Information About Radio-oncology-Centre KSA-KSB
Radiotherapy for all cancer conditions
- High-precision irradiation (incl. IMRT, stereotactic surgery)
- Re-irradiation (partially concomitant with hyperthermia)
- Clinical studies (incl. breast, prostate, lung, CNS tumours), both nationally (SAKK) and internationally (RTOG-USA)
- Combined hyperthermia / radiotherapy
- Superficial hyperthermia
- Deep tissue hyperthermia
Radiotherapy for benign conditions of the musculoskeletal system
- Chronic inflammatory degenerative conditions of the musculoskeletal system
- Chronic skin conditions
- Painful degenerative conditions of the musculoskeletal system (e.g. chronic inflammations of the shoulder)
Range of therapeutic services
- Stereotactic surgery:
Small-volume high-precision irradiation of primary and secondary cerebral tumours and cerebral metastases; Re-irradiation of cerebral tumours; Irradiation of meningiomata.
Systemic stereotactic surgery for carcinoma of the lung; carcinoma of the prostate, spinal metastases; liver metastases.
Thoracic wall recurrence in carcinoma of the breast, malignant melanoma, locally advanced cervical, bladder, prostate and rectal carcinomata, soft tissue sarcomata.
Repeated treatment where there is recurrence and in previously irradiated regions.
- Benign irradiation:
Epicondylopathia humeri radialis / ulnaris (tennis elbow, golfer’s elbow), calcaneodynia, plantar or dorsal calcaneal spur, painful degenerative conditions in joints such as hip-, knee-, shoulder- and finger- and thumb-joints and arthroses in other joints.
About Radio-oncology-Centre KSA-KSB
The KSA-KSB Radio-oncology Department at the Cantonal Hospital in Aarau is one of the largest radiology centres in Switzerland. The site at the Cantonal Hospital in Baden will be brought into operation in 2016.
As one of the largest radiology centres in Switzerland, we combine the highest quality standards and the best possible individual care for our patients. We hold membership in national and international networks for clinical studies (including SAKK, RTOG/NRG).
The team at the Radio-oncology Department at the Cantonal Hospital in Aarau consists of highly qualified radiotherapists (radio-oncologists), medical physicists, and medical technical radiology assistants, IT specialists and qualified administration staff. Their goal is to treat adults and children with a variety of tumour conditions in accordance with the highest medical and humane standards. The Radio-oncology Department, Aarau provides the entire range of up to date radiotherapy for malignant tumour conditions, including metastases. These include breast cancer, cancer of the prostate, gastrointestinal tumours, lung cancer, skin cancers and cerebral tumours.
One focus of our centre is regional hyperthermia (HT). This is always performed in combination with radiotherapy (RT). We work evidence-based and in clinical studies (nationally and internationally). HT and RT are performed for radiation-resistant tumours (e.g. melanomata), for curative, organ-preserving multimodal treatments (e.g. cancer of the bladder, sarcomata) or for local recurrences (also following preliminary radiotherapy treatment) (e.g. recurrent carcinoma of the breast, recurrent rectal carcinoma). We have an active research group within a strong network.
In another focus, we perform radiotherapy on inflammatory and degenerative conditions of the musculoskeletal system (arthroses, arthritis). In particular, the results are very good for finger polyarthroses, tennis and golfer’s elbow, for calcaneal spur and foot complaints. We work in close collaboration with rheumatologists and orthopaedic surgeons. We also have an ongoing clinical study in this area, with a review of the therapeutic success (functional tests with physiotherapists) and regular follow-up checks.
The team at the Radio-oncology Department in Aarau places particular value on giving patients detailed information (options and limitations of radiotherapy, as well as the side-effects to be expected in each individual case) and on collective therapeutic decision-making. The initial consultation lasts for one hour. The high quality of the treatment at the Cantonal Hospital in Aarau is ensured by an active exchange programme with national and international oncology and research centres and by interdisciplinary collaboration with a variety of cantonal and university hospitals and is critically reviewed.
A further focus of the team at the Radio-oncology Department in Aarau is radiosurgery. A special accelerator will be brought into operation at the end of 2015, in close collaboration with the Neurosurgery Department and other surgical /oncological disciplines. Radio-surgery is a gentle and extremely precise tumour removal technique. Using an extremely precisely localised, high-energy single radiation exposure, tumour cells can be killed off in one step.
