Two radiation oncologists in conversation in the library

Teaching and research

Teaching

As part of the curriculum for students of human medicine and dentistry, numerous lectures and practical courses are held by the staff of the Clinic for Radiotherapy and Radiation Oncology. The Department of Radiation Oncology participates in the state examination in medical radiology.

The head of the clinic is dean of studies and thus responsible for optimal teaching and reliable performance assessment. He also heads the SRO examination board and its quality assurance.

  • In addition, various courses are organized or co-organized for the MTRA school and the nursing staff of the University Hospital Basel.
  • We regularly give information lectures for non-specialist medical colleagues as part of interdisciplinary colloquia.
  • We are involved in the further education and training of German-speaking specialist societies with interdisciplinary presentations.

Research

The clinically oriented research activities mainly involve participation in multicentre national, and in some cases international, studies to optimize multimodal therapies (surgery, chemotherapy, radiotherapy). Within the framework of the Swiss Society for Clinical Research (SAKK), neoadjuvant concepts (radiotherapy and chemotherapy prior to planned surgery) are implemented in particular. The head of the clinic heads the scientific, radio-oncology section of SAKK.

  • The possibilities of modern radiation techniques are tested in preclinical and clinical studies. The main focus here is on intensity-modulated and stereotactic radiotherapy of tumors of the head and trunk.
  • Employees of the clinic are also represented on the scientific committee of German-language specialist journals.

Good, practical teaching is very important to us. For this reason, we offer a varied program in which we teach the important contents of radiotherapy.

By incorporating interviews with patients and practical exercises, we aim to facilitate access to the medical and technical subject of radiation oncology. All exam-relevant content is covered in the lectures and practicals and can be studied in greater depth at any time by visiting our clinic. The catalog of learning objectives lists the most important content and knowledge that students should have mastered after completing their studies.

In addition to the lectures, there is also the possibility of a practical course in radiotherapy. The aim of this internship is to provide students with sufficient insight into all relevant aspects of radiologic oncology during this time and to actively involve them in the treatment and care of our patients. During the 1 to 2 month stay, the students get to know the most important work stations in the clinic. The training is tightly organized and is supervised by the head physician and senior physicians. In addition, there is sufficient free time and access to literature in the clinic's own fully equipped library.

Radiation oncology requires not only clinical skills and knowledge but also an understanding of physical-technical and radiobiological principles. This is taken into account in our clinic through special events and lectures to which students are cordially invited. Written summaries of the lectures or the figures/tables presented are available on our intranet.

A visit to our clinic is possible at any time by prior arrangement if you would like to learn more about our specialty. We warmly welcome all interested parties.

We are also happy to welcome students of human medicine or dentistry for one-day or half-day visits at any time. They can get an idea of the numerous possibilities of radiotherapy while caring for patients.

We offer Master's theses, which are not only intended to evaluate the results of radiation oncology therapy, but also provide insights into patient management and help to develop students' didactic skills. Overall, the Master's theses serve to expand the medical, scientific and didactic skills of the Master's students.

Oncological and radiotherapeutic principles

The most important contents and knowledge that students should have mastered after completing their studies are listed below.

Students should

  • know that ionizing radiation is used to treat malignant diseases and be able to list examples of such diseases
  • know that ionizing radiation is used to treat benign diseases and be able to list examples of such diseases
  • know the following oncological principles
    1. the problems of solid tumors with regard to infiltrating and destructive growth, lymphogenous and hematogenous metastasis and metastatic pathways, disease-related symptoms and complications, differentiation criteria between malignant and benign tumors
    2. the problems of malignant systemic diseases with regard to infiltrating and destructive growth, pathways of spread, disease-related symptoms and complications
    3. the principles of tumor spread and its diagnosis
  • be able to explain the terms "staging", "grading", "multimodal therapy", "curative", "palliative", "adjuvant", "additive", "neoadjuvant
  • be able to list the most important tumor diseases such as breast carcinoma, lung carcinoma, rectal carcinoma, prostate carcinoma, head and neck tumors and basic treatment strategies
  • be able to name types of metastasis and common metastatic sites of the most important tumor diseases
  • know that radiotherapy is particularly important for organ preservation; examples of tumor diseases include breast carcinoma, prostate carcinoma, laryngeal carcinoma and anal carcinoma

Use of percutaneous radiation devices (linear accelerators)

