Radiation Oncology

Introduction
Radiation therapy (RT) plays an essential role in the care of patients with cancer. It is used as curative treatment for many patients with malignant disease, as integrated therapy with chemotherapy and surgery, and as palliative treatment for those in whom curative treatment is not an option. The dose of radiation delivered to the tumor must be as high as possible, while being as low as possible to surrounding normal tissues. The focus of The Radiation Oncology Division is to develop, evaluate and expand the role of RT in cancer treatment. Establishing optimal irradiation techniques, including proton treatment, is also an important goal of the Division.

Routine Activities
The Radiation Oncology Division includes four consultant physicians and four technologists, and around 600 new patients were treated in 1997. Treatment has been mostly based on three-dimensional planning with isodose distributions, performed by RT-dedicated helical scanning CT, to confirm the dose to the tumor. More than 15 clinical trials, with RT as the sole or a combined treatment modality, for various cancers are ongoing.
The Division is equipped with three treatment machines (a Microtron with 2 gantries, a linear accelerator and a high dose rate brachytherapy unit), a CT-simulator, three treatment planning computer workstations, and many other innovative devices. Regular maintenance and calibration of these machines is also an important project aimed at delivering RT safely and accurately. Tests and developments of the equipment for our proton therapy system constitute an important part of our work in 1997.
Case conferences are held on Wednesday afternoons. A tele-image conference between the Department of RT, the National Cancer Center Hospital, Tokyo, and our division was initiated in 1995.

New Developments
1. A new RT treatment planning system, which is the first helical scanning CT-based system in the world, was originally developed at our division. We developed several new software programs, i.e. the DRR plan and Port View function, for the system in 1997.
2. Proton treatment will be initiated in 1998 at our hospital. Construction of the proton treatment facility and equipment installation were finished in March, 1997. Several new technologies developed by our division were applied to this project. We are in charge of the project, and are now preparing to treat patients.

Statistics

Number of Patients treated in 1993-1997

1993 1994 1995 1996 1997

New patients 464 458 558 593 631

New treatments 598 629 810 796 807

Head & neck 133 99 134 138 144

Lung, mediastinum 226 206 247 267 237

Breast 62 75 78 82 94

Gastrointestinal tract 67 79 128 135 150

Hepatobiliary & pancreatic 56 91 103 85 77

Gynecology 2 5 17 11 11

Urology 8 8 17 7 12

Bone & soft tissue 15 22 45 29 22

Hematology 14 25 34 32 46

Others 15 19 6 10 14

Primary site 198 202 297 312 352

Recurrent, metastatic site 294 315 399 367 344

Prophylactic intent 106 112 114 117 111

Intraoperative RT 43 50 62 57 55

Brachytherapy - 5 39 27 15

Number of Patients treated in 1993-1997
	1993	1994	1995	1996	1997
New patients	464	458	558	593	631
New treatments	598	629	810	796	807

Head & neck	133	99	134	138	144
Lung, mediastinum	226	206	247	267	237
Breast	62	75	78	82	94
Gastrointestinal tract	67	79	128	135	150
Hepatobiliary & pancreatic	56	91	103	85	77
Gynecology	2	5	17	11	11
Urology	8	8	17	7	12
Bone & soft tissue	15	22	45	29	22
Hematology	14	25	34	32	46
Others	15	19	6	10	14

Primary site	198	202	297	312	352
Recurrent, metastatic site	294	315	399	367	344
Prophylactic intent	106	112	114	117	111

Intraoperative RT	43	50	62	57	55
Brachytherapy	-	5	39	27	15

(T. Ogino)

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