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 portfolio of Radiotherapy Deparment includes:

Three-Dimensional Conformal Radiotherapy (3D-CRT):
This is a standard technique used to treat tumors anywhere in the body. It allows for a precise distribution of the radiation dose, adapting to the shape and size of the tumor while minimizing exposure to nearby healthy tissues.

Intensity-Modulated Radiotherapy (IMRT):
By modulating the intensity of the radiation beam, this technique makes it possible to deliver higher doses directly to the tumor while reducing exposure to surrounding healthy tissues. This improves treatment precision 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 a step further by also regulating the intensity of the radiation, making it more effective for treating complex tumors and minimizing side effects in healthy tissues.

Volumetric Modulated Arc Therapy (VMAT):
An evolution of the IMRT technique, it combines the advantages of “rotational arc” radiotherapy with intensity modulation. It enables a more complex distribution of the radiation dose in less time, ensuring high precision and safety during treatment.

Image-Guided Radiotherapy (IGRT):
This technique uses imaging obtained before and during treatment to verify the exact position of the tumor and adjust for any variations. It improves accuracy and safety, especially when the tumor or adjacent tissues change over time.

Surface-Guided Radiotherapy (SGRT):
An advanced technique that uses body surface motion detection (e.g., through structured light or body temperature) to ensure the patient is correctly positioned during treatment. It also allows continuous monitoring of patient movements throughout the session.

Stereotactic Ablative Radiotherapy (SABR/SBRT):
This method delivers a high radiation dose over a small number of sessions (3 to 8). It is especially useful for small, hard-to-reach tumors, offering effectiveness comparable to surgery but without the need for surgical intervention. This technique can be used for: early-stage, non-surgical non-small cell lung cancer, oligometastases, prostate cancer, and the treatment of ventricular arrhythmias resistant to conventional therapies.

Stereotactic Cranial Radiotherapy (SRS + FSRT):
A form of stereotactic radiotherapy used to treat brain tumors. A high dose of radiation is delivered in a few sessions, using a precise immobilization system to guarantee sub-millimeter accuracy in treatment.

Respiratory Motion Management:
In certain treatments, especially when tumors are located in the lungs or near the thorax, breathing movements can interfere with treatment accuracy. Specialized techniques are therefore used to quantify and control respiratory motion during radiotherapy.

Deep Inspiration Breath Hold (DIBH):
The patient takes a deep breath and holds it during the radiotherapy session. This approach is particularly useful for tumors in the chest area, such as breast or lung cancer, since deep inhalation moves the heart away from the treatment area, helping reduce radiation exposure to cardiac tissues.

Gating:
With this technique, treatment is delivered only during specific phases of the patient’s breathing cycle. This increases treatment precision, focusing radiotherapy on the tumor and reducing exposure to surrounding healthy tissues.

Total Body Irradiation (TBI):
Mainly used in patients undergoing stem cell or bone marrow transplantation. Total body irradiation prepares the patient’s body for the transplant by eliminating abnormal or cancerous cells.

Superficial Radiotherapy:
Indicated for the treatment of skin tumors, this technique uses low radiation doses that achieve effective results with minimal impact on surrounding healthy tissues, also offering excellent cosmetic outcomes.

Brachytherapy:
This involves placing a radioactive source inside or very close to the tumor, allowing high doses of radiotherapy to be delivered directly to the affected area. It is used in cancers of the cervix, prostate, breast, and endometrium, and is particularly useful when high precision and protection of surrounding healthy tissues are required.

Intraoperative Radiotherapy (IORT):
In some cases, radiotherapy is delivered during surgery to remove the tumor. For example, in breast tumors, the area at risk can be irradiated directly during the operation, avoiding the need for external irradiation and minimizing damage to surrounding healthy tissues. This technique is performed using a portable linear accelerator installed in the operating room.