The students should

  • be able to define the terms "percutaneous radiation treatment", "teletherapy"
  • be able to name devices for the generation of therapeutically used photon beams and explain their basic functional principles
  • be able to name a device for generating therapeutically used electron beams and explain its basic functional principle
  • be able to explain the terms "standing field", "opposing fields" and "multi-field technology" and list their advantages and disadvantages
  • know that fixation and positioning aids can improve the precision of irradiation
  • know that it is possible to apply therapeutic radiation doses for the treatment of benign and malignant diseases
  • be able to list typical early and late reactions of various organs/organ systems to radiation treatment
  • be able to list at least two typical examples of benign diseases that are amenable to radiotherapy

Use of brachytherapy


Students should

  • be able to explain the terms "brachytherapy", "afterloading", "intracavitary irradiation", "interstitial irradiation" and provide examples of these terms
  • be able to list the fundamental differences to teletherapy, in particular the aspect of better protection of the surrounding normal tissue
  • be able to list typical examples of the treatment of malignant diseases using brachytherapy, alone or in combination with percutaneous radiotherapy

Physical principles


Students should

  • be able to explain what ionizing radiation is
  • be able to name the properties of direct and indirect ionizing radiation and give examples
  • be able to list the basic differences between wave and particle radiation and give examples of each
  • know how ionizing radiation can be generated for therapeutic purposes
  • be able to explain the concept and generation of "X-ray bremsstrahlung"
  • know that radiation treatment is mainly carried out with photons or electrons and be able to name typical energy ranges of therapeutic photon or electron radiation
  • be able to describe the typical shape of depth dose curves of high-energy photons and electrons

Biological basics


Students should

  • be able to list and explain the most important effects of ionizing radiation on cells, tissue and the organism as a whole
  • be able to name the most important target molecules in the cell for the effects of ionizing radiation
  • know that there are recovery and repair mechanisms for radiation damage in cells
  • be able to explain the terms "deterministic" and "stochastic" with regard to the effects of radiation and list the differences between these effects
  • be able to explain the terms "normofractionation", "hypofractionation" and "hyperfractionation"
  • know the significance of the tumoricidal effect of ionizing radiation for the treatment of malignant tumors
  • be able to list several factors influencing local tumor control

radiation planning

Tools
The students should

  • be able to name the most important tools and methods of radiation planning
  • be able to explain the importance of 3D radiation planning based on cross-sectional imaging (CT, MRI)
  • know that CT can also be used to include tissue x-ray density in the dose calculation
  • know that the radiation fields can be shaped using shielding blocks or multi-lamella collimators
  • be able to explain the terms "intensity-modulated" and "stereotactic" radiotherapy

Prescribe therapeutic radiation doses
The students should

  • be able to explain the significance of fractionation on the total dose level and tumor healing
  • know that the tolerance of the surrounding tissue often limits the total dose that can be irradiated

Visualization of the radiation dose and its distribution (isodoses)
The students should

  • know that there are tools for visualizing the dose distribution and be able to explain the term "isodose"
  • know that the isodoses can also be displayed in three dimensions if a 3D data set of a cross-sectional image examination is available
  • know that so-called dose-volume histograms are tools for evaluating a radiation treatment plan
  • know that quality assurance is required by law

Catalog of learning objectives for the internship in the Department of Radiotherapy and Radiation Oncology at the University Hospital Basel

The aim of the internship is to provide students with sufficient insight into all relevant aspects of radiologic oncology during this time and to actively involve them in the treatment and care of our patients. During their 1 to 2-month stay, the students get to know the most important work stations in the clinic. The training is tightly organized and is supervised by the head physician and the senior physicians. It includes "General Oncology", "Clinical Radiation Oncology", "Medical Physics" and "Radiation Biology". It goes without saying that the students organize parts of their training independently. Sufficient time and access to literature in the institute's own fully equipped library are provided.

During the internship, students get to know the following work stations within the institute:

  • Polyclinic (1-2 weeks)
  • Linear accelerator (1-4 weeks)
  • Simulation and radiation planning (2-4 weeks)

This basic rotation structure also provides an insight into stereotactic radiotherapy and brachytherapy (afterloading, seeds). The responsible senior physician monitors the process at the respective workplace, serves as a contact person for questions regarding content and supports the acquired knowledge in repeated technical discussions.

