In this presentation we have tried to show how we are working at our centre. we are also showing out data collected at our centre in last one year.

1. Dr S.S. Solanki MD (Radiation Oncology )
Consultant , Radiation Oncology
“BA” Lilaben Chimanlal Parikh Cancer Centre,
Navsari , Gujrat

2. Topic for this presentation
 Facilities at Ba cancer Centre
 Self developed “Electronic Medical Record System”
 How we practice Radiation therapy- Immobilization,
planning and plan execution.
 Systematic review of Patients treated in year 2011.

3. Facilities to offer
 At Present
Diagnostic- CT Scan, X Ray facility, USG
Laboratory- Simple lab test
Therapeutic- Radiation Oncology including
External Beam Radiotherapy (IMRT and 3D CRT) and
Brachytherapy.
 Future Proposal
Chemotherapy unit, Surgical unit, Image Guided
Radiotherapy.

4. CT scan
Simens’ Somatom Sprit Dual slice

5. Data of CT Scans
Chart Title Total RT scans - 486
120 Total CT Diag. - 481
100 Total Brachy - 57
80
Total no of scans- 845
60
40
20
0
Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12
Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12
RT Scan 19 31 36 34 23 23 42 34 36 33 35 30 32 21 20 37
Daignostic Scan 36 32 64 70 35 24 30 28 35 25 29 18 19 16 7 13
Brachy Scan 0 0 0 5 5 2 7 3 9 2 7 3 2 4 6 2
Total Monthly Scan 55 63 100 109 63 49 79 65 80 60 71 51 53 41 33 52

6. Siemens Digital X ray unit
X ray

7. Ultrasonography unit

8. Data for X-ray and USG
Chart Title
70
Total X-Rays - 381
Total USG - 210
60
50
No. of scans
40
30
20
10
0
Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12
X-Ray 12 24 39 65 20 19 16 32 21 26 23 22 16 17 19 10
Sonogrphy 4 12 18 32 11 13 12 12 25 11 12 9 12 5 15 7

9. Laboratory services

10. No. of Pathological test done
200
180
160
140
120
Average
100
80
60
40 Total Pathological test done- 1696,
20
Avg Pathological test -106 per mth
0
Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 nav-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12
No of PathoTest 10 61 74 98 138 114 93 184 124 117 151 109 112 104 122 85

11. Therapeutic Units
 External Beam Radiotherapy. Linear Accelerator
from Varian Medical System (Clinac iX)
Total no patients treated till date –396
No of Patients on Radiotherapy -35
Total patients in planning process –16
Total =447
 Brachytherapy Unit (Nucleotron’s Microselectron)
Total no. of patients treated- 32
Total no. of session of Brachy- 92

12. External Beam Radiation Therapy unit
Head
Gantry
Couch

13. Bending magnate
Tungsten target Electron
gun
Beam flattening
device
Ion chamber
Asymmetrical
jaws
Multileaf
collimator
Electron
Acceleration
tube

14. Blue phantom –for measuring Beam parameters

15. Nucelotrons’ Microselectron Brachytherapy Unit

16. Brachytherapy instruments
Central Vaginal Source
Intracavitary Applicators

19. Data from Brachytherapy
No. of No of
Brachytherapy Patients fraction
CVS 23 66
ICRT 7 22
Intraluminal
Rectum 1 2
Esophageal 1 2
Total 32 92

