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Intensity Modulated Radiotherapy
Intensity Modulated Radiation Therapy (IMRT) is an advanced mode of high-precision radiotherapy that utilises computer-controlled x-ray to deliver precise radiation doses to a malignant tumour or specific areas within the tumour.

The radiation dose is designed to conform to the three-dimensional (3-D) shape of the tumour by controlling the intensity of the radiation beam to focus a higher radiation dose to the tumour while minimising radiation exposure of the surrounding normal tissues. IMRT also has the capability of ‘dose-painting’, a technique where different doses can be delivered to different parts of the treated volume. IMRT is especially useful in treating head and neck cancers.

Stereotactic Radiosurgery (Gamma-Knife and X-Knife)
Radiosurgery refers to the use of small parallel beams of ionising radiation to surgically remove intracranial lesions (brain injury/tumours) which were previously classified as "inoperable" or as an alternative to open microneurosurgery.

Radiosurgery offers a non-invasive alternative for many patients for whom traditional brain surgery is not an option and removes the physical trauma and majority of risks associated with conventional surgery.

This procedure has the advantage of requiring no hospitalisation or ICU stay, no general anaesthesia (except in young children), and an overall reduced treatment mortality (including no risk of haemorrhage or infection) for most indications compared to conventional open microneurosurgery. It is more cost-effective than open microneurosurgery.

Molecular Targeted Therapy
It refers to a group of drugs that specifically target cancer cells, leaving the other cells unharmed; hence they are regarded as "Magic Bullets". Since these drugs only target cancer cells, they are usually thought to be free of side effects. However, this is not true. There are different types of side effects, depending on the kind of drug taken. It is also important to note that every individual’s experience with side effects may differ.

Interventional Radiology
This plays a large role in treating hepatic (liver) malignancies that cannot be removed. It is important to stress that these treatments are palliative, and not for curative intent. There are two interventional techniques.

The first is transarterial chemoembolisation (TACE) which combines hepatic artery embolisation with simultaneous infusion of a concentrated dose of chemotherapeutic drugs. Embolisation deprives the tumour of blood supply and promotes tumour cell death.

The second is radiofrequency ablation (RFA) of liver tumours. RFA uses the principle of microwaves to generate heat within target tissue. It does not distinguish between tumour and normal tissue. The needle is placed into the lesion under imaging guidance. Both CT and ultrasound work well for this technique.

25 August 2009

This article first appeared on Let's Conquer Cancer, SingHealth Healthy Living Series 2006

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