Precisely in the highly complex and technical field of radio-oncology, a high level of experience and precision is crucial for the quality of the treatment. The Radio-oncology Department at the cantonal Hospital in Aarau is optimally equipped for this. Computer planning and computer-guided, high-precision radiotherapy are performed by specialists with years of experience using the most up to date medical devices. The team at the Radio-oncology Department performs around 1,200 treatments each year. The Radio-oncology Department collaborates closely, inter alia, with the Paul Scherrer Institute (for Proton Therapy) in order to be able to offer you all radiotherapy treatment options at the highest level.
We have been awarded several certificates (German Cancer Society Breast Centre, German Cancer Society Intestinal Centre, German Cancer Society Gynaecological Tumours such as uterine conditions, US certified by RTOG/NRG).
HYPERTHERMIA / Dr Emsad Puric
Hyperthermia represents an effective treatment method, with controlled overheating of the tumour. Hyperthermia is an intense radio- and chemosensitising agent with synergistic effects in combination with standard therapeutic techniques in oncology (e.g. with ionising radiation or with chemotherapy), without significant increase in side-effects. Hyperthermia frequently enables an efficient repetition of the treatment for recurrent tumours, even for already irradiated tumours. Various clinical studies suggest the advantage of heat therapy in combination with radiotherapy, for example, thoracic wall recurrence in carcinoma of the breast, melanoma, bladder cancer, soft tissue sarcomata, locally advanced or recurrent rectal tumours, gynaecological tumours, such as cervical carcinomata, etc. Unfortunately, patients with severe cardiac conditions, cardiac pacemakers or with metal implants are not suitable for this treatment.
RADIOTHERAPY / Dr Istvan Takacs
Radiotherapy can successfully eradicate pain in signs of wear and tear and inflammations in joints, practically without side-effects. The Radiotherapy Department of the Cantonal Hospital, Aarau, is considered to be one of the most experienced departments in the treatment of benign conditions in Switzerland. The prerequisite for radiotherapy at our clinic is that nothing more can be achieved through medication or using conventional methods and that the patient is being treated by a specialist (e.g. a rheumatologist, orthopaedic surgeon). The most frequently treated conditions: epicondylopathia humeri radialis / ulnaris, calcaneodynia, plantar or dorsal calcaneal spur, painful degenerative conditions in joints such as hip-, knee-, shoulder- and finger- and thumb-joints and arthroses in other joints.
STEREOTACTIC SURGERY / Dr Susanne Rogers
Stereotactic surgery is the high-dose, precision irradiation of small or very small tumours (primary tumours, metastases). Preferably, re-irradiation can be provided for certain tumours using stereotactic surgery. Today, this type of radiotherapy no longer needs invasive immobilisation and is guided by continuous imaging monitoring. Stereotactic surgery can be performed in the head and body region for selected patients.
GENERAL RADIO-ONCOLOGY / Reception / Medical Administration / Sandra Spreiter
The Medical Secretary is responsible for patient reception and for written inquiries and enquiries by telephone. The patients are also supported for their skin care by our specialist personnel. Mrs Sandra Spreiter is the Senior Medical Secretary.
RADIOPROTECTION DEPARTMENT / Dr Gerd Lutters
The Radioprotection Department has service contracts for the optimisation of testing dosage with clinics engaged in radiology at the Cantonal Hospital, Aarau, and with other public hospitals in German-speaking Switzerland. Workflows, safety measures and dosage protocols are adjusted in close co-operation with the manufacturers and physicians. Measurement phantoms and data capture and analysis software developed in collaboration with the Zurich University of Applied Sciences monitor the doses received in the clinical context. In the case of undesired exposure to radiation, the Department determines the probable organ dose received and helps with further measures.
