Proton therapy for retinoblastoma
Charite University Hospital Berlin
Berlin, Germany
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If necessary, the physician will prescribe you additional examinations in order to clarify the diagnosis and determine the localization of the tumor more accurately.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Preparation for proton therapy<\/strong> begins with manufacturing the special device – the individual immobilizer that will fix the position of your body during a proton therapy session. Immobility is essential for high irradiation accuracy.<\/p>\n\n<p style=\"text-align: justify;\">After the control computed tomography, during which you will stay in the immobilizer, the healthcare professionals will develop an individual treatment scheme. The treatment scheme determines the number of proton therapy sessions, the radiation dose, the angle of the rays and the depth of their penetration. In accordance with these, technical devices are manufactured that determine the depth and form of irradiation. These are the collimator (determines the shape of the proton beam) and the bolus (determines the depth of the proton beam penetration).<\/p>\n\n<p style=\"text-align: justify;\">After that, a trial irradiation session is carried out using the individual immobilizer, collimator and bolus. Doctors evaluate the radiation dose received by the tumor and its compliance with the treatment scheme.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Proton therapy<\/strong>. The procedures are carried out once a day, 5 days a week. Usually Saturday and Sunday are your free days when you do not need to visit the hospital.<\/p>\n\n<p style=\"text-align: justify;\">Before each procedure, specialists check the position of your body using X-ray in two projections. If necessary, the irradiation is synchronized with the respiratory movements. After that, the tumor is exposed to the proton beams for 1-3 minutes. The total duration of the session with all the checking procedures is 15-30 minutes.<\/p>\n\n<p style=\"text-align: justify;\">The procedure is painless and is performed in open-type devices (this is important for overweight people or people with claustrophobia). Proton therapy does not require bed rest or other restrictions of physical activity.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Monitoring the treatment effectiveness<\/strong>. After completing the treatment, you will be advised to come in for the long-term follow-up. You will visit your doctor regularly for a clinical examination and, if necessary, a CT scan.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li style=\"text-align: justify;\">Medical records<\/li>\n\t<li style=\"text-align: justify;\">MRI\/CT scan (not older than 3 months)<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the clinic<\/li>\n\t<li>clinical history taking<\/li>\n\t<li>review of medical records<\/li>\n\t<li>physical examination<\/li>\n\t<li>laboratory tests:\n\t<ul>\n\t\t<li>complete blood count<\/li>\n\t\t<li>general urine analysis<\/li>\n\t\t<li>biochemical analysis of blood<\/li>\n\t\t<li>TSH-basal, fT3, fT4<\/li>\n\t\t<li>tumor markers<\/li>\n\t\t<li>indicators of inflammation<\/li>\n\t\t<li>indicators blood coagulation<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>ophthalmological examination<\/li>\n\t<li>planning of proton therapy<\/li>\n\t<li>surgical clip marker<\/li>\n\t<li>a full course of proton therapy<\/li>\n\t<li>full hospital accommodation<\/li>\n\t<li>nursing services<\/li>\n\t<li>explanation of future recommendations<\/li>\n<\/ul>\n<div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align: justify;\">Proton therapy is the outpatient procedure, you do not need to stay in the hospital all the time.<\/p>\n\n<p style=\"text-align: justify;\"><strong>During the first visit<\/strong>, the physician will conduct a clinical examination, go through the available medical records and CT scans. If necessary, the physician will prescribe you additional examinations in order to clarify the diagnosis and determine the localization of the tumor more accurately.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Preparation for proton therapy<\/strong> begins with manufacturing the special device – the individual immobilizer that will fix the position of your body during a proton therapy session. Immobility is essential for high irradiation accuracy.<\/p>\n\n<p style=\"text-align: justify;\">After the control computed tomography, during which you will stay in the immobilizer, the healthcare professionals will develop an individual treatment scheme. The treatment scheme determines the number of proton therapy sessions, the radiation dose, the angle of the rays and the depth of their penetration. In accordance with these, technical devices are manufactured that determine the depth and form of irradiation. These are the collimator (determines the shape of the proton beam) and the bolus (determines the depth of the proton beam penetration).<\/p>\n\n<p style=\"text-align: justify;\">After that, a trial irradiation session is carried out using the individual immobilizer, collimator and bolus. Doctors evaluate the radiation dose received by the tumor and its compliance with the treatment scheme.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Proton therapy<\/strong>. The procedures are carried out once a day, 5 days a week. Usually Saturday and Sunday are your free days when you do not need to visit the hospital.<\/p>\n\n<p style=\"text-align: justify;\">Before each procedure, specialists check the position of your body using X-ray in two projections. If necessary, the irradiation is synchronized with the respiratory movements. After that, the tumor is exposed to the proton beams for 1-3 minutes. The total duration of the session with all the checking procedures is 15-30 minutes.<\/p>\n\n<p style=\"text-align: justify;\">The procedure is painless and is performed in open-type devices (this is important for overweight people or people with claustrophobia). Proton therapy does not require bed rest or other restrictions of physical activity.