Modern, especially curative therapy concepts in oncology are complex and require interdisciplinary cooperation and coordination. This is taken into account in our clinic through numerous, regular tumor conferences. Participation in the meetings listed below is planned as follows:

  • Visceral tumors (2 times)
  • Soft tissue and bone tumors/pediatric tumors (up to 2 times)
  • Head and neck tumors (2 times)
  • Lymphoma conference (1 time)
  • Gynecological tumors and breast cancer (2 times)
  • Urological tumors (1 time)

Attendance is confirmed by the respective senior physician who is responsible for the conference on the radiotherapy side.

Radiation oncology requires not only clinical skills and knowledge but also an understanding of physical-technical and radiobiological principles. This is taken into account in our clinic through special events and lectures. The lectures are usually given by junior doctors under the supervision of a specialist in radiotherapy, medical physicists or radiation biologists. Written summaries of the lecture or the figures/tables presented are available. The required specialist books and reviews are made available to students free of charge. The clinic's own library is available to students every day without restriction, as is Internet access with the usual literature search programs (pubmed, cancerlit, uptodateonline.com)

The following is a detailed list of the topics that students are expected to deal with during the internship:



1. for all entities: Anatomic principles; clinical symptoms; diagnostic measures; staging; prognostic factors; general treatment principles; treatment-related side effects; major treatment protocols.


2. special contents that require particular attention are listed below in keywords for the individual tumor entities. Here too, students should gain an initial insight into the possibilities of radiation oncology:

  • CNS tumors (radiotherapeutic techniques, stereotaxy)
  • Head and neck tumors (primary and postoperative radio- and radiochemotherapy)
  • Lung cancer (NSCLC: primary radiotherapy, combined radiochemotherapy, postoperative radiotherapy; SCLC: combined radiochemotherapy)
  • Breast cancer (indications for postoperative radiotherapy, combination with chemotherapy and hormone therapy, metastasis patterns, prognostic factors)
  • Rectal cancer (neoadjuvant and adjuvant concepts)
  • Prostate cancer (indications for primary and postoperative radiotherapy, indications for combined hormone and radiotherapy, side effects of radiotherapy)
  • Gynecological tumors (brachytherapy technique)
  • Radiotherapy of metastases (goals of palliation)

3. students have the opportunity to deepen the knowledge of radiobiology and radiation physics gained in the radiooncology lecture by participating in the clinic's internal continuing education program for all employees.

It is advisable to study the relevant guidelines for the treatment of individual tumor diseases. The list under Clinic offers -> Recommended literature is a non-binding selection without any claim to completeness. It is possible to deepen the knowledge acquired as part of the daily routine at the workplace and in the tumor conferences.

The Department of Radiotherapy and Radiation Oncology offers a structured program of further medical training. The procedures required for comprehensive further medical training to become a specialist in radiotherapy and radiooncology are set out in the clinic's internal guidelines. Specialist medical instruction is ensured at every workplace. The content of the further training is based on the recommendations of the specialist societies, but also goes beyond these in some areas due to local circumstances.

At the same time, the further training courses and internal hospital guidelines ensure that existing specialists have a high level of knowledge. This applies in particular to the continuous offerings in the context of interdisciplinary tumor conferences, internal discussions on therapy planning and lectures and presentations on clinical radiation oncology, medical physics and tumor and radiation biology as well as the comprehensively supported participation in national and international congresses. The doctors involved can and should play an active role in shaping the further training program.

Further training to become a specialist in radiation oncology takes at least 6 years for full-time employment and is automatically extended for part-time employment. As part of our program (see further training concept for FMH specialists in radiation oncology / radiotherapy at the University Hospital Basel.pdf), doctors should acquire in-depth knowledge and experience in all areas of modern radiotherapy. In principle, the training periods, the workplaces to be completed and the services to be provided independently are listed in the training regulations, which can be viewed at the Swiss Radiation Oncology Society (SRO).

