• Ms Mary Chan
• Ms Yvonne Loh​
  
• Ms Tan Chek Wee
  

• ​Ms Wendy Hoy​
  
• Ms Samatha Koh
  

• Ms Richerlyn Beltran
• Mr Cai Shao Bin
• Ms Tabitha Chan
• Ms Desiree Chen
• Ms Serene Cher
• Ms Clara Chew
• Ms Corin Chng
• Mr Jeremy Chong
  
• Mr Guo Weiguang
• Mr Mohd Hafiz
• Mr Muhammmad Haziq
• Ms Carinne Ho
  
• Mr Ho Guan Da
  
• Ms Esperanza Humigop
• Ms Kang Chern Lynn
• Mr Koh Guan Lee
  

• Mr Cheow Min Wah
  
• Ms Lee Xin Min
• Ms Nur Fathiah Abdul Razak
• Ms On Chin Leng
  
• Ms Jaslyn Tan
  

• ​Mr Shaun Baggarley
  

• ​Ms Tan Poh Wee
  

• Ms Joan Faith Loria
• Ms Leong Yun Fun
  
• Ms Teh Mun Woan
  

• ​Mr Khor Jong Shin
  
• Mr Jessen How 
  

• Ms Charmaine Cheong
  

• ​Ms Arifah Binte Hussein
  
• Ms Ong Gek Ting
• Ms Noratiqah Binte Hassan​
  

• Ms Lee Wan Jing
  
• Ms Ho Poh Geck
  

Stereotactic radiosurgery/radiotherapy for benign and malignant brain tumours has demonstrated durable tumour control and symptomatic relief with acceptable toxicity in suitable patients. HyperArc® high-definition radiotherapy from Varian was designed and optimised for intracranial central nervous system radiosurgery applications. In addition to fast treatment delivery, HyperArc® can highly conformal X-ray dose distributions to the multiple brain lesions with steep dose gradients, which has the potential to spare the adjacent normal structures and to improve the accuracy of patient set-up and target localisation.

Immobilisation via a whole body vacuum bag to achieve positioning required for stereotactic radiotherapy.

These specialised treatment techniques make use of precise positioning, immobilisation devices and multiple treatment beams to achieve highly focused radiation therapy targeting suitable tumours. This allows larger radiation doses to be delivered during each treatment, thereby shortening the treatment duration without compromising safety. SRS is typically used for tumours in the brain. SBRT (also known as stereotactic ablative radiotherapy) can be used to treat small tumours in the lung, liver, spine or other organs. In certain tumour sites like the lung and liver, respiratory motion may compromise the therapeutic efficacy of stereotactic techniques. For such cases, respiration control capabilities are available including Active Breath Control (ABC) which limits such motion, as well as 4D CT simulation that can account for tumour motion at the planning stage.

Patient being prepared before radiation therapy treatment

3D Conformal Radiation Therapy makes use of 3-dimensional imaging and computer-based planning to deliver radiation therapy to targeted areas while sparing normal organs. Its versatility and proven track record makes it a suitable and reliable radiation therapy technique for almost all tumour sites.

Image-Guided Radiation Therapy (IGRT) 

Cone beam CT evaluation for positional accuracy immediately prior to radiation therapy treatment

Image guidance can be used with any external beam technique to optimise patient positioning immediately prior to initiating radiation therapy. We often use cone beam computed tomography (CT) to visualise the body’s internal structures in three dimensions. These near real-time images enable us to make fine positional adjustments, ensuring that radiation therapy is delivered to the intended tumour location precisely, while sparing normal organs. Cone beam CT imaging is a marked improvement over traditional imaging methods which are limited by their two-dimensional nature and lower resolution images.

​

CT simulation staff guiding patient on optimal position

Step 2 - CT Simulation 

During CT Simulation, a CT scan will be done on the area that requires treatment. This scan is done in the treatment position, and may require the use of immobilisation devices. In addition, small permanent reference marks may be placed on the body. The immobilisation devices and reference marks enable us to reproduce the position accurately during treatment, which is crucial for successful treatment. As far as possible, your therapists will ensure that the scan and treatment position is comfortable for you. Do let them know if you face any discomfort or are unable to maintain the required position. 

For certain treatments, you may be required to have a full bladder or empty stomach. If contrast is needed for the scan, an intravenous plug will be placed for administration of contrast. Please inform us if you have any kidney problems, asthma or previous allergies to contrast. 

Typically, a CT Simulation will require between 30 to 60 minutes. It may take slightly longer if the treatment is expected to be complex, requiring specialised equipment or preparatory work beforehand.

