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Radiation Medicine Program



​Radiation therapy is a highly effective treatment modality for patients with cancer. Used alone, or in combination with other approaches like surgery or chemotherapy, it can cure many patients and control tumours to reduce symptoms and improve quality of life.

We provide consultations for patients with all types of cancer, recommend treatment approaches, deliver safe and effective radiation treatments and offer ongoing follow-up care.

Our team is organized into cancer Site Groups that have developed treatment protocols based on research evidence. These protocols guide decisions on the role, indications and benefits of radiation therapy in specific, individual circumstances.

Our specialized programs are:

  • QuickStart Program
    QuickStart offers women with early-stage breast cancer expedited treatment planning and delivery of the first radiation treatment in one day. Patients receive the same quality and effective radiation treatment without the unnecessary waits, and avoid potential negative impacts to their treatment experience and outcomes.
  • Oligometastases Program
    Oligometastases is the presence of metastatic disease that is limited in number and location. Selected patients, may achieve improved survival after aggressive minimally invasive local treatment, such as radiosurgery, high-dose radiotherapy, and surgery.
  • Palliative Radiation Oncology Program
    Palliative radiotherapy is an important tool for managing cancer-related symptoms. It can provide rapid pain relief and defer or prevent complications from metastatic disease, allowing preservation of quality of life.
  • Pediatric Radiation Therapy Program
    Radiation therapy remains a critical type of therapy for children with cancer. Its uses include local control of the primary tumour, prophylactic radiation of the brain in patients with high-risk leukemia, radiation of the lungs when there are metastases to the lungs, and total body irradiation in patients undergoing bone marrow transplants.

 

Our specialized radiation approaches include:

  • Brachytherapy Program
    Brachytherapy is the implantation of radioactive sources, usually in the form of needles, seeds or wires, directly into a tumour. Brachytherapy may be used as the sole form of radiotherapy or may be combined with external radiation.
  • Stereotactic Radiation Therapy Program
    Stereotactic radiation therapy is a very precise type of radiation treatment delivery, usually requiring an external frame of reference, such as a head frame for intracranial disease. This method permits accurate delivery of high doses in a few fractions to a small, conformed tumour volume.
  • Gamma Knife Radiosurgery
    Housed at Toronto Western Hospital, the Gamma Knife Centre is the only one of its kind in Ontario. As a unique collaboration between Neuroscience, Medical Imaging and the Princess Margaret Radiation Medicine programs, this state-of-the-art radiosurgical treatment is available to people with benign tumours and other medical conditions. A second Gamma Knife Perfexion unit at Princess Margaret is used to treat brain metastases.

 

QuickStart Program

Whole breast radiation therapy is a standard treatment option for women with breast cancer following breast conserving surgery. On an annual basis, this treatment accounts for more than 60 per cent of all breast cancer patients treated at the Princess Margaret Cancer Centre. With increasing rates of breast cancer and greater use of advanced, yet time-consuming planning methods, the hospital needed an innovative, efficient approach to treat patients and prevent delays.

Implemented in January 2010, the QuickStart program brings together technological advances in software with clinical expertise to expedite scans, treatment planning and delivery of the first treatment, all within one day. It is now a treatment option offered to women with early-stage breast cancer.

For patients who experienced delays in their cancer journey prior to radiation therapy, having an expedited radiation therapy treatment process avoids potential negative impacts to their treatment outcomes.  The QuickStart program offers breast patients the same quality and effective RT treatment without the unnecessary waits. 

Patients may be referred to one of the radiation oncologists in the Breast Site Group either through the departmental referral process or by contacting one of the physicians directly.

Visit the QuickStart webpage to learn more about the program and how it benefits patients.

Radiation Oncology Lead
Anne Koch

Radiation Therapy Lead
Grace Lee

Team
Anthony Fyles
Jennifer Croke
Fei-Fei Liu
Kathy Han
Robert Dinniwell
Tatiana Conrad
Wilfred Levin

Coordinator
Anila Samji
Phone: 416 946 4501 ext. 3639
Email: breastreferrals@rmp.uhn.ca

 

Oligometastases Program

The Radiation Medicine Program is a major contributor to the multidisciplinary Princess Margaret Oligometastases Program and is dedicated to refining the optimal radiotherapeutic technique, patient selection and evaluation of long-term outcomes for the treatment of patients with oligometastases.

The technical and toxicity consideration for the treatment of oligometastases depends strongly on the site of metastases. The clinical relevance of aggressive treatment of oligometastases hinges on the natural history of the site of origin. The biological potential for sterilizing the metastases is a complex interaction between radiosensitivity, tumour burden, dose-limiting structures and biological dose.

The Oligometastases Group brings together expertise across clinical sites to provide the best opinions for our patients.