20. Electronic Medical Record
 self developed excel sheets.

21. Electronic Medical Record

22. Electronic Medical Record

23. Electronic Medical Record

24. Case Sheet- Page 1 page 569
"BA" Smt L. C. Parikh Cancer Centre, Navsari,
Gujarat-396445
Date 25/04/2012 Reg.No. LCA1049 RT No.
Patient's Name Anarsingh Ratiramsingh Tevatia
Father/Husband's
Name Ratiramsingh Tevatia
Age & Sex 76 Years Male Birth Date.
Address Opp. Police head Quarter AbramaVAlsad
Religion Hindu Marital Status Married
Citizenship Indian Birth Country
Mobile self 9820134043 Passport No.
First Name of
Contact(Mobile) 9724902926 contact/Relationship
E-mail ID.
Reffered From Dr. Parimal Lad
Original Complaints :- Pt is K/ case of CA Past History :- No H/O HTN, DM
rectum Post op , new developed brain mets
First O/E - DR Parimal Lad - 24/03/2012, P/A - growth in rectum lower
Examination with margine in 3.5 - 4cm from anal verge, post wall margin high
Dig.
Previous CT Abdomen ( 17/03/2011) - 6-7cm of lower rectum shows
Investigations diffusecircumferential heterogeneous thickening max thickening - 17
done (Imaging) mm, paracolic infiltration with multipale Nodes.
Biopsy with Date Bx - 21/803/2011 => well diff adenocarcinoma
ICM Codes
(description)
Previous Sx - 26/03/2011 => Dr. Parimal Lad - abdomino perineal resection.
Treatment Per op - circumferential growth of lower rectum 3-5cm from anal
Recived. verge. Extending 5cm, adviced adjuvant EBRT + chemo. Pt had not
taken. In Apr 2012 C/O. severe headache walking difficulty, left side
weakness, MRI Brain - 11/04/2012 - multiple lung mets, tru cut
biopsy from lung - 21/04/2012 - metastatic adenocarcinoma.
Actual File EMR Sheet

25. Case Sheet page 2
Histopatho Report well diff adenocarcinoma recutam
with date :- Site tumor involve full thickness of wall to external fat
31/03/2011 Desai lab
Tumor
Surat
Size
Margin
Status cut margine free
Invasion LVI - 1
Nodal Examined 7/10 Level
Involvem Largest
ent (cm) ECE
Comment
s
Post
Present status treatment days
Present Complaints Present Examination :- GC stable pallor - ve, No neurological
deficiency, P/A soft colostomy by on left side abdomen.
Final Diagnosis Ca rectum with brain mets T3N2M0post op Stage IV
RT Decision palliative EBRT
Plan Dose/Site 30 Gy / 10 #
Planning Technique Conv
Time Period 2 weeks
Indications for
Radiation Therapy Brain metastasis
Expected Reaction Alopacia
Comments Advices :- to be taken for EBRT. CT Scan for RT
planning(27/04/2012) --> 3.6x2.2cm lesion in right high
frontal region with surrounding edema,. 1.7x1.6 cm nodular
lesion in right temporal region . S/O - metastasis.
Consent For RT Taken/Not Taken Dr Surendra Singh Solanki MD
Consultant, Radiation Oncology
Actual File EMR Sheet

26. Files on Desktop for Record
Files on Desktop for Record
Daily Backup of files into
hospital’s Gmail Account

27. OPD 2 All patients record
OPD 2 All patients record

28. RT list- Patient enrolled
RT list- Patient enrolled

29. Pt seen in OPD and RT enrolled
Avg new pts per month = 35.87 Range(64-21) Total 598
Chart Title
70
Avg new pts enrolled = 26.68 Range(37-18) Total 447
60
No of Patients
50
40
30
20
10
0
Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12May-12
Mar- May-
Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Apr-12
12 12
New Pt Seen in OPD 64 47 40 35 24 27 55 45 38 36 28 25 33 21 23 33 24
CT scan done for EBRT 19 29 34 30 18 22 37 31 32 30 24 19 29 20 19 34 20

30. 1st Step - Radiation planning
1st Step - Radiation planning
 CT scan + immobilization
 CT scan + immobilization

31. Good Immobilization Practice
 Immobilization is a team effort involving Radiation
technologist, CT technician, Nursing staff, ward boys
 Supervised by medical physicist and radiation
oncologist.

