The radiotherapy department at Netcare Unitas Hospital in Centurion delivered a course of full-body irradiation using volumetric arc therapy in the treatment of a seven-year-old patient leukaemia patient.
According to Dr Sheynaz Bassa, in this young boy’s case, the radiation therapy planners did extensive research before deciding on the use of volumetric arc technology.
They drew on international experience in which a similar treatment approach had been used for leukaemia to ensure the most accurate planning and treatment possible.
“The total body irradiation treatment was done to destroy the cancer cells in the young boy’s blood, ahead of a bone marrow transplant he was scheduled to undergo just days after the completion of the radiation therapy.
“As far as we are aware, this is the first time in South Africa that a leukaemia patient has been treated using volumetric arc therapy prior to bone marrow transplantation,” said Bassa.
Bassa, a clinical and radiation oncologist who practices at Unitas said leukaemia was cancer originating in the bone marrow frequently seen in children.
“In cases where cancer relapses, a bone marrow transplant is often performed. It is important, however, to clear the body of cancer cells prior to the bone marrow transplant. In this case, we used volumetric arc therapy.
“This enables us to radiate the entire body in single sessions with the patient lying comfortably, as well as chemotherapy.
“It is a combination of radiotherapy (which uses high energy X-rays to kill cancer cells) and chemotherapy (which uses drugs given intravenously to kill the cancer cells and is traditionally used to irradiate the entire body to destroy cancer cells in leukaemia patients).
“Using traditional techniques, full-body irradiation is usually a long and laborious process. It involves complicated manual planning techniques, with the patient sitting in an uncomfortable treatment position for a long period of time.
“It also often requires production and use of cumbersome lead blocks to shield important organs like the lungs which are radiosensitive.
“The accuracy in the radiation dose to these organs is reduced due to the manual planning techniques and the patient does not have the benefit of a computed tomography scan being used in the planning,” said Bassa.
“Using this advanced technology, we are able to pre-determine the doses that will be delivered. We can adjust them to reduce the doses to be delivered to organs such as the lungs and kidneys, thus minimising the likelihood of side effects in these patients.
“This is important for transplant recipients who are already experiencing side effects from their chemotherapy.
“Being more accurate, volumetric arc irradiation enables us to visualise the planned treatment before delivery with the use of three-dimensional imaging,” she said.
The treatment course was completed over three consecutive days.
“It was most encouraging for the radiotherapy team at Netcare Unitas hospital to successfully treat our young patient using a new technique which we believe ensured the best and safest possible care for him,” said Bassa.
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