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Department of
Therapeutic Radiology
Yale University
School of Medicine
P.O. Box 208040
New Haven, CT 06520-8040

Department of Therapeutic Radiology

In 1958, the Yale University School of Medicine committed itself to a long-range program in support of research and training in clinical radiation therapy and radiobiology with the construction of the Robert E. Hunter Radiation Therapy Center. In 1962, Yale was awarded one of the original NIH Program Project Grants in Radiation Therapy and Radiobiology. This program provided funds for the support of a nucleus of physicians with a focused interest in the therapeutic application of radiation and related basic research.

A variety of sources provide millions of dollars annually for support of research activities within the department. A separate training program in therapeutic radiology was established in 1961, and since the original NIH Program Project Grant in the early 1960s, the department has developed and expanded to provide a multitude of scientific and translational research opportunities. In 1972, Therapeutic Radiology became an independent department at Yale and was organized into three major divisions: Radiation Therapy, Radiobiology and Radiological Physics. Currently, there are 14 University radiation oncology attending physician faculty who provide specialized clinical service, multidisciplinary care, education for housestaff/students, and pursue clinical and basic research endeavors.

The Robert E. Hunter Radiation Therapy Center at Yale-New Haven Hospital includes approximately 20,000 net square feet (not including laboratory space) of space, the majority of which has been renovated during the past four years. It includes treatment facilities, physics, dosimetry and planning facilities, an outpatient clinic with procedure room, office space, a departmental library with computer terminal internet access, and two conference rooms of 15 and 50 person capacity. Conference space is equipped with audio visual links to other centers, as well as secure online computer access to dosimetry, diagnostic radiology, portal imaging, and internet. Multiple treatment planning systems are available, and MR and PET data/image merge, in conjunction with CT simulation, is available for treatment planning. Major items of equipment include a new Varian Trilogy linear accelerator with multiple photon and electron energies, stereotactic body radiosurgery and gating capability, and image guided radiotherapy (IGRT/IMRT/MLC/Portal Imaging) which was installed in early 2007, a 2100D Varian linear accelerator with electron capability (IMRT/MLC/Portal Imaging), a Varian EX linear accelerator (IMRT/MLC/Portal Imaging) which also provides Total Skin Electron Beam Therapy (TSEBT) to approximately 30 patients annually, a Gamma-Med high dose rate after-loading unit, a 250 KV constant potential Siemens x-ray unit, a Ximatron conventional fluoroscopic simulator, one of the first CT-simulators in Connecticut (GE with Advantage-Sim), and a B-mode Acquisition Targeting(BAT) device. The Yale program has a stock supply of sources for interstitial and intracavitary brachytherapy applications. The department offers 4D gating simulation and treatment delivery equipment, in addition to cone beam CT as integral features and components of the IGRT and stereotactic body radiosurgery programs. The department has a fully integrated Varis-Aria record and verify system. All portal and IGRT images may be viewed from various workstations within the department and include all clinical areas as well as attending and resident physician offices. A dedicated machine and electronics shop also resides in-house. Approximately 1500 new patients per year are seen, in addition to follow up visits.

The Department of Therapeutic Radiology will be moving all clinical operations to the New Cancer Hospital at Yale-New Haven in 2009. The department will have 5 vaults which will accommodate 4 linear accelerators, and a gamma knife unit. Additional major equipment will include 2 CT simulators with 4D capability, a high dose rate unit, and an orthovoltage unit. Patients will also benefit from access to PET-CT simulation and MR with full electronic merge-integration with the Eclipse treatment planning system. The clinical facilities will represent the state of the art. Multidisciplinary clinical care will take place on the floors above the Department of Therapeutic Radiology, and the new building will include 112 inpatient beds, 12 operating rooms, and 61 chemotherapy suites exclusively for the care of oncology patients.

The department will continue to maintain basic research operations in the newly renovated laboratory space on the 2nd and 3rd floors of the Hunter building and the department will continue some administrative operations in the current Hunter location.

The net square footage for the department, within the new cancer center facility, will add an additional 32,000 nsf. This will bring the departmental total (including laboratory space) to over 60,000 nsf.

The Radiation Therapy Center at the Backus Hospital in Norwich includes over 10,000 net square feet of space devoted primarily to the treatment facility, a treatment planning and physics area, and an outpatient clinic. The center is an integral component of the Yale radiation oncology program with full time support from University attending staff. Equipment includes an Elekta Synergy linear accelerator with multiple photon and electron energies, IGRT/IMRT/MLC, a 2100C/D Varian linear accelerator with MLC, Impac record and verify system, a Varian simulator, a Theraplan Plus treatment planning unit, a Scandotronix automatic isodose plotter, and related physics equipment. Over 400 new patients are evaluated and managed annually.