32. Good Immobilization Practice
Multiple hand support
Siemens’ Somatom Spirit
LAP LASERs
All in one Base plate

33. Good Immobilization Practice
Proper laser Alignment
Blue marking- CT marks
Red marking- treat marks at LA
Indexed Carbon Couch

34. Good Immobilization Practice
Self Designed Vac-Lok Support (by Amol) Vac-Lok for Pelvis and abdomen cases

35. 2nd Step- CT images in TPS
Treatment
planning
system

36. 3rd step Precise Target marking
and field Placement.
 Conventional Radiotherapy - square or rectangle
fields 2 or 3 fields
 3Dimentional Conformal Radiotherapy- MLC based
Multiple Fields to conform target
 IMRT- Intensity modulate during movement of MLCs
with 7-9 fields optimize the doses to target

37. Conventional Radiotherapy

38. Three Dimensional Conformal
Radiotherapy

40. Pain in wrist due to excessive
contouring

41. Pen Tablet- a good solution
Smooth
working
Faster speed in marking

42. Intensity Modulated Radiotherapy

44. 95 % of
PTV to
receive
100 %
of dose

45. Page 32
"BA" Smt L. C. Parikh Cancer Centre, Navsari, Gujarat-396445
Date of Reg. 01-12-2011Reg.No. LCA694 RT No. RT2011309
Patient's Name Nitinbhai Bhagubhai Patel Age/Sex 50 / M
Diagnosis Ca tongue T4N2MO
Treatment period From 14-12-2011To 25-01-2012Days
EBRT IMRT SIB/Phase treatment
PTVs Prescription Vol D95% D98% D2%
PTV1 6600cGy/30# 213 cc 6428 6366 6806
PTV2 6000cGy/30# 600.55 cc 5933 5841 6620
PTV3 5400cGy/30# 333 cc 5038 4935 5746
OAR Dose Prescription Dose tye Dose Achive approval comment
Spinal Cord <4500 Dmax 3828
Spinal Cord PRV <5000 Dmax 4409
Brain stem <5400 Dmax 4047
Brain stem PRV <6000 Dmax 4603
Parotid Lt <3000 Dmean 5138
Parotid Rt <3000 Dmean 4808
Larynx <4500 Dmean 5804
DARS <4500 Dmean
Trachea <4000 Dmean 4539
Esophagus <4000 Dmean 3910
Oral Cavity <4000 Dmean
Lips <4000 Dmean 3827
Buccal Mucosa <4000 Dmean
Mandible <6600 Dmax 6776
Middle ear Lt <3000 Dmean 2517
Middle Ear Rt <3000 Dmean 2995
Eye Lt <4000 Dmax 244
Eye Rt <4000 Dmax 464
eye Lens Lt <600 Dmax 228
Eye Lens Rt <600 Dmax 227
Optic chiasma <5400 Dmax 356
Brain <2000 Dmean 515
Optic Nerve Lt <5000 Dmax 358
Optic Nerve Rt <5000 Dmax 351
Parotid Sup Lt <2600 Dmean 3584
Parotid Sup Rt <2600 Dmean 2602

46. First Day –Set up Verification
 Marking on Orfit CT scan by blue pen= Set up origin
in 3 D coordinates(x=0,y=0,z=0)
 Field centre = Isocentre (new point in CT scan images)
 The shift from set up origin to isocentre is called
isocentre shift.
 After that shift we mark new point with red ink

47. Fiducial
Fiducial
User origin
X=0,
Y=0,
Z=0

48. Digitally Reconstructed
Y= -7.9 Radiograph
Z= 0.88 X= 0.18

49. Shift
y axis Blue ink marking
Shift Z axis
Red ink marking

50. EPID matching

51. Treatment Console
Machine Machine
Patients data
Computer Planner
Inside room
camera

52. Setup Verification With EPID
X rays passing
Electronic Portal
Imaging Device

53. Digitally reconstructed
Radiograph
Fusion of both images
EPID image

54. Quality Assurance of IMRT plan
 Im’RT MatriXX is unique solution to show us what ever
is planned at TPS is in reality executed by Linac

