Organization - Radiotherapy Oncology Service

The Radiotherapy Oncology Deparment is organized in different specialized areas to offer a more personalized service.

The Deparment participates in the following Units:

The Radiation Oncology Department is divided up into different specialized areas in order to offer a more personalized Department. The centre in Granollers also brings treatment closer to the whole of the C17 area, facilitating access and treatment for patients. 
The team of professionals includes doctors, hospital radiation physicists, advanced practice nurses, specialist radiotherapy technicians (TIRT), two MIR residents (medical residents) per year (four years of residency in total) and one and one FIR resident (pharmacy resident) (three years of residency in total), which are distributed in different teams in accordance with the disease. 

• Breast cancer
• Gynaecological cancer
• Gastrointestinal cancer
• Melanoma and Non-melanoma skin cancer
• Lung cancer
• Genitourinary cancer
• Head and neck cancer
• Central nervous system
• Haematopoietic  transplantation

The Radiotherapy Department’s portfolio includes:

Three-dimensional Conformal Radiation Therapy (3D-CRT):

This is a standard technique used to treat tumours in any part of the body. This technique allows for precise distribution of the radiation dose, adapting to the shape and size of the tumour, while minimizing irradiation of nearby healthy tissue.

Intensity-Modulated Radiation Therapy (IMRT):

By modulating the intensity of the radiation beam, this technique allows higher doses to be administered directly to the tumour, while reducing exposure to surrounding healthy tissue. This improves the precision of the treatment and reduces side effects.

The main difference between 3D-CRT and IMRT is that, while the former adjusts the shape of the radiation beam in three dimensions, IMRT goes one step further and also regulates the intensity of this radiation, making it more effective in treating complex tumours and minimizing side effects on healthy tissue.

Volumetric Modulated Arc Therapy (VMAT):

An evolution of the IMRT technique, combining the advantages of "rotating arc" radiotherapy with intensity modulation. It allows for a more complex distribution of the radiation dose in less time, ensuring high precision and safety during treatment.

Image-Guided Radiation Therapy (IGRT):

Radiotherapy is performed with the support of images obtained before and during treatment, allowing the exact position of the tumour to be verified and any variations to be adjusted. This improves precision and safety, especially when the tumour or surrounding tissues change over time.

 Surface-Guided Radiation Therapy (SGRT):

Advanced technique that uses detection of body surface movements (e.g., through structured light or body temperature) to ensure that the patient is correctly positioned during treatment. It also allows continuous monitoring of patient movements during the session.

Stereotactic Ablative Radiation Therapy (SABR/SBRT):

This technique allows a high dose of radiotherapy to be administered in a small number of sessions (3 to 8). It is particularly useful for small tumours that are difficult to access, as it is as effective as surgery but does not require surgical intervention. This technique can be used in: the treatment of non-small cell lung cancer in early stages that are not suitable for surgery, oligometastases, prostate cancer and in the treatment of ventricular arrhythmias that are resistant to conventional treatment.

Stereotactic Radiosurgery (SRS + SBRT):

This is a type of stereotactic radiotherapy used to treat brain tumours. A high dose of radiotherapy is administered in a few sessions, using a precise immobilization system to ensure sub-millimetre accuracy in the treatment.

Respiratory Motion Control:

In certain treatments, especially when tumours are located in the lungs or near the chest, respiratory movements can interfere with the accuracy of the treatment. For this reason, we use specialized techniques to quantify and control respiratory motion during radiotherapy.

Deep Inspiration Breath Hold (DIBH) Technique:

The patient takes a deep breath and holds it during the radiotherapy session. This approach is particularly useful for tumours in the chest area, such as breast or lung tumours, as deep inhalation moves the heart away from the area to be treated, helping to reduce radiation to the heart tissue.

Gating:

Using this technique, treatment is administered only at specific phases of the patient's respiratory cycle. This allows for greater precision in treatment, concentrating radiotherapy on the tumour and reducing radiation to surrounding healthy tissue.

Total Body Irradiation (TBI):

Mainly used in patients who are undergoing stem cell or bone marrow transplantation. Total body irradiation prepares the patient's body for transplantation by eliminating abnormal or cancerous cells.

Superficial Radiation Therapy (SRT):

Indicated for treating skin tumours, this technique uses low doses of radiation that achieve effective results with minimal impact on surrounding healthy tissue, while also achieving excellent aesthetic results.

Brachytherapy:

This involves placing a radioactive source inside or very close to the tumour, allowing high doses of radiotherapy to be administered directly to the affected area. This technique is used in cervical, prostate, breast and endometrial cancers, and is particularly useful when high precision and protection of adjacent healthy tissue is required.

Intraoperative Radiation Therapy (IORT):

In some cases, radiotherapy is administered during the same surgery to remove the tumour. In the case of breast tumours, for example, the risk area can be irradiated directly at the time of surgery, avoiding the need for external irradiation and minimizing damage to surrounding healthy tissue. This technique is performed using a portable linear accelerator installed in the operating theatre.