The William W. Backus Hospital: 860-892-2777
326 Washington Street
Norwich, CT 06360

The Lawrence and Memorial Hospital in New London offers radiation oncology services as part of a recognized Community Cancer Center. The Department of Radiation Therapy at Lawrence and Memorial Hospital is an integral component of the Yale University program and utilizes 12,000 net square feet of dedicated space. Attending and resident physicians, as well as technical/therapy and physics staff from Yale-New Haven Hospital constitute the multidisciplinary care team. This facility, which has state-of-the-art equipment and software including two Varian 2100 dual energy linear accelerators with full electron capabilities, MLC/IMRT, a Varian simulator, Impac record and verify system, Eclipse treatment planning software, and an orthovoltage unit, provides therapy for over 450 new patients annually. A CT simulator with 4D gating capability is being acquired and will replace the Varian simulator in early 2008. Calypso technology for prostate IGRT and intra-fraction motion detection is also being installed as of April of 2008.

Lawrence & Memorial Hospital: 860-442-0711 ext. 3128
Community Cancer Center
365 Montauk Avenue
New London, CT 06320

The Yale Gamma Knife Center. This facility provides specialized multidisciplinary radiosurgical management for patients. The center is located within walking distance of Yale New Haven Hospital. Approximately 250 procedures are performed per year.
Stereotactic/Gamma Knife

Gamma Knife Center: 203-688-4040
Sterotactic Radiosurgery
60 Temple Street
New Haven, CT

The Shoreline Medical Center. Since July 2004, the Department of Therapeutic Radiology of the Yale-New Haven Medical Center has been operating a clinic and treatment facility in Guilford, Connecticut. As an integral part of the Yale-New Haven Shoreline Medical Center (YNHSMC), various subspecialty services are located in a convenient setting for those patients who live on or near the Shoreline region. This facility along with our Radiation Oncology practice in Guilford is located just off Exit 59 of the Interstate 95 Highway. Medical services include not only external beam radiotherapy for our cancer patients, but also more generally include diagnostic imaging, laboratory testing, ambulatory surgery, endoscopy, emergency room, several private physician offices, and other support services such as nutrition counseling and preadmission testing. For the cancer patient who lives or works in the Shoreline area, this means that external beam radiotherapy may be administered more conveniently. The Department of Radiation Oncology at the YNHSMC is a full service practice, representing more than just an extension of our clinic in New Haven at the Yale-New Haven Medical Center.
Shoreline Medical Center

Shoreline Medical Center: 203-453-7170
111 Goose Lane
Guilford, CT 06437

The Veterans Administration Medical Center in West Haven is an integral part of our program, but there are no radiation treatment facilities at the VA Hospital. Patients who require therapy are transported daily by car or ambulance to the Hunter Radiation Therapy Center at the Yale-New Haven Hospital.

Research Facilities
The Department of Therapeutic Radiology performs clinical research in almost all types of cancer including head and neck, breast, lung, Hodgkin's disease, non-Hodgkin's lymphomas, all of the major gastrointestinal cancers, glioblastoma multiforme and other neurological based malignancies, genito-urinary cancer, and the common childhood malignancies including Wilm's tumor, neuroblastoma and leukemia. The majority of these studies involve collaborative efforts with members of other departments, most commonly Medical Oncology, Pediatric Oncology and the various surgical sub-specialties. In addition to these intramural programs, the department offers patients the opportunity to participate in multi-institutional cooperative group trials, in addition to other collaborative inter-institutional endeavors.

Approximately 19,000 net square feet of laboratory space is presently available in the Department of Therapeutic Radiology. The majority of the laboratory space is located on the second and third floors of the Hunter Radiation Therapy building directly above the clinical area. Facilities for virology and bacteriology, biochemistry including nucleic acid chemistry, tissue culture, experimental animal tumor work, and others are available. Major renovations to improve and modernize this space are almost complete, funded in part by a substantial construction grant from the National Institute of Health.

There is a dual corridor animal care facility that includes radiation therapy facilities, and animal breeding and care facilities within the barrier. Investigators also of course can arrange and have access to other critical technologies from other parts of the Yale Comprehensive Cancer Center and Yale School of Medicine.

Laboratory research is performed in radiation biology, and radiologic physics by over ten separate groups, each consisting of a senior faculty member together with various pre- and post-doctoral fellows and technical assistants. The range of research interests varies from basic molecular and cancer biology to in vivo tumor biology and gene therapy approaches.

The Department of Therapeutic Radiology is an integral part of the Yale Comprehensive Cancer Center and benefits from well established relationships with other clinical and basic research departments.