Technology and Treatment

Our department currently boasts three Varian TrueBeam linear accelerators equipped with OBI, advanced imaging packages, RapidArc, Optical surface monitoring systems (OSMS), RPM, PerfectPitch 6DOF couch tops and HDMLC.

The TrueBeam system is an advanced technology providing enhanced imaging capabilities and many forms of external beam radiation therapy used to treat various types of cancerous and noncancerous tumors in the head, neck and throughout the body. These include image-guided radiation therapy (IGRT) and intensity-modulated radiation therapy (IMRT). With similar features and capabilities as TrueBeam, the TrueBeam STx also offers stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT). This is a specialized type of treatment in which high-dose radiation is delivered to targeted locations in a patient’s body in five or fewer treatments.

Both technologies have advanced imaging features that allow physicians to pinpoint a patient’s tumor and shape the system’s radiation beams to match the size and shape of the tumor. This precision and accuracy allows physicians to tailor treatments to each patient’s particular cancer and may result in fewer overall side effects.

During TrueBeam treatment sessions, you lie on a treatment table while the machine rotates around you, delivering targeted radiation from various angles. By delivering high-dose radiation beams that match the shape of the tumor being treated, TrueBeam also significantly reduces treatment time. A typical session takes about 15 minutes, reducing potential errors that can occur in longer-lasting procedures. Most patients go home right after treatment and immediately resume normal activities. There may be side effects, such as fatigue, but these are usually minor and temporary.

Key advantages of TrueBeam:

• Treatment is an outpatient procedure, painless and noninvasive.
• Extreme precision minimizes radiation damage to normal tissue.
• Beam shaping offers highly accurate and uniform treatment.
• Short treatment times – about 15 minutes – eliminate errors from minor patient movements during longer treatments.
• Patients return immediately to normal routines with minimal side effects.
• No overnight hospital stay required.

One of only two in South Carolina, the Leksell Gamma Knife® Perfexion is a high precision neurosurgical tool that utilizes 192 radioactive Cobalt sources to deliver radiation to intracranial targets in single and multi-fraction applications. It is considered the gold standard for non-invasive management of benign and malignant brain tumors, vascular malformations and other abnormalities of the head and neck areas.

Our team of physicians and physicists helped bring radiosurgery to South Carolina more than 20 years ago. As a joint partnership between MUSC Health Radiation Oncology and Neurosurgery, our Gamma Knife Center performs approximately 300 Gamma Knife radiosurgeries per year and is one of the largest Gamma Knife facilities in the country. Our extensive experience results in better outcomes for our patients and our team approach streamlines the process of evaluating each patient’s options, so that the most appropriate course of treatment can be developed and initiated without unnecessary delay, confusion or anxiety. This system represents our continuing commitment to offer patients the latest options in radiosurgery.

This is the newest development in helical tomotherapy systems. Most conventional radiation therapy machines use five to nine beam angles, and were developed for 2D and 3D conformal therapy. The Radixact Treatment System delivers radiation continuously from all angles around the patient, and features patented beam-shaping technology created specifically for intensity-modulated radiation therapy (IMRT). More beam angles, plus more precise beam modulation, creates dose distributions that conform to complex tumor shapes.

Helical delivery is an excellent treatment option for exceptionally long treatment volumes, such as extended field pelvic radiation and craniospinal irradiation. It is capable of treating these volumes with straight forward single-setups that would usually require patient-repositioning and repeat setup-imaging for a standard linear accelerator. It also serves as an excellent treatment alternative for re-irradiation of head and neck lesions as it allows for treatment of targets that are in close proximity to an organ of risk, while sparing much of the dose to the at-risk structure. The Radixact system has faster treatment delivery and imaging, vastly increased planning and evaluation capabilities, and increased couch stability compared to the older tomotherapy units.

These allow for quantitative iodine and virtual non-contrast imaging, metal artifact reduction for improved contouring and much more. DECT is a rapidly evolving technology with the potential for many new applications in the near future.

MUSC is a high-volume center for both MR-guided HDR gynecologic brachytherapy and LDR prostate brachytherapy. Our knowledgeable team of dedicated physicians, physicists, therapists and nurses, coupled with our extensive experience with challenging cases has earned us a place as the referral center for brachytherapy in the state of South Carolina. As a result, we continue to see yearly growth in this area.

Our prostate program has pioneered a technique for building custom linked seeds in the operating room and has recently adapted the technique to the use of Cs-131 seeds. Our gynecologic brachytherapy program utilizes an Elekta Flexitron brachytherapy delivery system and can perform a variety of implants utilizing various applicators including the Venezia advanced gynecological applicator, the Utrecht interstitial CT/MR applicator, the interstitial ring CT/MR applicator, Syed templates, dual tandem implants and the vaginal CT/MR multi-channel applicators.

We also perform HDR brachytherapy for a variety of rarer applications including soft tissue sarcomas, endobronchial lesions, esophageal cancer and benign and malignant skin conditions. In addition, MUSC has a thriving LDR eye plaque brachytherapy program.

For more than 30 years, MUSC Hollings Cancer Center has been South Carolina's leader in blood and marrow transplantation. We are the only combined adult and pediatric FACT (Foundation for Accreditation of Cellular Therapy) accredited Blood and Marrow Transplant (BMT) Program in the state. According to the most recent national multi-variate report (which includes the years 2015-2017), MUSC achieved an overall survival rate of 81.1% for patients receiving first allogeneic transplants, above the national average of 72%. Only 10% of BMT programs nationally achieve an overall survival rate above the national average and only 3% (including MUSC) were combined centers. We offer Total Body Irradiation as part of conditioning regimens for bone marrow transplants at MUSC. TBI is currently performed on our Varian 600C unit.

Hollings is the only cancer center in South Carolina to offer total skin electron beam therapy to treat cutaneous T-cell lymphoma. Total skin electron beam therapy covers the entire skin surface with low-dose electron beam radiation to reduce the skin patches and plaques caused by cutaneous T-cell lymphoma. The radiation penetrates only 1-2 millimeters below the skin, so organs are not affected, but the cancer cells will die off.

The Department of Radiation Oncology boasts a Precision X-Ray X-Rad 320 small animal irradiator that is used for translational research.

• IBA
• Blue Phantom 2
• Blue Phantom Helix
• Sun Nuclear
• MapCheck 2
• Daily QA3
• Tomodose
• 1D Scanner with PC electrometer
• ArcCheck
• Landauer MicroStar OSL system 2
• Mobius DOSELAB, Mobius3D, MobiusFX
• Various ion chambers, diodes, electrometers
• MUCheck

• Varian Eclipse with RapidPlan
• Varian ARIA
• RayStation Treatment Planning for RadiXact
• Elekta GammaPlan
• Velocity Al
• Elekta Oncentra brachytherapy
• Varian Variseed