Radiation Oncology Services

The Cancer Center at UW Academic Medical Center is proud to consistently rank as one of the leading cancer care facilities in the nation. Radiation oncology services represent one aspect of the multi-disciplinary approach provided to patients for comprehensive cancer care within the University of Washington system.

Intensity-modulated radiation therapy, high-dose rate radiation, neutron therapy, coronary artery brachytherapy, 3-D conformal treatment, and stereotactic radiosurgery are just a few of the specialized radiation treatment modalities offered at UWAMC, Harborview Medical Center, and the Seattle Cancer Care Alliance.

Intensity-modulated radiation therapy (IMRT) is a unique tool that allows radiation oncologists and physicists to shape and control the intensity of a radiation beam to conform it to a tumor's shape, thus protecting healthy surrounding tissues.

High-dose rate radiation is used for gynecologic, gastrointestinal, lung, and recurrent cancers and is a standard care practice that UWAMC helped establish. UWAMC has a strong record of using concurrent chemo/radiation therapy with good results for tongue and other head and neck cancers. In the case of high-grade soft tissue sarcomas, for new or recurrent lesions, the newest protocol combines adjuvant chemotherapy with surgery, radiation, and final chemotherapy treatment. It is believed that chemotherapy improves outcomes for tumor removal. Working with the radiation oncology team, Dr. Janet Eary, UW professor of nuclear medicine, uses Positron Emission Tomography (PET) to watch the response to chemotherapy treatments, especially with concurrent chemo/radiation used for inoperable tumors.

The cyclotron used for our neutron therapy program has proven to be more reliable than most linear accelerators used for X-ray therapy. Most patients treated at our facility have salivary gland tumors and come to the UW from all over the world for therapy. New control software and hardware for the isocentric treatment unit, that was completed in July 1999, makes our system even more reliable. At the present time, there are only two other operating neutron radiotherapy centers in the United States. The UW facility is the only one with a computer-controlled, multileaf collimator for field shaping and is capable of the same degree of technical sophistication as the most modern X-ray units.

Brachytherapy is one method of transmission for high-dose rate radiation which can be delivered via temporary or permanent implants and in conjunction with surgery, especially in recurrent disease. Radioactive seeds are implanted in tumors to reduce the tumors' size and kill them altogether.

Typically used in prostate cancer and other encapsulated tumors, brachytherapy is now being used investigationally in some breast cancers. It is also being used for patients with coronary artery disease experiencing instent restenosis. Coronary artery disease treated with angioplasty and stents has a 20 to 25 percent occurrence of reocclusion. The Food and Drug Administration (FDA) licensed this therapy for this use to reduce the rate of restenosis even further. With brachytherapy, there is a 50 percent reduction for a second reocclusion occurrence. There is some evidence that coronary brachytherapy will be effective for new lesions, but studies are not as conclusive and this approach is not yet approved by the FDA for this purpose.

3-D conformal treatment, pioneered at the UW, uses state-of-the-art equipment to exactly target local and regional disease. This treatment is used on virtually all cancer patients. Patients are first treated broadly, to include adjacent tissue and lymph nodes. Then the focus is targeted to post-operative areas at the highest risk for recurrence. Computed tomography (CT) scans are taken and specific software is used to determine the final beam direction.

Stereotactic radiosurgery services have revolutionized the treatment of human brain disease.

The UW Gamma Knife Center, located at Harborview Medical Center, is one of the first sites in the world to have received the latest version of the Gamma Knife--the C model.

Magnetic resonance imaging (MRI) or CT scans are used to compute the location of the lesion. A single high-dose rate of radiation is delivered via 201 separate sources focused on one point to the site in a manner that is very patient-friendly and with a miniscule margin of error.

On average, the Gamma Knife corrects arterial venous malformations 60 to 90 percent of the time and delivers a control rate for brain metastases of 70 to 90 percent.

In 2000, the University's complement of radiation oncology services expanded to include the Seattle Cancer Care Alliance. Combining expert cancer research and health care, the Fred Hutchinson Cancer Research Center, University of Washington, and Children's Hospital & Regional Medical Center now serve the public through an outpatient clinical center located in Seattle's Eastlake neighborhood. Radiation oncology services are also provided at Overlake Medical Center.