RADICAL-CURATIVE:

As an exclusive therapy:
– treatments with conventional fractionations
– hypofractionated treatments i.e., the ability to deliver high doses with the same or higher therapeutic efficacy thus reducing the overall duration of treatments compared to more traditional schemes

As combination radiotherapy, integrated in various modalities with surgery (preoperative, intraoperative, postoperative) or in combination with chemotherapy (neoadjuvant, concomitant, sequential), or in combination with hormone therapy or immunotherapy

PALLIATIVE-SYMPTOMATIC:To decrease and/or eliminate symptoms due to neoplastic disease such as pain , compressive syndromes (e.g. mediastinal syndrome, spinal cord compression, etc..) or rarely otherwise uncontrollable bleeding, and/or combined with other therapeutic weapons.
RADIOTHERAPY OF BENEFICIAL LESIONS:For example, pituitary adenomas, meningiomas, arteriovenous malformations (AVMs), Basedow’s disease, keloids, aneurysmal cysts, cranial nerve pathologies (e.g. trigeminal), vascular pathologies.

Clinical evaluation Oncology:

The first contact between the patient and the Center occurs with the first visit to the Radiotherapy Department (“Radiotherapy Oncology Consultation”). During the consultation, the radiation oncology oncologist collects all information, through medical records, about the patient’s current and remote health status to determine the nature and extent of the disease thus proceeding to multidisciplinary consultations.

Once the clinical issue is identified, the radiation oncologist analyzes the possibility of radiation treatment, choosing the most suitable delivery modality for the individual patient, in consultation with colleagues in Medical Physics.

Centering TC:

Upon accepting the patient for radiation therapy, the Radiation Oncologist and the Medical Radiology Health Technician (TSRM) perform a centering CT scan by defining the patient’s position on the couch and determining the type of immobilization system best suited for the type of therapy to be delivered.

Contornation:

Next, the radiation oncologist identifies the sensitive structures to be contoured on the centering CT scan. To do this it also uses information from other diagnostic investigations such as MRI and PET. Thanks to modern software in the Center, the radiation oncologist has the ability to “fuse” all the patient’s diagnostic images, managing to pinpoint with millimeter precision the region to be irradiated.

Development of the treatment plan:

The Medical Physicist prepares the Treatment Plan by optimizing the dose in the target volume while trying to spare the healthy organs surrounding the disease as much as possible. Each patient will therefore have a Care Plan that is strictly individualized, and suitable for achieving the most accurate dose distribution; consequently it will be different from that of any other patient. After the planning is finished, the Medical Physicist presents the plan to the Radiation Oncologist, which will be analyzed, discussed, possibly modified, and accepted.

Before being delivered to the patient, the Plan is verified on the ArcCheck dummy (for verification of rotational treatments) by evaluating its correct dose delivery (step in the overall Quality Control pathway)

Verification of positioning and treatment:

To carry out the treatment session, the patient is introduced inside the room (Bunker) where the linear accelerator is housed and is made to lie on the treatment couch. A CT scan is taken of the region to be irradiated before radiation is delivered and compared with the centering CT scan. With this procedure, it is possible to position the patient with pinpoint accuracy.The patient inside the therapy room is constantly monitored by the TSRM via a closed-circuit video system. In addition, an intercom system via intercom allows the patient to communicate with the technician. Throughout the radiotherapy treatment, the Patient will undergo follow-up visits during which any supportive therapy will be prescribed. Periodic follow-up visits are carried out after the conclusion of treatment.

Radiation treatment is performed either on an outpatient basis or on an inpatient or day-hospital basis for special clinical cases or for ‘performing combination therapies ( e.g., chemotherapy, nutrition, supportive medical therapy). Admission to the ward or dedicated housing is also possible for special logistical situations (Click here to see our solutions for your stay)

Radiation Therapy collaborates both within the Casa di Cura within dedicated Multidisciplinary Groups and with the various specialists at other National Centers for the discussion of the most complex clinical cases to ensure that each patient receives the proper integration and personalization of planned treatments based on International protocols and internal guidelines adapted to the clinical situation of each individual patient.