56. QA-IMRT by Im’RT MatriXX

58. Today's fraction/
Total fraction

59. Daily Patients on Linear Accelerator

60. Average No. of Patients on LA
30
0
35
40
45
5
50
10
20
15
25
Jan-11
Feb-11
Mar-11
Apr-11
May-11
Jun-11
Jul-11
Aug-11
Sep-11
Oct-11
Nov-11
Dec-11
Jan-12
Feb-12
Mar-12
Apr-12
Conv
IMRT
3DCRT
Diff. RT Practices + Avg Pt on LA
Palliative
Average pT

61. Average Patients on Linac
Avg Patient per month
Average No. of Patients on LA
50
40
30
20
10
0
Aug-11
Jan-12
Jul-11
Feb-12
Jan-11
Feb-11
Jun-11
Dec-11
Oct-11
Apr-12
Apr-11
Sep-11
Nov-11
Mar-12
May-12
Mar-11
May-11
Jan- Feb Mar Apr May Jun- Jul- Aug Sep Oct Nov Dec Jan- Feb Mar Apr May
11 -11 -11 -11 -11 11 11 -11 -11 -11 -11 -11 12 -12 -12 -12 -12
Avg Patient per month 4.6 22. 37. 36. 36. 36. 32. 44. 39. 44. 40. 34. 28. 31. 31. 28. 36

62. Side Effect analysis
 During weekly review patients in quantify for side
effects of radiation therapy and its recording.
 27 side effects are being investigated
 Also taking their picture of radiation side effects esp
skin

63. Side effect sheet
"BA" Smt L. C. Parikh Cancer Centre, Navsari, Gujarat-396445
Date 06-01-2012Reg.No. LCA772 RT No. RT2012374
Patient's Name Mohammadmustafa Mohammadkasim Khan
Father/Husband's Name Mohammadkasim Khan
Religion Muslim EBRT From 06-03-2012To
Citizenship Indian Dose
Region Face & Neck Diagnosis Ca left PFS T3N2M0
Adv.effects wk1(1-5#) wk2(6-10#) wk3(11-15#) wk4(16-20#) wk5(21-25#) wk6(26-30#)
Dates 7#15/03/2012 11#21/03/2012 16#28/03/2012 25#11/04/2012 29#18/04/2012
Malaise Gr- Gr-II Gr-I Gr-I Gr-I Gr-I
Fever Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Headache Gr- Gr-0 Gr-I Gr-I Gr-I Gr-0
Infection Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Pain Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Cough Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Skin reac. Gr- Gr-0 Gr-0 Gr-0 Gr-I Gr-0
Acne. rashes Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-I
Pruritis Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Sl Gl changes Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Taste alter. Gr- Gr-I Gr-I Gr-I Gr-I Gr-0
Mucositis Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-I
Dysphagia Gr- Gr-0 Gr-II Gr-II Gr-III Gr-III
Nausea Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
vomiting Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Constipation Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Diarrhea Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Anorexia Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Dyspepsia Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
weight loss Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Dehydration Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Haematuria Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
freq. of urine Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Hemoglobin Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
WBC Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
ANC Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Platelets Gr- Gr-0 Gr-0 Gr-0 Gr-0 Gr-0
Grading acc to CTCAE ver 4.0

64. Side effect Pictures

65. Tejus Beauty Cream
Excellent healing in Skin reaction
24th # EBRT 30th # EBRT

67. S.S. Solanki1 , M. Loganathan1, R. Swathika’ 1 ,Amol Palaskar1 ,
Boniface Chettri1 , Jyoti Pokale 1 , P.B. Lad2
1Department of Radiation Oncology,
2Department of Onco-Surgery,
“BA” Lilaben Chimanlal Parikh Cancer Centre, Navsari , Guj

68. Introduction
 Computerization of medical record of patients is one of
the key to access the information in least time.
 To keep patient’s data at par with good institutes, we use
our own self developed Electronic Medical Record
System in form of Microsoft’s Excel sheets in our day to
day activities.
 This study is being conducted to show how the medical
data is recorded and analyzed at our centre for the year
2011.

69. Objectives
 To find number of patients treated for curative and
palliative intent.
 To find how many patients completed radiation therapy
for their prescribed doses.
 To find present status of patients in terms of alive and lost
to follow up through record search and phone calls.
 To find overall survival in months for Radiotherapy in
year 2011.