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Monitoring the treatment effectiveness<\/strong>. After completing the treatment, you will be advised to come in for the long-term follow-up. You will visit your doctor regularly for a clinical examination and, if necessary, a CT scan.<\/p>\n<\/div>","is_ambulant":"0","bh_fee":"0","only_for_children":"1","no_service":"0","with_prepayment":"1","show_calculator":"1","paket_type":"1","btn_type":"2","clinic_icon":"60018c63b444d.jpg","city":"Berlin","clinic_site":"http:\/\/www.charite.de\/","department_recommend":"1","country":"Germany","country_id":"1","clinic_name":"Charite University Hospital Berlin","cinic_name":"Charite University Hospital Berlin","department_id":"1565","duration":"10","direction":"Proton therapy","min_duration":0,"clinic_id":"254","paketPrice":13800,"paket":"<ul>\n <li>Interpreter up to 30 hours<\/li>\n <li>Translation up to 15 pages<\/li>\n <li>Visa support<\/li>\n\n<\/ul>","title":"Proton therapy for retinoblastoma","price":{"val":41777.11,"type":"val"},"price_surcharge":0,"price_surcharge_clear":0,"extra_service_clinic":[{"id":"need_to_use_head_doctor","title":"Treatment by leading experts","type":"val","val":"6307.20","req":0},{"id":"1_person_room","title":" Single room (whole period)","parent":"duration","type":"count_val","val":"160.00"},{"id":"2_person_room","title":" double room (whole period)","parent":"duration","type":"count_val","val":"80.00"},{"id":"attendant_place","title":"Accommodation for the accompanying person ","parent":"duration","type":"count_val","val":"90.00"}],"extra_service":[],"translation_hours":"0","translation_doc_count":null,"roads":[{"id":"22","distance":"20","airport_title":"Berlin-Tegel"},{"id":"20","distance":"172","airport_title":"Leipzig"},{"id":"3","distance":"288","airport_title":"Hannover"}],"pakets":[],"lang":{"day":"Day","days":"days","ambulatory":"Outpatient","stationaryProgram":"Inpatient"}}
Program id #
642605
Dr. rer. nat. Andrea Denker
Center for Proton Therapy BerlinProtonen
Specialized in: proton therapy The program includes:
- Initial presentation in the clinic
- clinical history taking
- review of medical records
- physical examination
- laboratory tests:
- complete blood count
- general urine analysis
- biochemical analysis of blood
- TSH-basal, fT3, fT4
- tumor markers
- indicators of inflammation
- indicators blood coagulation
- ophthalmological examination
- planning of proton therapy
- surgical clip marker
- a full course of proton therapy
- full hospital accommodation
- nursing services
- explanation of future recommendations
How program is carried out
Proton therapy is the outpatient procedure, you do not need to stay in the hospital all the time.
During the first visit, the physician will conduct a clinical examination, go through the available medical records and CT scans. If necessary, the physician will prescribe you additional examinations in order to clarify the diagnosis and determine the localization of the tumor more accurately.
Preparation for proton therapy begins with manufacturing the special device – the individual immobilizer that will fix the position of your body during a proton therapy session. Immobility is essential for high irradiation accuracy.
After the control computed tomography, during which you will stay in the immobilizer, the healthcare professionals will develop an individual treatment scheme. The treatment scheme determines the number of proton therapy sessions, the radiation dose, the angle of the rays and the depth of their penetration. In accordance with these, technical devices are manufactured that determine the depth and form of irradiation. These are the collimator (determines the shape of the proton beam) and the bolus (determines the depth of the proton beam penetration).
After that, a trial irradiation session is carried out using the individual immobilizer, collimator and bolus. Doctors evaluate the radiation dose received by the tumor and its compliance with the treatment scheme.
Proton therapy. The procedures are carried out once a day, 5 days a week. Usually Saturday and Sunday are your free days when you do not need to visit the hospital.
Before each procedure, specialists check the position of your body using X-ray in two projections. If necessary, the irradiation is synchronized with the respiratory movements. After that, the tumor is exposed to the proton beams for 1-3 minutes. The total duration of the session with all the checking procedures is 15-30 minutes.
The procedure is painless and is performed in open-type devices (this is important for overweight people or people with claustrophobia). Proton therapy does not require bed rest or other restrictions of physical activity.
Monitoring the treatment effectiveness. After completing the treatment, you will be advised to come in for the long-term follow-up. You will visit your doctor regularly for a clinical examination and, if necessary, a CT scan.
Required documents
- Medical records
- MRI/CT scan (not older than 3 months)
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About the department
The Center for Proton Therapy BerlinProtonen at the Charite University Hospital Berlin offers advanced proton therapy for the treatment of benign and malignant eye tumors. The Director of the center is Dr. rer. nat. Andrea Denker.
Since 1998, the department has successfully used proton therapy for the treatment of neoplasms of the choroid, iris and ciliary body. Thanks to the highly effective treatment of intraocular tumors, the center has gained an excellent reputation in the European medical arena. Over the years of the center’s clinical practice, the coordinated and productive work of medical physicists, radiation therapists and ophthalmologists has improved the accuracy and efficiency of proton therapy. As of today, innovative proton therapy helps to control tumor growth and maintain the functionality of the affected eye in 96% of patients.
