Radiation Oncology Unit

The mission of the Unit is to care for patients affected by solid or hematological tumors in adults and children who require radiotherapy treatments for curative or palliative purposes, within shared multidisciplinary pathways of diagnosis and care (PDTA).

Radiotherapy is a Specialized Unit belonging to the Department of Diagnostic Imaging and Radiotherapy. It includes the following Simple Structures:

• Radiotherapy for Breast Tumors

• Radiotherapy for Genitourinary Tumors

• Radiotherapy for Pediatric Tumors

The following tumors are treated within the Structure:

• breast tumors

• tumors of the genitourinary system

• tumors of the digestive system

• lung tumors

• hematological neoplasms

• soft tissue sarcomas

• pediatric tumors

• tumors of the gynecological district

• tumors of the head and neck district

• ocular tumors

• skin neoplasms

• all secondary presentations of the above mentioned neoplasms.

At the S.C. Radiotherapy, thanks to a constantly updated technological endowment, the most modern radiotherapy treatment technologies are used, such as stereotactic treatments or multi-arc intensity-modulated treatments with respiratory control, within various programs, ranging from patients with metastases to adjuvant treatments requiring cardio-protection. Chemotherapy/immunotherapy-radiotherapy combination programs are also active, sometimes associated with surgical treatments, and in some cases within experimental studies.

Additionally, a stereotactic radiotherapy program for metastatic sites is active, including the brain, liver, lung, adrenal glands, abdominal lymph nodes, and bone sites, in patients with various neoplasms.

In addition to treatments performed with linear accelerators, brachytherapy is performed, primarily for gynecological patients, a technique that uses sealed radioactive sources (Iridium 192) that are carefully placed for a predetermined period of time, in contact with or in close proximity to the lesions to be treated. Depending on the treatment site and the methods used to position the radioactive sources, the following are performed:

• interstitial brachytherapy;

• intracavitary brachytherapy;

• endoluminal brachytherapy.

For melanomas of the ocular district and for secondary lesions of the ophthalmic district, brachytherapy with Ruthenium 106 plaques is performed in close collaboration with the Ocular Oncology Structure.

The activities of the S.C. Radiotherapy are organized as follows:

• initial outpatient visits for external patients (clinical evaluation, interview with the patient, informed consent), in the National Health Service (SSN) and in private practice

• consultation activities and initial visits for internal patients (hospital wards and day hospital)

• visits during radiotherapy treatment

• follow-up visits

• specific procedures related to RT treatment (image acquisition, fusion, contouring, treatment plan evaluation, therapy initiation) in collaboration with Technical, Nursing, and Medical Physics staff. These procedures can also be performed in a private practice setting.

The diagnostic and treatment pathways for various pathologies are shared during weekly multidisciplinary visits and/or collegial case discussions among the involved specialists (surgeons, radiation oncologists, medical oncologists, pathologists, radiologists, pain therapists, etc.). Further sharing of indications and treatment choices for more complex clinical situations takes place in meetings among the radiation oncologists affiliated with the structure.

In the inpatient department, patients are admitted for the management of systemic treatments concurrent with Radiotherapy.