In order to provide doctors with sufficient insight and systematic knowledge of all modern types of treatment and techniques in radiation oncology, there is a regular rotation to all outpatient workstations. In order to impart comprehensive knowledge of the various diseases quickly, the rotation takes place with the care of the patients by the individual doctors. This ensures that patients are cared for by one doctor right from the start. On the one hand, this avoids a loss of information that could have an unfavorable effect on treatment and, on the other hand, enables the doctor in charge to quickly familiarize himself/herself with all work stations:

  • Polyclinic (patient consultation, indication for radiation treatment, aftercare)
  • Linear accelerator (treatment of malignant and benign diseases, stereotactic radiotherapy and radiosurgery)
  • Therapy planning and simulation (real and virtual simulation, technology and implementation of sectional imaging, 3D-conformal therapy, IMRT and IGRT)

At the same time, students are familiarized with brachytherapy (afterloading) and conventional X-ray therapy. This begins with the 3rd year of further training.

Further training in diagnostic cross-sectional imaging procedures (CT, MR, ultrasound) is useful with regard to refined and precise radio-oncological procedures (IMRT, IGRT, stereotactic radiotherapy). Through rotation in neighboring clinics and departments, most likely medical oncology but also radiology, skills and knowledge in the inpatient care of patients and the necessary radiological diagnostics are also imparted. This is also ensured through participation in interdisciplinary tumor conferences, where pathological principles and radiological imaging are presented and explained in detail. In addition, regular inpatient ward rounds are held at least once a week, during which drug-based oncological and supportive therapies are explained in detail.

Over the course of 3 years, all of the achievements required in the further training catalog for the outpatient area should be achieved. The knowledge acquired by the assistant doctors and the scope of the required services are assessed by the clinic's training supervisor in six-monthly staff appraisals.

Modern, especially curative therapy concepts in oncology are very complex. They require good interdisciplinary cooperation and coordination, especially between radiology and medical oncology and the surgical disciplines. This is taken into account in further training through mandatory participation in tumor conferences. Participation is confirmed in the training calendar by the consultant radiologist responsible for the respective conference.

In addition to acquiring knowledge and experience in everyday clinical practice, a sound theoretical knowledge of the basics of biology, physics and therapeutic principles in oncology is important. For this reason, lectures are held regularly as part of a rotating program. The lectures are given by all physicians, in the case of residents under the supervision of a specialist in radiotherapy or medical physicists. Written summaries of the lecture or the slides presented are then made available to all employees on the clinic's intranet platform. Participation in a course on radiation biology and the basics of radiation physics or therapy planning (e.g. ESTRO, Dresden, Heidelberg) is recommended. As part of the clinic's further training program - also accessible to the clinic's medical specialists - psycho-oncological training (lecture, participation in balint groups) and training in interviewing take place.

In addition, after the respective biology, physics and clinical training blocks, short lectures are held for a period of 2 months each to update the clinic's internal therapy recommendations and as part of a journal club. These take into account the results of current clinical studies that have been published in the meantime, insofar as they have produced results relevant to clinical radiation oncology.

Structured weekly training events take place both in cooperation with other oncology disciplines and as independent radio-oncology-oriented lectures at the Clinic for Radiotherapy and Radiooncology. All weekly training events are accredited by the Swiss Society of Radiation Oncology (SRO) and the Baden-Württemberg Medical Association. If you wish to participate, please contact the chief physician's office with your name, telephone number and e-mail address. An overview of the current topics can be sent to you.

The Clinic for Radiotherapy and Radiation Oncology is open to students at any time. We offer a comprehensive insight both in the context of internships, clinical traineeships or junior doctor periods.

The aim of the stay in our clinic is to provide students with sufficient insight into all relevant aspects of radiologic oncology during this time and to actively involve them in the treatment and care of our patients. During the 1 or 2-month stay as a sub-assistant, the students get to know the most important work stations in the clinic. The training is tightly organized and is supervised by senior physicians. It includes "General Oncology", "Clinical Radiation Oncology", "Medical Physics" and "Radiation Biology". It goes without saying that the students organize parts of their training independently. Sufficient freedom and access to literature are provided.

During the internship, students get to know the following work stations within the clinic:

  • Polyclinic (1-2 weeks)
  • Linear accelerator (1-2 weeks)
  • Simulation and radiation planning (2-4 weeks)

This basic rotation structure also provides an insight into stereotactic radiotherapy and brachytherapy (afterloading, seeds). The responsible senior physician monitors the process at the respective workplace, serves as a contact person for questions regarding content and clarifies the acquired knowledge in technical discussions.

We also offer the opportunity to carry out scientific work as part of Master's theses and dissertations. Close personal supervision is provided by the academic head of the clinic. Participation in courses on the design of clinical or experimental studies and the statistical planning and evaluation of experiments is encouraged.