Radiation Oncology Program Lead

Rebecca Wong

Radiation Oncology Site Group Leads

Andrea Bezjak, Lung Metastases Lead
Laura Dawson, Liver Metastases Lead; Palliative Radiation Oncology Program (PROP) Lead
Normand Laperriere, Brain Metastases Lead (brainmetsclinic@rmp.uhn.on.ca)

Coordinator
Alannah Pyke
Phone: 416 946 2130

Patients can be referred by contacting the lead physician or the team coordinator.

 

Palliative Radiation Oncology Program

The Princess Margaret Palliative Radiation Oncology Program offers rapid turnaround for patients with a wide array of cancer-related symptoms, including tumour-related bleeding, that require palliative radiation treatment. The program aims to see and initiate treatment for patients within 48 hours of referral, more quickly if necessary.

Radiation therapy can palliate bleeding from many cancers such as lung, head and neck, esophagus, stomach, bladder, cervix, uterus, rectum, anal canal and subcutaneous masses (e.g. from highly vascular melanomas or renal cell cancers).

Radiation Site Group Lead
Laura Dawson 

Radiation Therapy Lead
Nareesa Ishmail

Team
Andrea Bezjak
Barbara-Ann Millar
Bernard Cummings
Jolie Ringash
Rebecca Wong
Wilfred Levin

Coordinator
Anila Samji​​
Phone: 416 946 2901
Email: PROPReferrals@rmp.uhn.ca

Patients can be referred by contacting the lead physician or the team coordinator. After-hours referrals can be readily obtained by contacting the radiation oncologist on call through the Princess Margaret switchboard at 416 946 2000.

 

Pediatric Radiation Therapy Program

Princess Margaret offers specialized, pediatric radiation for children with cancer. Our group treats children with Wilm’s tumour, brain tumours, neuroblastomas, leukemia, Hodgkin’s Disease and sarcomas.

We use radiation treatment for local control of the primary tumour, prophylactic radiation of the brain in patients with high-risk leukemia, radiation of the lungs in cases of lung metastases and total body irradiation in patients undergoing bone marrow transplants.

In some cases, radiation can provide improved outcomes for pediatric patients who might otherwise require radical surgery.

As a partner with the Hospital for Sick Children, Princess Margaret Hospital participates in numerous Children’s Oncology Group clinical and biologic trials. For more information, see Children's Oncology Group.   

Patients may be referred to one of the radiation oncologists in the Site Group either through the departmental referral process or by contacting one of the physicians directly.

Through our Patient Education program we offer a multi-media education program called Radiation for Kids. 

Radiation Site Group Lead
David Hodgson

Radiation Therapy Lead
Kimberly Lam

Team
Normand Laperriere
Tatiana Conrad

Coordinator
Chantel Credo
Phone: 416 946 2902

Patients may be referred by contacting the appropriate Site Group.

 

Brachytherapy Program

The Princess Margaret Brachytherapy Program delivers brachytherapy using a number of methods for both inpatients and outpatients. We can provide high-dose, slow continuous or intermittent/pulsed radiation. Slow continuous and intermittent/pulsed radiation require hospital admission, while high-dose rate techniques are done on an outpatient basis. 

Brachytherapy is most effective in cancers of the prostate, cervix and uterus, as well as in esophageal, lung and penile cancer. This very effective high-dose conformal radiation approach spares healthy tissue. 

The two primary methods for delivering brachytherapy are interstitial and intracavitary. Interstitial brachytherapy involves the implantation of radioactive sources directly into a tumour, usually in the form of needles, seeds or wires.

Intracavitary brachytherapy involves placing a small radiation source directly into a natural body cavity. This method is effective for delivering very localized radiation to small tumours that have not spread, or for delivering an additional dose of radiation to a small volume at high risk for recurrence.

 

Stereotactic Radiation Therapy Program

Stereotactic radiation therapy is commonly used to manage cancers within the head and increasingly in other locations in the body, such as the spine, lungs and liver. It can offer an alternative to surgery where there may be a significant likelihood of morbidity with surgery. Stereotactic radiation is also useful in increasing tumour control rates for selected patients with metastases.

In addition to the ability to precisely deliver high-dose radiation to the tumour, this type of radiation significantly spares normal tissues, significantly reducing the likelihood of acute or long-term effects.

 

Gamma Knife Radiosurgery

Gamma knife radiosurgery is a sophisticated radiation tool known worldwide for its precise treatment to targeted areas of the brain.

In a single treatment session, 201 beams of gamma radiation can focus with a precision of less than 1 mm. The exposure is brief and only the tissue being treated receives the radiation dose, while the surrounding tissue remains unharmed.

Since gamma knife radiosurgery is performed without incisions or general anesthesia, many of the usual risks associated with conventional neurosurgery, such as neurological deficit, infection and bleeding, are reduced.

Patients are discharged from the Gamma Knife Centre on the day of treatment and are usually able to return to their normal activities within 72 hours.

 

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Last reviewed: 8/24/2015
Last modified: 5/24/2017 6:44 AM