Before carrying out proton therapy, doctors conduct the comprehensive diagnostics, which gives them a complete picture of the eye state and allows them to plan treatment as accurately as possible. Since choroidal melanomas can form distant metastases, primarily in the liver, the patient may need additional examinations in order to identify them.
The doctors have to detect the exact tumor location for targeted proton irradiation. In order to do this, four (in rare cases more) markers made of tantalum are placed on the surface of the orbit. This procedure is called clipping and lasts about 45 minutes (it is performed under general anesthesia). The markers with a diameter of about 2.5 mm remain in the eye after proton therapy completion. They do not cause inconvenience to the patient and they are clearly visible on X-rays or MRI.
In the course of сomputer-aided process planning, an eye model of a particular patient with a tumor is created. In order to do this, the doctors use high-resolution CT data, which is performed after clipping procedure. Additional ultrasound examinations may also be performed. In rare cases (for example, in large tumors), high-resolution MRI can be performed.
An important advantage of proton irradiation is the characteristic exposure of energy to the tissues (Bragg-Peak), which allows to achieve the most accurate irradiation of the tumor with the preservation of adjacent organs and tissues. The center is equipped with a device for emission of a proton beam with an energy of 68 MeV, which can penetrate into the body to a depth of about 30 mm. This energy is ideal for the treatment of intraocular tumors. Malignant choroidal melanomas are primarily irradiated. They are divided into choroidal melanomas or ciliary body melanomas and iris melanomas. In addition, proton therapy can be used to treat other tumors, such as conjunctival melanoma, hemangioma, and retinoblastoma.
Proton therapy is an effective treatment method for the following eye tumors:
- Choroidal melanoma
- Ciliary body melanoma
- Iris melanoma
- Other tumors
- Ocular mucosal melanoma
- Hemangiomas
- Retinoblastomas
- Other eye diseases
Photo of the doctor: (c) Charité – Universitätsmedizin Berlin
About hospital
According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities!
The hospital in Germany provides modern diagnostics and treatment of patients, as well as the training of practicing physicians and scientists. More than half of all German Nobel Prize winners in the field of medicine and physiology, such as Emil von Behring, Robert Koch and Paul Ehrlich, trained and worked in the hospital. The structure of the medical complex includes over 100 specialized departments and institutes, which allows the doctors to guarantee their patients' services in all the existing medical fields. The hospital in Germany has outstanding experience in treating particularly complex clinical cases.
The hospital annually diagnoses and treats more than 152,693 inpatients and about 692,920 outpatients. It also has a huge medical team consisting of 4,225 scientists and doctors and and more than 4,500 nursing staff members who provide top-class medical treatment in Germany. The key task for all specialists of the medical facility is restoring the patient's health or preserving in critical cases. At the same time, the hospital offers a friendly atmosphere, and each patient feels care, respect and sympathy.
The excellent technical medical equipment, highly skilled personnel, availability of innovative diagnostic and treatment techniques, and high ethical standards form a solid foundation for successful clinical and scientific activities. Thus, the hospital is a leading provider of high-quality treatment in Germany.
Photo: (с) depositphotos
Accommodation in hospital
Patients rooms
The patients of the Charite University Hospital Berlin live in comfortable rooms made of modern design. Each room is equipped with an ensuite bathroom with a toilet and a shower. The standard room furnishing includes an automatically adjustable bed, a bedside table, a wardrobe for storing clothes, a table and chairs for receiving visitors, and a TV. If desired, Wi-Fi access can be provided. The hospital also offers enhanced-comfort rooms.
Meals and Menus
The patient and his accompanying person have a daily choice of three menus. If for any reason, you do not like the food, you will be offered an individual menu. Please inform the medical staff about your dietary preferences before the treatment.
Further details
Standard rooms include:
Toilet
Shower
Wi-Fi
TV
Religion
Religious services are available upon request.
Accompanying person
During the inpatient program, an accompanying person may stay with you in a patient room or at the hotel of your choice.
Hotel
During the outpatient program, you can live at a hotel of your choice. Managers will help you to choose the most suitable options.
The hospital offers a full range of laboratory tests (general, hormonal, tests for infections, antibodies, tumor markers, etc.), genetic tests, various modifications of ultrasound scans, CT scans, MRI and PET / CT, angiography, myelography, biopsy and other examinations. Treatment with medications, endoscopic and robotic operations, stereotaxic interventions is carried out here, modern types of radiation therapy are also used. The hospital offers patients all the necessary therapeutic techniques.
- Proton therapy
- CyberKnife treatment
- Hyperthermic intraperitoneal chemotherapy (HIPEC)
- PSMA therapy with Lutetium-177
- Joint replacement in adults and children
These are oncological diseases, benign neoplasms of the brain and spinal cord, heart valve defects, diabetes mellitus and its complications, joint diseases and other pathologies.
- Neurosurgery
- Oncology
- Plastic and reconstructive surgery
- Interventional radiology
- Proton therapy (Proton Therapy Center BerlinProtonen)
The medical team includes more than 4,225 highly qualified scientists and doctors.