A significant portion of daily treatment time is spent to place the patient in the exact treatment position required

​Step 4 - Treatment and Review 

When the radiation therapy sessions commence, you will be required to attend treatment daily. A radiation therapy schedule will be provided to you to inform you of your treatment times. 

During treatment, radiation therapists will position you exactly as you were during the CT Simulation. You will undergo radiation therapy in a treatment room with radiation therapists monitoring your progress via a CCTV during the process. 

Some days, treatments may seem to last longer due to additional imaging being done to ensure accuracy of the treatment. During the course of treatment, you will be scheduled for weekly appointments to see your radiation oncologist where you will be monitored for any side effects developed during the treatment process, as well as tumour response, if applicable. You may also be given medication to relieve some of the side effects. 

In addition, weekly consultations with our in-house dietitian may be arranged for patients whose nutritional status warrant review.

​1. Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidelines for the prevention and management of acute radiation dermatitis: international Delphi consensus-based recommendations

Acute radiation dermatitis is a common side effect of radiotherapy, which is a type of cancer treatment. However, there's no universally agreed-upon way to care for patients with this condition. This is mainly because the current guidelines differ and the evidence supporting them is contradictory. To address this, an international group of 42 experts used a method called the Delphi consensus process to review existing medical literature and establish a consensus on how to manage and prevent this condition. 

The experts agreed on six methods for preventing acute radiation dermatitis: photobiomodulation therapy and Mepitel film for breast cancer patients, Hydrofilm, mometasone, betamethasone, and olive oil. For managing existing cases, they recommended Mepilex Lite dressings. However, most potential treatments couldn't be recommended because there wasn't enough evidence to support their effectiveness, the evidence was conflicting, or the experts couldn't reach a consensus. This suggests that more research needs to be done in this area. Until then, doctors can consider using the agreed-upon methods in their practice to help their patients deal with acute radiation dermatitis.

3. State-of-the-Art Imaging Techniques in Metastatic Spinal Cord Compression.

This paper provides an overview of the best imaging techniques used to diagnose Metastatic Spinal Cord Compression (MSCC), a serious complication in cancer patients. The paper discusses the pros and cons of various imaging methods, including MRI, CT scans, and CT Myelogram, and their role in planning and verifying treatments like stereotactic body radiotherapy (SBRT). MRI is considered the best method, with high accuracy. However, CT scans can be useful in emergency situations when MRI is not available. The paper also looks at how new tech, such as deep learning tools, can help detect spinal issues faster, allowing for quicker treatment and better patient outcomes.

5. Splenic irradiation contributes to grade ≥ 3 lymphopenia after adjuvant chemoradiation for stomach cancer

We explored how radiation therapy for stomach cancer, which unintentionally exposes the spleen to radiation, affects the severity of lymphopenia (a condition where you have fewer lymphocytes, a type of white blood cell, than normal). This could impact survival time and risk of infection. The study looked at patients who underwent this therapy between 2015 and 2020. Findings show that higher radiation doses to the spleen resulted in more severe lymphopenia, leading to a higher risk of infection and lower survival rates. This suggests that adjusting the radiation to lower the dose to the spleen may reduce the risk of severe lymphopenia.

7. Palliative radiotherapy for bladder cancer: a systematic review and meta-analysis

The study investigated the effects of different radiation therapy doses on symptom relief for advanced bladder cancer patients. Researchers looked at a variety of studies and focused on how well symptoms like blood in urine, painful urination, and frequent urination were managed. They found that higher doses of radiation didn't necessarily improve the relief of these symptoms. However, a higher radiation dose did seem to lengthen the time that blood in urine was controlled, and it reduced the improvement of painful urination. There was also a notable occurrence of severe side effects, affecting the digestive and urinary systems, in about a quarter of patients. The study concluded that more research is needed to understand how palliative radiation therapy affects the quality of life of patients with advanced bladder cancer.

9. Risk of Stroke in Nasopharyngeal Cancer Survivors: A National Registry-Based Population Cohort Study

We examined the risk of stroke and death within a month after stroke in survivors of nasopharyngeal cancer (NPC), a type of cancer that starts in the upper part of your airway, behind the nose. The study looked at patients diagnosed with NPC over a span of around 13 years. The findings showed that survivors of NPC, particularly those diagnosed with early-stage disease, had a significantly higher risk of having a stroke compared to the general population. However, if they did have a stroke, their chances of dying within 30 days were not significantly higher. These findings suggest that doctors need to pay special attention to the potential risk of stroke in people who have survived NPC.