The Physician verifies and evaluates all parameters of your treatment plan, verifies every radiological image taken before and during treatment including by Cone Beam verifications at the time of treatment for correctness of therapy; performs intercura

The medical physicist:

It ensures through periodic checks that the characteristics of the equipment are within the tolerance levels chosen to ensure the optimal performance of treatments. It ensures the treatment pathway: from the preparation of the treatment plan, to its approval following discussion with the physician, from the transfer of the plan to the treatment machine through the Record and Verify (ARIA) system that allows the identification of the patient, the correct association of his or her treatment plan and the recording of the dose delivered to each fraction, to the verification before the start of the treatment of the correct delivery of the plan by the equipment and also supervises with other working figures (physicians and technicians) during treatments with respiratory gating.

The TSRM health technician:

Works according to the instructions of the radiation oncologist at the various stages of the radiation therapy procedure: performs patient set up, if necessary using positioning and immobilization systems; during the simulation phase of the treatment, acquires the images necessary for the production of the treatment plan and prepares the accessories necessary for its implementation (shielding, etc.); performs the radiation treatment according to the indications of the plan prepared and approved by the physicist and physician and is responsible for the correct application of the plan itself; acquires the images produced with IGRT technology and assists the radiation oncologist in the “on line” control for the correction of the set up. Prior to the start of treatment carry out the check together with the physicist of the correct delivery of the plan by the machine.

Dr. Maria Grazia Fabrini – Head of the Radiotherapy Operating Unit

Dr. Francesco Cartei – Radiotherapy

Rm peripheral joint districts with and without MDC
Skull Rm with and without MDC
Rm neck with and without MDC
Rm abdomen with and without MDC
Cardiac MRI with and without MDC
Rm spine
Multiparametric prostatic Rm
Massive facial MRI with and without contrast medium
Rm colangium

Tc peripheral joint districts
Tc spine
Tc abdomen with and without MDC
Chest CT with and without MDC
Skull Tc with and without MDC
Total body Tc with and without MDC
Coronary Tc with and without MDC
Tc dentalscan dental arches
Virtual colonoscopy tc

Dr. Alessandro Paolicchi – Radiology service manager, specialist in diagnostic imaging

Dr. Alessandro Lunardi – Interventional radiology

Dr. Mario Sabato – Radiodiagnostics

Dr. Anna Cilotti – Breast Radiodiagnostics

Dr. Carolina Marini – Breast Radiodiagnostics

Dr. Barbara Ginanni – Breast Radiodiagnostics

Dr. Massimo Lombardi – Radiologist Cardiologist

Dr. Salvatore Mazzeo – Radiologist Endocrinologist

Dr. Cristina Bisogni – Radiodiagnostics

Rigid dilatation, hydraulic, pneumatic
Placement PEG (Percutaneous Endoscopic Gastrostomy)
Endoprosthesis placement
Mucosectomia (EMR, Endoscopic Mucosal Resection)
Endoscopic submucosal resection (ESD)
Radiofrequency Ablation (RFA)
Treatment of esophageal fistulas and perforations
Endoscopic myotomy for achalasia (P.O.E.M., PerOral Endoscopic Myotomy)

Video-capsule endoscopy allows visualization of the colorectal mucosa by ingesting a small capsule-shaped camera that, as it advances along the digestive tract, records images and sends them to a small external recorder strapped to a belt that the patient wears around the waist.Compared with traditional colonoscopy and virtual colonoscopy, video-capsule colonoscopy allows direct visualization of the colon mucosa (like the traditional exam), does not rely on radiation (like virtual colonoscopy), and most importantly is non-invasive (but not therapeutic).

Dr. Giovanni Pallabazzer – General Surgeon, Endoscopist, perfected in the diagnosis and treatment of diseases of the esophagus and stomach
Dr. Lorenzo Bertani – Gastroenterologist
Dr. Adolfo G. Puglisi – General surgeon, specializing in Endoscopy and Proctology
Dr. Biagio Solito – General Surgeon, specializing in Esophageal Surgery, Endoscopy and Proctology
Dr. Roberto Spinsi – General surgeon, specializing in endoscopy of the digestive tract
Dr. Alessandro Sturiale – Colo-proctology surgeon, specializing in pelvic floor surgery
Dr. Gianluca Toniolo – Specialist in Surgery, Endoscopy and Anesthesiology