Radiation Oncology Residency Program
Clinical Activities
Residents will participate in the full spectrum of radiation oncology practice. This includes both inpatient and outpatient evaluations and consultations. Residents will be involved in CT assisted simulation procedures as well as treatment planning procedures including three-dimensional conformal radiation procedures as well as intensity modulated radiation treatment procedures (IMRT) and stereotactic radiation treatment procedures.
A separate treatment planning system is used for stereotactic radiation treatments.
Patients seen in the program represent the broad diversity of patients from the San Francisco Bay Area and include those diagnosed at both early and late stages of illness. Because of our integrated programs residents see a variety of approaches employed by a number of clinical faculty at different hospitals (which incorporate radiation oncology nurses, radiation physicists, radiation dosimetrists, nutritionists, social workers, psycho-social therapists. Residents also actively participate in site-oriented multi-disciplinary tumor boards at each facility. Tumor boards include: general tumor boards, pediatric, gynecologic, neurologic, genito-urinary, otolaryngology and gastrointestinal tumor sites.
Residents also have a 4 month brachytherapy rotation. Patients rotate 1 on 1 with a radiation oncologist and carry out under direct supervision low- and high-dose-rate brachytherapy. Brachytherapy services are provided to selected patients in multiple tumor sites, including; prostate, breast, lung, GI, GU, GYN and interstitial tumor sites. A Gamma-MED plus treatment afterloading Ir-192 unit is employed for HDR brachytherapy treatments in prostate, GYN and other interstitial tumor sites. Residents will become proficient in Flectcher-Suit low-dose and high dose rate applications, vaginal cylinders and interstitial gynecological implants. Esophageal and endobrochial high dose rate applications are also performed in addition to endorectal, biliary tree, nasopharyngeal and interstitial breast (Mammosite) applications.
For low-dose rate prostate brachytherapy patients, residents will become proficient in carrying out ultrasound volume studies, transperineal ultrasound guided preloaded interstitial prostate permanent seed implants, interpretation of brachytherapy preplans & post-implant CT scans. Treatment planning is carried out using Brachyvision (a Varian product). Residents will also carry out on average 1-2 transrectal ultrasound guided fudicial marker placement in prostate cancer patients for IGRT (intensity modulated guided radiation therapy.
On average, residents will carry out at least 200+ brachytherapy procedures during their rotation.
California Pacific Medical Center - An average of 75 patients per day is treated at California Pacific's Department of Radiation Oncology. Equipment presently includes:
- 2 Varian 21EX (6/15 MV) linear accelerator with portal vision and 120 Multi-leaf collimators. Gating is also available.
- 1 Varian Trilogy (6/15 MV) linear accelerator with portal vision, 120 MLCs and cone beam CT.
- General Electric light speed CT simulator,
- Odelft superficial x-ray unit,
- Varian Eclipse treatment planning equipment, and
- Intensity modulated treatment planning equipment (IMRT)
- Stereotactic radiaosurgery and therapy equipment, including an M3 micro-multileaf collimator. Brain Lab planning system.
- Varian 2100C, 600C
- Ximatron simulator
- ADAC Pinnacle treatment planning system.
- Varian Clinac 2100 IX, 600C
- General Electric light speed CT simulator,
- Picker superficial unit
- ADAC Pinnacle & Eclipse treatment planning.
- Parenteral and oral radio-isotope administration (eg. I-131 and therapeutic radioisotope administration)
