What is a TrueBeam™ System?

Our Radiology Department has implemented the fully equipped most advanced high-precision radiotherapy device, TrueBeam™ STx, from Varian Medical Systems.TrueBeam™ STx is a device which emits radiation (X-ray and electron beam) and enables highly precise radiation therapy. The technology delivers an accurate and sufficient amount of radiation to tumors, while minimizing exposure to the surrounding healthy tissues.

Features of TrueBeam™

Multileaf Collimator

The maximum size of 40 x 22㎠ of radiation field can be set with TrueBeam™ STx.Furthermore, there are 32 pairs of 2.5mm multileaf collimator in the central part, and 28 pairs of 5mm multileaf collimator in the surrounding parts. This structure enables to create a radiation field that highly fits the size and shape of the tumor or target organs.

Image-Guided Technologies

As radiation therapy can be carried out with high precision, improving the positional accuracy becomes an important issue.Our radiation therapy device has been equipped with various technologies to solve this important issues.

ExacTrac Xray System

ExacTrac Xray system takes images by two X-ray equipments which are embedded on the floor. It instantly calculates the misregistration between the calculated position of the patient and the actual position, and then corrects the positional displacement.

On Board Imager

Built-in X-ray equipment in the body of the radiation therapy device takes images from various directions.Furthermore, Cone Beam CT, which utilizes On Board Imager technology, allows you to see the condition of not only the bone structures, but also the soft tissues of patients while keeping them on the radiotherapy couch.

What is Radiation Therapy?

Radiation Therapy is one of the methods of cancer treatment. Along with surgery and chemotherapy, an anti-cancer agent, radiation therapy is one of the key treatments for cancer.Compared to surgery, radiation therapy is less invasive. Thus, it can be used with patients whom would have difficulties undergoing surgery due to lower physical strength caused by aging or other complications.
Depending on a patient's physical condition, types of cancer, and progression of cancer, radiation therapy can be used for many purposes. For example, aiming to cure the cancer completely or to ease the symptoms.There are two types of radiation therapy: External and Internal. A high energy radiation beam is applied from the outside of the body in External Radiation Therapy, while radioactive sources are implanted to the affected areas in the Internal Radiation Therapy. Our hospital utilizes External Radiation Therapy.

What Kind of Conditions Can TrueBeam™ Treat?

TrueBeam™ can treat various cancers including lung cancer, breast cancer, esophageal cancer, uterine cancer, and prostate cancer. Furthermore, it can treat metastatic tumors, such as brain and bone metastasis.

Stereotactic Radiation Therapy

Stereotactic Radiation Therapy is one of the high-precision radiotherapy using TrueBeam™ STx. It is also called pinpoint radiation. By delivering radiation beam from various directions to the affected area, it can increase the effect of radiation to the area while reducing the delivery of the radiation beam to the surrounding healthy tissues. The technique of reducing the delivery of radiation to the surrounding area by irradiating from various directions has been used with other regular radiation therapy. However, in the Stereostactic Radiation Therapy, radiation beams are delivered from many more directions compared to the other regular radiation therapy.Unlike Gamma Knife, treatment using Stereotactic Radiation Therapy to the head, with TrueBeam™ STx, do not utilize metallic stereotactic frame and pins to stabilize the cranial bone. It uses a plastic mask, called a shell, to stabilize the head. Therefore, patients experience less pain and it enables them to receive the treatment more frequently.

Our hospital implements Stereotactic Radiotherapy which treats intracranial tumors (metastatic brain tumor, meningioma and acoustic neuroma) and Stereotactic Body Radiotherapy which treats other parts of the body.Lung and liver tumors with the following conditions can be treated with Stereotactic Body Radiotherapy.

• Primary cancer with the size of less than 5 cm and with no metastasis.
• Metastatic cancer with the size of less than 5 cm and with less than 3 parts of metastasis. Also has no metastasis to other parts of the body.

However, we will make a final judgement of whether implementing this treatment or not according to patient's condition, medical history, respiratory function and liver function.

Example of Stereotactic Radiotherapy to metastatic brain tumors

Treatment Preparation

1. Reservation

   Consulting our Radiology Department requires referral from other hospitals or other departments in our hospital.Patients from outside the hospital can make reservations through the Medical and Nursing Collaboration Office. Patients whom are seeing doctors from other departments can make reservation consulting their department.

2. Reception

   Please visit the hospital Reception Counter on the day of your reservation.

3. First Visit
   1. We will judge whether the patients can receive our radiation therapy according to the examination data and interview. Patients may be asked to take additional examinations depending on circumstances.
   2. We will explain the objectives, expected results and side effects of radiation therapy. We will also give explanations regarding the preparation and duration of the treatment.
   3. Once we acquire the agreement for the treatment, we will give information regarding the date for the Treatment Planning Simulation and starting the actual treatment.
4. Treatment Planning Simulation
   1. It is very important to keep the same posture/position during every treatment. Therefore, we will make a personal immobilization device if necessary.
   2. We will prepare for the treatment and take CT scans. At this time, the patient's skin will be marked. This mark will be important when adjusting the position of the patient during the treatment, therefore, please do not erase the mark until the treatment is finished.
   3. The said process above is called “Treatment Planning Simulation”.
   4. After the simulation, we will explain treatment schedules and instructions on the preparation.
5. Treatment Planning

   Based on the CT images obtained during the process of the Treatment Planning Simulation and with other data from image diagnosis and pathological diagnosis, we will use a treatment planning computer to find out the best treatment method.
   This planning process can take from a few days to about 2 weeks depending on the complication of the treatment.

6. Starting Treatment
   1. We check to see if there have been any changes or problems with the patient's health from the day of the Treatment Planning Simulation to the first treatment.
   2. We will start the treatment. During the treatment, a large device will rotate around the patient's body. Or the bed where the patient is lying down may move to adjust position, but please note that patients should not feel any pain or heat.
   3. The first treatment may take from 20 - 30 min to an hour.
   4. Treatments given from the next day usually takes less time.
   5. The duration of the treatment vary depending on the type and condition of cancer, however, it usually takes 2-8 weeks. The duration is set depending on the type and the location of the tumor. Longer durations do not mean the patient is in a serious condition. Treatment will be given everyday except for Saturdays, Sundays and national holidays.

Life During Treatment

1. Patients can have regular daily life during treatment.
2. Nurses will give patients detailed instructions on how to spend life during treatment.
3. If patients are undergoing radiation therapy for a long period of time, their body might get tired easily. Therefore, patients should take plenty of rest and try to keep their regular daily routines.
4. Patients might experience side effects of radiation therapy. Please listen to the doctor's and nurse's explanations carefully and try to understand how to ease the symptoms of side effects.
5. There is no dietary restrictions. However, some patients experience difficulties consuming food due to side effects. Please consult your doctor or nurses if you experience such symptoms.
6. There is no restrictions on bathing. However please ask your doctor or nurses before taking a bath.

Safety Management

Since Suita Tokushukai Hospital has implemented the most advanced radiotherapy device, TrueBeam™ STx, sophisticated expertise is required to operate and manage it.In order to prevent medical accidents from occurring, quality control and safety management are thoroughly upheld. The Radiology Department works extremely hard to share information and analyze data.Our staff continuously makes effort to improve themselves by studying about highly precise radiotherapy technologies. They strive to perform quality assurance and quality control of medical equipments and devices.

About Departments that Implement Treatment with TrueBeam™

*The following departments offer treatments with TrueBeam™

Radiology Department