Research & Training
- Clinical study activities
- 0415: Phase III Hypofractionated versus Conventionally Fractionated RT for Favorable-Risk Prostate Cancer: 3 Patients
- 0433: Randomized Trial of Single versus Multiple Fractions for Re-Irradiation of Painful Bone Metastases: 12 Patients
- 0933 Hippocampal Avoidance During Whole Brain Radiotherapy for Brain Metastases: No Patients
- 1005 Accelerated Whole Breast Irradiation With Hypofractionation Plus Concurrent Boost Versus Standard Whole Breast Irradiation Plus Sequential Boost For Early-Stage Breast Cancer: 23 Patients
- SAKK 09/10: Dosisintensivierte Bestrahlung bei Patienten mit Prostatakarzinom und PSA-Wiederanstieg nach Prostataentfernung
- SAKK 01/10: Chemotherapy and involved node radiotherapy in stage IIA/B seminoma
- SAKK 75/08: Multimodal therapy in patients with locally advanced esophageal carcinoma. An open-label phase III trial
- Prospective clinical hyperthermia protocols from our institution
- Phase IIB study of tetramodal therapy in muscle invasive bladder cancer: This on-going study is intended to explore the safety and efficacy of combined radiotherapy, chemotherapy and hyperthermia in muscle invasive bladder cancers after maximal TURBT. The study has been approved by the Ethical Committee. Based on the results of a pilot group of patients treated with this approach, the protocol is expected to produce more than 80% tumor control with functional bladder preservations in the majority of treated patients. The study is being jointly undertaken by KSA, KSO and KSB and is supported by Research Council, KSA. KS Winterthur and KS Chur have expressed their interest to join this study.
- A phase I / II clinical trial of hyperthermia and proton therapy in unresectable soft tissue sarcomas “HYPROSAR”: This is phase I/II study uses proton beam radiotherapy and local hyperthermia for primary unresectable and recurrent soft tissue sarcoma. This is a novel approach and is based on taking the physical dose distribution advantage of protons and radio-thermobiological advantanges of hyperthermia in clinical settings. The study has been launched in Jan 2014 following the approval of the Ethical Committee and undertaken in joint collaboration with KSA, PSI, USZ and Uniklinik Balgrist, Zurich. The study is also registered with ClinicalTrials.gov (Identifier NCT NCT01904565).
- Development of a phase II randomized study in locally advanced pancreatic cancer: The study design is in progress and is to be conducted in collaboration with the departments of medical, surgical (pancreaticobilliary) and radiation oncology at KSA and USZ. The study is designed for patients of locally advanced pancreatic cancers who depending on their tumour sizes could be recruited to either (a) RIEPAC study, (or primary tumours upto 4 cm) which involves randomization between inrreversible electroporation or sterotactic body radiotherapy or (b) HEATPAC study which randomizes patients to either chemoradiotherapy or chemoradiotherapy with local hyperthermia. The study protocol is being currently drafted and the study is expected to be launched for patient recruitment in early 2015 in joint collaboration with University Hospital, Zurich.
- Technical studies from the hyperthermia research activites ( this is No 1, 6, 8 as listed before)
- Development of a novel hyperthermia treatment system: There is a modern, digital "lego-block" based hyperthemia soft-and hardware system with a completely new and innovative system which has been designed and assembled in collaboration with IT'IS/ETH. Presently the system is installed at Tiersspital, Zurich for preclinical testing in dog and cat limb sarcoma and would be subjected to a range of quality checks. Once successfully implemented in animals, a permission for using it in clinics would be sought from Swiss Medic.
- Development of a phantom for QA checks of hyperthermia units: Radio-Onkologie-Zentrum, KSA has designed and developed inhouse a unique hyperthermia phantom that would be used for conducting various QA checks for hyperthermia treatment systems. The phantom is unique and uses a single diode detector to scan the signals in all 3 axes. The equipment can also be used to measure directly the SAR values with a SAR probe. Presently, the system is undergoing field testing at KSA.
- Thermal and radiotherapy modelling: KSA in collaboration with ZHAW is exploring to model the dynamic changes that take place during hyperthermia – e.g. changes in perfusion resulting in changes in oxygenation and reoxygenation, inhibition of DNA repair and also changes in cytokinetics. Computer simulation of these have been carried out for fractioned radiotherapy and a multi-hit model has been proposed for a dual interaction of heat and radiation. This model once validated through in vitro and in vivo studies, could be incorporated in radiotherapy treatment planning systems to estimate the thermal enhancements following a combination of hyperthermia and radiation.