70. Material and Methods:
In the year 2011, a total of 325 patients were enrolled for
Radiotherapy.
 All information about patients details were first written on case
sheet then typed on Microsoft’s excel sheet specially prepared for
medical records. (Fig 1& 2- excel sheet for data).
 Treatment decisions were taken to treat patient for radiation
therapy on clinical grounds for curative intent (radical, post op or
Adjuvant EBRT) or for palliative intent( bone metastasis, brain
metastasis, or haemostatic EBRT).
 All Patients were immobilized with Thermoplastic Cast (ORFIT
Industries) and CT scans done (Siemens' Emotion Sprit) for
planning purpose on flat indexed Carbon Couch (Civco) with help
of All in one Base plate (POCL). (Fig 3)

71. Material and Methods:
 Patients were planned on Eclipse treatment planning system
(version 8.9) (Fig. 4)
 All patients were treated on Varian’s Clinac iX Linear Accelerator
daily for 5 days a week. (Fig.5)
 Weekly OPD review for side effect analysis and adequate treatment
was offered for their problems. (Fig 6.)
All Patients were given treatment summary after their completion of
EBRT from the record.
Patients are advised to come on follow up every 2-4 monthly in first
year.

72. Material and Methods:
To find present status of patients , they were called on mobile
in the month of March and Apr 2012 and their status regarding
alive with disease free or with disease progression was noted.
The analysis was done only for those patients who have
completed radiotherapy as per prescribed doses.
The data was analyzed for treatment completion, overall
survival and average survival in alive.
For Overall survival months were found between date of
evaluation to date of registration.

73. Results-Major groups
Table 1. EBRT Data Survival Figures
Incomp Complete Complet Alive Median
No RT Alive Alive Lost to
Major Groups Enrolled lete d ed (dis. survival
started ( with dis.) (Total) Follow up
EBRT EBRT EBRT Free) (months)
288 8.35 (1.36-
Curative intent- 6 25 257 257 177 25 202 55
(88.61%) 14.63)
37 7.90 (3.60-
Palliative intent 1 1 35 35 0 12 12 23
(11.38%) 13.90)
325 7 26 292 292 177 214 8.32 (1.36- 78
Total 37 (12.67%)
(100%) (2.1%) (8%) (89.8%) (100%) (60.6%) (73.28%) 14.63) (26.7%)

74. Results- Curative Group
Table 2. EBRT Data Survival Figures
Curative Alive Alive Median
No RT Incomplete Completed Complete Alive Lost to
intent-Major Enrolled (dis. ( with survival
started EBRT EBRT d EBRT (Total) Follow up
Groups Free) dis.) (months)
14 9.80 (5.90 -
CNS Tumors 0 0 14 14 7 4 11 3
(4.86%) 14.13)
Head and Neck 8.16 (3.10 -
171 (59.37%) 0 18 153 153 103 10 113 40
Tumors 14.63)
Thoracic 11 7.88 (4.36 -
0 2 9 9 5 1 6 3
Tumors (3.81%) 10.53)
28 7.69 (1.36 -
Breast Tumors 2 0 26 26 25 1 26 0
(9.72%) 14.60)
6 7.61 (5.83 -
GI Tumors 0 2 4 4 4 0 4 0
(2.08%) 11.00)
Urinary Tract 3
0 0 3 3 1 0 1 12.03 1
Tumors (1.04%)
Male G.U. 3 4.86 (1.73 -
0 0 3 3 2 0 2 1
Tumors (1.04%) 8.00)
Gynecological 38 9.67 (2.93 -
3 1 34 34 20 8 28 6
Tumors (13.19%) 14.6)
Hematological 10 7.29 (3.73 -
0 2 8 8 7 1 8 0
and Lymphoma (3.47%) 11.36)
Sarcomas-Bone 2 10.56 (8.60 -
0 0 2 2 2 0 2 0
and Soft Tissue (0.69%) 12.53)
Pediatric 2
1 0 1 1 1 0 1 6.33 0
Tumors (0.69%)
288 6 25 257 257( 177 25 202 8.34 (1.36- 55
Total
(100%) (2.08%) (8.68%) (89.23%) 100%) (68.87%) (9.72%) (78.59%) 14.63) (21.2%)

