offered with state-of-the-art infrastructure, medical technology, patient-focused approach, high capacity and high quality standards.

The radiotherapy center which opened in April 2008 enables one-stop diagnosis and treatment for cancer patients. Presence of highly-specialized physicians in all departments obviates the need to travel to other cities and saves precious treatment time for patients. Acibadem Bursa Hospital serves the tertiary needs of not only the city of Bursa but the entire south Marmara region.

The first TRILOGY in Turkey is at Acibadem Bursa Hospital since April of 2008 and the device is able to perform IMRT, IGRT, Stereotactic radiotherapy and 3-dimensional conformal therapies. Over 80 patients have received IMRT treatments at the center. Furthermore, the first Stereotactic surgery using linear accelerators on an isolated metastatic lung cancer patient has been performed at Acibadem Bursa Hospital.Top

Acibadem Adana Hospital
Two linear accelerators are available in the Oncology and Radiotherapy Center since May 2009. Both devices have IMRT and IGRT capabilities. Brachytherapy can also be performed using the HDR device. Acibadem Adana Hospital is the only center in Southeast Anatolia with IMRT and IGRT capabilities.Top

Acibadem Kayseri Hospital
Two linear accelerators are available in the Oncology and Radiotherapy Center since June 2009. Both devices have IMRT and IGRT capabilities. Brachytherapy can also be performed using the HDR device.Top