- Datta N.R., Samiei M, Bodis S. Radiotherapy infrastructure and human resources in Europe – present status and its implications for 2020. Europ J Cancer, 2014, DOI:1016/j.ejca.2014.06.012.
- Srivastava A, Datta NR. Brachytherapy in cancer Cervix. Time to move beyond “point A”? World J ClinOncol 2014; 5(4): 764-774.
- Datta N.R., Samiei M, Bodis S. Radiation therapy infrastructure and human resources in low- and middle-income countries: present status and projections for 2020. Int J RadiatOncolBiolPhys, 89; 448-457, 2014.
- Datta N.R., Puric E, Schneider R, Fuchs B, Bodis S, Weber, D. HYPROSAR: Hyperthermia and Proton Radiotherapy in Soft Tissue Sarcoma. Leading Opinions in Oncology 2014; 2: 158-160.
- Datta N.R., Puric E, Bodis S. 2014 Hyperthermia: its role in soft tissue sarcomas and recurrent breast carcinomas. Info@Onkologie, 2014, 4;34-36.
- Datta N.R., Heuser M, Samiei M, Shah R, Lutters, Bodis S. Tele-radiotherapy network for low- and middle –income group countries for providing cost effective comprehensive radiotherapy care for cancer patients. In: Al-Shanableh T, Dabaj F, editors. Proceedings of the 2nd international conference on e-health and telemedicine and international course on tele-pathology systems and applications, Istanbul, Turkey. ICEHTM; 2014, p121-30.
- Datta NR, Bodis S. Personalized radiation oncology: From “4 lines” to “4 dimensions” SchweizerKrebsbulletin 2014: 34 (1);20
- Datta N.R., Puric E, Schneider R, Fuchs B, Bodis S, Weber D.C. Thermoradiobiological basis of “HYPROSAR”: A clinical trial with hyperthermia and proton radiotherapy in unresectable soft tissue sarcoma, ESHO, Turino, 11-14 June 2014, Italy, PanminervaMedica, 56, p5-6, 2014
- Puric E, Datta N.R., Heuberger J, Lomax, N, Timm O, Marder D, Memminger P, Bodis S. Hyperthermia and re-irradiation for postirradiatedlocoregionally recurrent breast cancer: a single institutional experience, ESHO, Turino, 11-14 June 2014, Italy, PanminervaMedica, 56, p15-16, 2014.
- Marder D, Brandli N, Lomax N, Timm O, Lutters G, Datta N.R. First results with a new 3D E filed scanning phantom for quality assurance in deep hyperthermia systems. ESHO, Turino, 20-21 June 2014, Italy, Panminerva Medica, 56, p15-16, 2014.
- Scheidegger S, Bonmarin M, Timm O, Rhodes S, Datta, NR. Estimating radiosensitization based on re-oxygenation after hyperthermia by using dynamic models.ESHO, Turino, 11-14 June 2014, Italy, Panminerva Medica, 56, p24, 2014.
- Datta, N.R., Samiei M, Bodis, S. Present and future status of radiation therapy in low-middle income countries: an imminent global crisis. RadiotherOncol, 111, Suppl 1, 2014,223.
- Datta N.R, Puric E, Heubergerer J, Lomax N, Timm O, Marder D, Memminger P, Bodis S. Hyperthermia and re-irradtaion for effective treatment of locoregional recurrences in breast cancers. RadiotherOncol, 111, Suppl 1, 2014,477.
- Khuller P, Sinha S, Garg C, Datta N.R. Is IMRT superior to 3D CRT for postmastectomyirradiation ? An in-silico comparative planning study. RadiotherOncol, 111, Suppl 1, 2014,620.
- Datta NR, Puric E, Meister A, Lomax N, Marder D, Timm O, Spoerri P, Bodis S. Effectiveness of radiation and hyperthermia in elderly patients with bladder carcinoma: preliminary results from an ongoing study. SASRO, Lugano, March 2014, StrahlentherOncol 2014.
- Datta NR, Khan, S, Lutters G, Bodis S. Staff projections with increasing adaptations to high precisions radiotherapy planning at KSA. SASRO, Lugano, March 2014, StrahlentherOncol 2014.