75. Results-Palliative Group
Table 3. EBRT Data Survival Figures
Palliative
Incompl Complete Alive Median
intent - No RT Complete Alive Alive Lost to
Enrolled ete d (dis. survival
Major started d EBRT ( with dis.) (Total) Follow up
EBRT EBRT Free) (months)
Groups
Metastasis- 27 8.38 (3.60-
1 1 25 25 0 9 9 14
Bone (72.97%) 13.90)
Metastasis- 7
0 0 7 7 0 1 1 6.8 5
Brain (18.91%)
Metastasis- 2 6.33 (5.70-
0 0 2 2 0 2 2 0
Soft tissue (5.40%) 6.96)
Hemostatic 1
0 0 1 1 0 0 0 0 0
EBRT (2.70%)
37 1 1 35 35 12 12 6.74(3.60- 23
Total 0
(100%) (2.70%) (2.70%) (94.59%) (100%) (34.28%) (34.28%) 12.70) (65.71%)

78. Results- CNS tumors
Table 4 EBRT Data Survival Figures
Alive Alive Median
No RT Incomplete Completed Completed Alive Lost to
CNS Tumors Enrolled (dis. ( with survival
started EBRT EBRT EBRT (Total) Follow up
Free) dis.) (months)
2 11.31
Ependymoma 0 0 2 2 2 0 2 0
(14.28%) (10.03-12.6)
Astrocytoma Gr 1
0 0 1 1 0 0 0 0 1
II (7.14%)
Astrocytoma Gr 2
0 0 2 2 1 0 1 7.63 1
III (14.28%)
Oligodendroglio 2 13.26
0 0 2 2 2 0 2 0
ma (14.28%) (12.40- 14.13)
Glioblastoma Gr 3 8.03
0 0 3 3 0 2 2 1
IV (21.42%) (6.43-9.63)
1
CNS Lymphoma 0 0 1 1 0 1 1 12.8 0
(7.14%)
Pitutary 3 7.51
0 0 3 3 2 1 3 0
Adenoma (21.42%) (5.90-8.60)
14 14 14 7 4 11 9.80 3
Total 0 0
(100%) (100%) (100%) (50%) (28.5%) (78.57%) (5.90 -14.13) (21.42%)

80. Table 5 EBRT Data Survival Figures
Median
Head and Neck No RT Incomp. Complete Complete Alive(Ds. Alive Alive Lost to
Enroll. survival
Tumors started EBRT EBRT EBRT Free) (with Dis) (Total) Follow up
(months)
7.85
Tongue 47 (27.48%) 0 5 42 42 29 1 30 12
3.10-13.66)
8.21
Buccal Mucosa 41 (23.97%) 0 3 38 38 31 1 32 6
(3.1-13.96)
Retromolar 7.04
12 (7.01%) 0 0 12 12 7 1 8 4
Triagon (4.86- 9.8)
8.27
Alveolus 23 (13.45%) 0 4 19 19 11 3 14 5
(5.0- 14.63)
1
Hard Palate 0 0 1 1 1 0 1 8.16 0
(0.58%)
2
Nasopharynx 0 0 2 2 1 0 1 11.56 1
(1.16%)
8.36
Oropharynx 14 (8.18%) 0 4 10 10 5 1 6 4
(3.4-10.96)
8.48
Larynx 12 (7.01%) 0 1 11 11 6 2 8 3
(4.6- 11.70)
6 5.5
Hypopharynx 0 0 6 6 5 0 5 1
(3.50%) (3.53- 9.10)
3
MUO 0 0 3 3 0 0 0 0 3
(1.75%)
Parotid + min. 5 12.56
0 1 4 4 4 0 4 0
salivary glands (2.92%) (8.43- 14.6)
2
Paranasal Sinus 0 0 2 2 0 1 1 11.53 1
(1.16%)
2 6.01
Orbit + eye lid 0 0 2 2 2 0 2 0
(1.16%) (3.93-12.)
1
Thyroid cancer 0 0 1 1 1 0 1 12.33 0
(0.58%)
171 18 153 153 103 10 113 8.16 40
Total 0
(100%) (10.5%) (89.47%) (100%) (67.32%) (6.53%) (73.8%) (3.10 - 14.63) (23.23%)

