Oncology in Korea
– The centers of Korean hospitals consist of specialized teams of esophageal cancer, stomach cancer, colon cancer, breast cancer, lung cancer, head and neck cancer, women’s cancer, cancer on urinary organs, blood cancer, pancreatic and biliary cancer, skin cancer, sarcoma and brain tumor.
– Based on a patient-oriented, multidisciplinary consultation system, they provide early diagnosis and timely treatments (surgery, chemotherapy, and radiation therapy). All specialists at the Cancer Center work as a team to provide accurate diagnosis and comprehensive treatment for the patients for optimum results.
– Korean doctors are committed to improving the diagnosis and treatment of adult patients with cancer in order to provide the highest standards of comprehensive care and treatment, working closely with many research centers. They also devote themselves to educating the next generation of medical oncologists and investigators through various training and research programs.
– The goal of the Department of Oncology is to provide their cancer patients with ‘optimum treatment for maximum outcome and minimum pain.’ To meet this goal, Korean surgeons engage in a broad range of not only compassionate and comprehensive care, but also cutting-edge basic, translational and clinical research.
Radiation therapy is one of the three major therapeutic option for cancers along with surgery and chemotherapy. The Korean staff ensures that each patient receives the best care for his/her particular cancer through close examination of the patient’s condition, and provides optimal treatment in close consultation with colleagues from pertinent departments. And they provide not only conventional treatments but also the current state-of-the-art treatments. Using the image-guided radiation therapy (IGRT) technology, Korean hospitals provide the respiration-gated radiation therapy, stereotactic body radiation therapy (SBRT), intensity-modulated radiation therapy (IMRT) and image-guided brachytherapy. Since the beginning of radiation therapy in Korea, the number of annually treated patients have increased dramatically.
It is crucial to ensure the quality of radiation therapy. The Departments of Radiation Oncology of Korea has been enrolled in the “Annual TLD Audit Program”, which is a part of the credentialing programs to assure the National Cancer Institute (NCI) and the cooperative groups in the United States the accuracy of radiation therapy. This auditing program has been conducted by ‘Radiological Physics Center’ of the MD Anderson Cancer Center at the University of Texas. Since the beginning of the enrollment, the accuracy of their auditing has been within 3% of deviation, which is an excellent result. This is a one-of-a-kind activity performed in Korea. All members of the Department of Radiation Oncology of Korea are determined to continue delivering the highest standards of quality control of our radiation therapy.
Image Guided Radiation Therapy (IGRT)
The radiation therapy is usually administered over several fractions to ensure the biological effect is maximized. Therefore, it is extremely important that radiation is projected on the same spot every time. The image-guided radiation therapy (IGRT) utilizes multiple medical image elements to minimize errors in radiation therapy. Korean hospitals use several images including CT, MRI and PETCT to ensure that the target volume determination is done appropriately. In addition, they use On-Board Imager (OBI) system, Exac Trac X-ray 6D system, Vision RT system and Real-time Position Management (RPM) system.
Stereotactic Body Radiation Therapy (SBRT)
Stereotactic Body Radiation Therapy (SBRT) was developed to focus regional radiation therapy to all part of the body. The three-dimensional coordinate system accurately finds the radiation targets and high-dose radiation is delivered to the targets. The SBRT system is considered extremely convenient and at the same time, safe and efficacious; as treatment sessions are reduced to less than 5 times, while guaranteeing a high success rate with reduced side effects; killing 3 birds with one stone. This treatment is as effective as surgery and it can be done on an outpatient basis. Korean hospitals have the Novalis TX system dedicated to the SBRT. The small size tumors of the lung, liver and spine are the best candidate for this novel treatment.
Intensity Modulated Radiation Therapy (IMRT) – based on Multi-static, Helical Tomotherapy, and Arc Therapy
Intensity modulated radiation therapy (IMRT) is customized three-dimensional conformal radiation therapy. To focus high doses of radiation to the tumor tissues without affecting the normal tissues, IMRT subdivides each radiation field into several dozens and modulates the intensity of radiation applied to each subdivision. IMRT has proven to be effective for cancers around the head and the neck, prostate cancers and re-treatment by radiation according to results attained from investigations on various parts of the body. In addition to the multi-static IMRT using a linear accelerator (LINAC), the Korean hospitals have used Helical Tomotherapy system and a dedicated RapidArc system for IMRT.
Four-dimensional Respiration-Gated Radiation Therapy
The tumor in the lung or liver is difficult to treat with radiation because they move as we breathe. To treat this kind of moving tumor, Korean surgeons need to have the patient breathe regularly and take the four-dimensional computed tomography (CT) scans. With four-dimensional CT, Korean surgeons determine the patient-specific movement of the tumor while breathing and make the treatment planning customized to the patient’s breathing. Before and during the radiotherapy every day, the location of the tumor is confirmed using On-Board Imager (OBI) snapshot images and its X-ray fluoroscopy. In that department, the Varian iX and Novalis TX, dedicated four-dimensional equipments that are equipped with four-dimensional CT simulator, On-Board Imager (OBI) system, Real-time Position Management (RPM) system, Exac Trac X-ray 6D system and Vision RT system, are used for 4-dimentional respiration-gated radiation therapy.
Proton Beam Therapy
The proton beam therapy device is called ‘the cancer-zapping radiotherapy device beyond reality’ as the proton beam delivers its maximum energy on the tumor tissue and immediately disappears outside the tumor without affecting normal tissues. The proton beam therapy can be applied to all kinds of cancers that can be indicated by conventional x-ray treatments-except the fact that its effectiveness and rarity of side effects exceeds the conventional x-ray treatment by a mile. In the proton beam therapy center, many state-of-the-art technologies such as respiratory-gated proton therapy system, Intensity-Modulated Proton Therapy (IMPT) system, and gantry mounted Cone Beam CT (CBCT) system are installed. The patients with cancer or tumor can be treated by proton therapy only in Korea, because only Korean hospitals have proton beam therapy facilities in Asia. So they are often referred to by the industry as the “cancer-zapping radiotherapy device beyond reality” and they will become the world’s hub of cancer treatment.