- Puric E. Datta NR, Heuberger J, Lomx N, Timm O, Marder D, Memminger P, Bodis S. Hyperthermia nd re-irradiation for loco-regional recurrences in breast cancers. SASRO, Lugano, March 2014, StrahlentherOncol 2014.
- Marder D, Brändli N, Lomax N, Lutters G, Datta NR, Timm O. Improved machine control in deep hyperthermia with a newly developed 3D E-field scanning phantom, SASRO, Lugano, March 2013, StrahlentherOncol 2014.
- Datta, N. R, Kahn S, Meister A, Puric E, Lutters G, Rabe E, Bodis, S. Present and future radiation therapy infrastructure in Europe: A wake up call to cut the mustard? Europ J Cancer, 49, Suppl 2, 2013, S 219.
- Datta, N.R, Puric E, Eberle B, Lomax N, SpoerriP, SeilerD, ZimmermannM, LehmannK, Bodis S. Variations in thermal parameters in hyperthermia of bladder cancers: A preliminary QA from an ongoing national trial. RadiotherOncol, 2013,106(Suppl), S274.
- Datta NR, Singh S, Kumar P, Gupta D, Bodis S. Does the quantum of local tumour HPV positivity in cervix cancers lead to a radiobiologically different tumour cell population? Wolfsberg Meeting, June 2013
- Datta NR, Puric E, Lomax N, Scheidegger S, Marder D, Bodis S. Time - Temperature Area Under Curve (TT-AUC): A Proposal for a Novel Thermometric Parameter for Clinical Hyperthermia in Bladder Cancers, ESHO , Munich, June 2013
- Datta NR, Puric E, Geismar JH, Eberle B, Meister A, Lomax N, Lomax T, Goitein G, Fuchs B, Studer G, Pruschy M, Bley CR, Kuster N, Caspar C, Spoerri P, TschalerO,Mamot C, Weber D, Bodis S, Proposals for Future Clinical Trials in Hyperthermia, ESHO , Munich, June 2013
- Puric E, Datta NR, Eberle B, Lomax N, Spoerri P, van der Zee J, Bodis S. Deep hyperthermia along with chemoradiotherapy in bladder cancer: Initial experience in Aarau with 2 year follow-up. ESHO, Munich, June 2013
- Scheidegger S, Lomax N, Olaf T, Datta NR, Fuschlin RM, Bodis S. Characterization of hyperthermia with radiotherapy: temporal homogeneity and limitations of the CEM concept. ESHO, Munich, June 2013
- Datta NR, Puric E, Lomax N, .Marder D, Lutters G, Geismar JH, Bley CR, Pruschy M, Fuchs B, Studer G, Kuster N, Neufeld E, Caspar C, Bodis S. Hyperthermia Collaborative Research Network (HCRN) - Aargau, Solothurn and Zurich, SASRO, Davos, June 2013, StrahlentherOncol 2013; 189(12),1085.
- Datta NR, Puric E, A.Meister, Lomax N, Heuberger J, Marder D, Timm O, Goitein G, Lomax T, Geismar JH, Fuchs B, Studer G, Bode B, Bodis S, A multi-institutional phase I/II pilot study of proton radiotherapy with local hyperthermia in adult soft tissue sarcoma, SASRO, Davos, June 2013, StrahlentherOncol 2013; 189(12),1085.
- Puric E, Datta NR, Lomax N, Timm O, Studer G, Fuchs B, Bode B, Bodis S. Differential effectiveness radiotherapy versus radiotherapy and hyperthermia in a soft tissue sarcoma of the extremity: A case study. SASRO, Davos, June 2013, StrahlentherOncol 2013; 189 (12),1085.
Prof. Stephan Bodis
Senior Consultant in Radio-oncology
Prof. Niloy Ranjan Datta
Head of Research
Dr Juerg Heuberger
Head of Planning
Shaka Khan MSc
Senior Dosimetrist / Clinical Studies
Dr Gerd Lutters
Head of Medical Physics / Radiation Protection
Dr Andreas Meister
Senior Physician in Radio-oncology
Dr Emsad Puric
Head of Hyperthermia
Dr Susanne Rogers
Head of Stereotactic Surgery
Dr Istvan Takacs
Head of Radiotherapy (Benign Indications)
Senior Medical Technician Radiology Assistant, Section Management, MTTD Central Office Medical Services
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