82. Results- Thoracic tumors
Table 6 EBRT Data Survival Figures
Median
Thoracic No RT Incomp. Complete Complete Alive(Ds. Alive (with Lost to
Enroll. Alive (Total) survival
tumors started EBRT EBRT EBRT Free) Dis) Follow up
(months)
Lung 3 6.04 (4.36-
0 0 3 3 3 0 3 0
Carcinoma (27.27%) 7.83)
Esophageal 9.73 (8.70-
8 (72.72%) 0 2 6 6 2 1 3 3
Cancer 10.53)
11 9( 9 6 7.88 (4.36 - 3
Total 0 2 (18.1%) 5 (55.5% 1 (11.11%)
(100%) 81.8%) (100%) (66.6%) 10.53) (33.3%)
Results- Breast tumors
Table7 EBRT Data Survival Figures
Median
Breast No RT Incomp. Complete Complete Alive(Ds. Alive Lost to
Enroll. Alive (Total) survival
Tumors started EBRT EBRT EBRT Free) (with Dis) Follow up
(months)
Breast
27 7.60 (1.36-
Tumors- Post 2 0 25 25 24 1 25 0
(96.42%) 14.60)
MRM
Breast
1
Tumors- Post 0 0 1 1 1 0 1 9.96 0
(3.57%)
BCS
28 2 26 26 25 1 26 7.69 (1.36 -
Total 0 0
(100%) (7.14%) (92.85%) (100%) (96.15%) (3.84%) (100%) 14.60)

84. Results- GI Tract tumors
Table 8 EBRT Data Survival Figures
Gastro- Median
No RT Incomp. Complete Complete Alive(Ds. Alive (with Lost to
Intestinal Enroll. Alive (Total) survival
started EBRT EBRT EBRT Free) Dis) Follow up
Tumors (months)
1
Stomach 0 0 1 1 1 0 1 11 0
(16.66%)
1
Pancrease 0 1 0 0 0 0 0 0 0
(16.66%)
1
Colon 0 1 0 0 0 0 0 0 0
(16.66%)
2 6.21
Rectum 0 0 2 2 2 0 2 0
(33.33%) (5.83-6.60)
1
Anal Canal 0 0 1 1 1 0 1 7.03 0
(16.66%)
6 2 4 4 4 4 7.61
Total 0 0 0
(100%) (33.33%) (66.66%) (100%) (100%) (100%) (5.83 - 11.00)
Results- Urinary Tract tumors
Table 9 EBRT Data Survival Figures
Median
Urinary Tract No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to
Enroll. survival
Tumors started EBRT EBRT EBRT Free) Dis) (Total) Follow up
(months)
1
Ureter 0 0 1 1 1 0 1 12.03 0
(33.33%
2
Bladder 0 0 2 2 0 0 0 0 2
(66.66%
3 3 3 1 1 2
Total 0 0 0 12.03
(100%) (100%) (100%) (33.33%) (33.33%) (33.33%)

