The main goal of the centre is to provide the patients with timely access to effective, evidence based, technologically innovative and safe radiotherapy.
Radiotherapy centre belongs to the Oncology-Haematology Clinic
Radiotherapy treatment at our centre was stared 65 years ago, most of that time the patients were treated in Estonian Cancer Centre at Hiiu. In 2011 we have moved to a new premises in Mustamäe, which allowed us to expand our treatment capabilities.
Radiotherapy team consists of radiation oncologists, radiologist, medical physicists (3 with PhD degree), dosimetrists, radiology and radiotherapy technologists, nurses, supportive care personnel and engineers.
Radiation oncologists are taking part in all tumour board meetings and also consult the patients requiring radiotherapy from East Tallinn - and West Tallinn Central Hospitals, Tallinn Children’s Hospital and other hospitals in Estonia.
What is radiotherapy?
Radiotherapy uses ionising radiation to treat malignant tumours. Radiotherapy is one of the three major treatment modalities for cancer treatment along with surgery and chemotherapy.
Radiotherapy could be applied with different intent – curative, adjuvant or palliative.
Radiotherapy is divided into external beam radiotherapy and brachytherapy.
External beam radiotherapy is mostly done nowadays with photons and electrons from a linear accelerators according to the previously created treatment plan, which directs the radiation beams from outside the patient to the tumour.
Brachytherapy uses radioactive source to be placed in the tumour or in the close vicinity of it using different applicators to destroy the cancer cells.
Structure of radiotherapy centre:
- Department of radiotherapy procedures is located at the basement of X-building in Mustamäel and consist of:
Radiotherapy treatment planning unit
External beam unit
Brachytherapy unit
- Medical Physics Service
- I radiotherapy inpatient ward at XII floor at Mustamäe
- II radiotherapy inpatient ward at Hiiu
Concomitant chemo-radiotherapy is performed in chemotherapy day care unit and II chemotherapy inpatient ward at XII floor.
The main focus of radiotherapy centre is treatment quality. In 2009 IAEA/QUATRO comprehensive external audit’s conclusion was that the radiotherapy centre operates at the level of competence centre.
Personnel of the centre takes part in the international clinical and research studies, participates in scientific meetings and makes publications in international journals.
Equipment:
Radiotherapy centre has a large bore computed tomography (CT) scanner for radiotherapy planning (GE LightSpeed RT16). For external beam planning also magnet resonance imaging (MRI) and positron-emission tomography (PET-CT) is used. For external beam treatment delivery „Varian Medical Systems“ linear accelerators are used with multileaf collimators (MLC 80 & 120) and MV/kV on board imaging system (OBI). OBI is capable of performing cone beam computed tomography (CBCT), which helps to localise tumour and normal tissues in 3D during radiotherapy.
24 channels Gammamed Plus (Varian Medical Systems) brachytherapy device is used for various intracavitary and interstitial applications. For brachytherapy planning different imaging modalities such as X-ray, CT, US and MRI are used.
Following procedures are performed at radiotherapy centre:
Radiotherapy is performed for different malignant tumours in accordance with international guidelines. There is a specialized radiation oncologist for every tumour site.
- 3D conformal external beam radiotherapy (3D-CRT)
- Intensity modulated radiotherapy (IMRT)
- Volumetrically modulated arc therapy (VMAT)
- Image guided radiotherapy (with implantable fiducial markers if needed) (IGRT)
- Concomitant chemo-radiotherapy and radiotherapy with targeted molecules
- Brachytherapy for gynaecological cancers
- Interstitial brachytherapy with permanent radioactive seeds (I-125) for prostate cancer
- Primary and consecutive appointments of cancer patients to radiation oncologists
- Follow-up visits
- Visits during treatment to manage radiotherapy associated acute toxicity
Training
Personnel have received regular training in different European institutions.
Since 2004 we are participating in the training of radiation technologists together with Tartu Healthcare College.
Since 2011 together with Tartu Healthcare College we have started radiotherapy technologist’s specialisation training. We provide the training to physicists and biomedical engineers in the field of radiotherapy for Tallinn Technical University, University of Tartu and Clinics of Tartu University.
Centre have active oncology residency programme.
Collaboration
- International Atomic Energy Agency (IAEA)
- Most of the personnel are members of European Society of Therapeutic Radiation Oncology (ESTRO)
- Estonian Cancer Society
- Tartu Healthcare College
- Tallinn Technical University, University of Tartu, Clinics of Tartu University, Tallinn Central Hospitals
- Tartu University Hospital, Central Hospitals in Tallinn