87. Results- Male Genito-urinary tumors
Table 10 EBRT Data Survival Figures
Male
Median
Genitouri No RT Incomp. Complete Complet Alive(Ds. Alive Alive Lost to
Enroll. survival
nary started EBRT EBRT e EBRT Free) (with Dis) (Total) Follow up
(months)
Tumors
1
Penis 0 0 1 1 1 0 1 8 0
(33.33%
2
Prostate 0 0 2 2 1 0 1 1.73 1
(66.66%
3 3 3 2 2 4.86 (1.73 - 1
Total 0 0 0
(100%) (100%) (100%) (66.66%) (66.66% 8.00) (33.33%
Results- Gynecological tumors
Table 11 EBRT Data Survival Figures
Median
Gynecologic No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to
Enroll. survival
al tumors started EBRT EBRT EBRT Free) Dis) (Total) Follow up
(months)
Endometrium 1 (2.63%) 0 0 1 1 1 0 1 10 0
32 9.12 (2.93 -
Cervix 3 1 28 28 15 8 23 3
(84.21%) 14.30%
14.11(13.63-
Vaginal Vault 2 (5.26%) 0 0 2 2 2 0 2 0
14.6)
Vagina 2 (5.26%) 0 0 2 2 1 0 1 8.7 1
Sarcoma 1 (2.63%) 0 0 1 1 1 0 1 13.86 0
34 34 8 28 9.67 (2.93 -
Total 38 (100%) 3 (7.89%) 1 (2.63%) 20 (58.82%) 4 (11.76%)
(89.47%) (100%) (23.52%) (82.35%) 14.6)

90. Results- Hematological and
Lymphoma
Table 12 EBRT Data Survival Figures
Median
Hematological No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to
Enroll. survival
and Lymphoma started EBRT EBRT EBRT Free) Dis) (Total) Follow up
(months)
Hodgkins 4 5.41 (3.73-
0 0 4 4 3 1 4 0
Lymphoma (40%) 7.03)
Non Hodgkins 9.5(8.43-
5 (50%) 0 2 3 3 3 0 3 0
Lymphoma 11.36)
1
ALL-PCI 0 0 1 1 1 0 1 8.2 0
(10%)
10 2 8 8 1 8 7.29 (3.73 -
Total 0 7 (87.5%) 0
(100% (20%) (80%) (100%) (12.5%) (100%) 11.36)

92. Results- Soft Tissue Sarcoma
Table 13 EBRT Data Survival Figures
Sarcomas- Median
No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to
Bone and Enroll. survival
started EBRT EBRT EBRT Free) Dis) (Total) Follow up
Soft Tissue (months)
Soft tissue 2 10.56 (8.6-
0 0 2 2 2 0 2 0
sarcoma (100%) 12.53)
2 2 2 2 10.56 (8.6-
Total 0 0 2 (100%) 0 0
(100%) (100%) (100%) (100%) 12.53)
Results- Pediatric tumors
Table 14 EBRT Data Survival Figures
Median
Pediatric No RT Incomp. Complete Complete Alive(Ds. Alive (with Alive Lost to
Enroll. survival
Tumors started EBRT EBRT EBRT Free) Dis) (Total) Follow up
(months)
Ewing 1
0 0 1 1 1 0 1 6.33 0
sarcoma (50%)
CNS-
1
pediatric 1 0 0 0 0 0 0 0 0
(50%)
tumor
2 1 1 1 1
Total 0 1 (100%) 0 6.33 0
(100%) (50%) (50%) (100%) (100%)

94. Conclusions
In one year of Radiation practice at Ba Cancer Centre we
have tried our level best to ensure good radiation practice for
our patients.
 Overall 292/325 (89.8% ) of patients were able to complete
their radiotherapy as per prescribed doses.
From curative intent group 214/325 (78.3%) patients are still
alive.
Median survival of all alive Patients were 8.32 months (range
1.36-14.63)

95. Charges at present
Ba Cancer Centre Any Pvt centre
Conventional 26,000/- 50,000/- to
Radiotherapy 80,000/-
3D Conformal 31,000/- 75,000/-to
Radiotherapy 1,00,000/-
Intensity 51,000/- 1,15,000/- to
Modulated 1,50,000/-
Radiotherapy
Palliative 10,000/-,15,000/- 30,000/-,45,000/-
Radiotherapy

96. Take home message
 Option of a Good Radiation therapy centre is opened
for the people of Surat and nearby areas in form of Ba
Cancer Centre, Navsari
 Electronic Medical Record System makes this centre
working smoothly.
 We offer world class Immobilization, radiation
Planning and Delivery methods.
 Economically less burden to patients