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Radiation Oncology, General Hospital
Paediatric oncological surgery is the branch of paediatric surgery that is dedicated to the surgical treatment of paediatric oncological and haematological diseases and their complications. It is one of the basic pillars for the treatment of solid paediatric tumours.
These are illnesses that, due to their severity, complexity, and rareness, must be centralised in hospitals that are equipped with experienced multidisciplinary teams and the technology and medical experience necessary. The evolution of this unit has often gone hand-in-hand with the surgical advances achieved in solid organ transplants, which has allowed it to develop advanced techniques that now make enormously difficult cases operable. In addition, it frequently requires collaboration from other highly complex paediatric specialities (heart surgery, neurosurgery, spinal surgery, plastic surgery, etc.).
Vall d’Hebron is the hospital that offers the most oncology services in Catalonia, and it is a member of the European Reference Networks (ERNs) for Paediatric Oncology “PaedCan” and Rare Haematological Diseases “EuroBloodNet”. It is also accredited by JACIE for paediatric haematopoietic stem cell transplants.
Paediatric tumours are complex and rare. Treating them in reference centres such as Vall d’Hebron offers the maximum chances of success. The Oncology Surgery Unit is a highly specialised reference unit that works in collaboration with the Paediatric Oncohaematology Department and other related departments, to offer the patient the best possible quality of care. We boast medical, surgical, and central departments that are highly specialised in oncological care and that ensure a comprehensive vision of the process. They incorporate all of the preventative, diagnostic, therapeutic, and monitoring aspects that these patients require, including personalised therapies and the use of genomic platforms. The hospital has some of the latest technological advances at its disposal, which allows us to offer everything from minimally invasive and robotic surgery to combined treatments using interventional radiology and complex multidisciplinary interventions. The position of Vall d’Hebron Hospital as a national reference centre for paediatric solid organ transplants allows for comprehensive care in cases where transplants are the only treatment or part of the treatment (especially in liver and kidney tumours) to cure the illness.
The Unit also provides the surgical treatments necessary for benign and malignant paediatric haematological diseases and haematopoietic stem cell transplants, such as fertility preservation techniques and the removal of the spleen in some types of anaemia.
We also participate in VHIR’s Translational Research in Cancer in Children and Teenagers Group as a fundamental part of the team, which works closely with clinical care, mostly through the Programme for Personalised Medicine in Paediatric Cancer. We also collaborate with other national and international research centres, along with several international collaborative groups for solid paediatric tumours. This allows us to remain at the forefront of surgical treatment for paediatric oncohaematology patients.
Either as a unit or individually, we participate in and/or are accredited by, via external audits, the following national and international networks, which guarantee that patients can access our unit from any point within the Spanish or European healthcare system:
ERN (European Reference Networks)
Reference Centres, Services and Units (RCSU)
The Unit treats all kinds of benign and malignant tumours, both visceral and of the soft tissue (thoracic and abdominal), with the exception of tumours of the central nervous system, the locomotor apparatus, and the heart, which are operated on by other surgical departments at our centre. We cover the age range from the prenatal period to adolescence, and even treat young adults (for some types of tumours).
We treat, among others, the following solid tumours:
Among the soft-tissue sarcomas, the following are included: retroperitoneal tumours, sarcomas of the biliary tract, gynaecological sarcomas, etc. We are a reference centre in Spain for the treatment of all kinds of paediatric sarcomas, and we are part of the EpSSG Surgical Subcommittee.
In bone sarcomas, we treat tumours of the thoracic wall, even when the vertebrae and medullary canal are affected (in collaboration with the Spine Unit) and/or the case requires complex thoracic reconstruction.
Regarding haematological diseases, we would especially like to mention:
Lastly, the Oncology Surgery Unit coordinates and takes part in Vall d’Hebron Hospital Paediatric Vascular Anomalies Committee, which meets once a month. This committee is comprised of dermatologists, plastic surgeons, paediatric surgeons, radiologists, pathologists, interventional radiologists, oncologists, and paediatricians. Its objective is to diagnose and treat the most complex cases of anomalies and both cutaneous and visceral vascular tumours.
At the Radiation Oncology Department, our goals are to help improve all aspects related to the prevention, diagnosis, treatment, teaching and research of cancer. We are a central plank in organising care for patients with cancer, especially with regard to radiation oncology. Working in multidisciplinary teams helps improve the healing rates of our patients, and makes us a reference department across Spain.
We have the most advanced technology in Europe. Techniques such as image-guided radiation therapy (IGRT) and intensity modulated radiation therapy (IMRT) mean we can provide more precise treatments by adapting the dose to the shape of the tumour to better protect healthy tissue.
These advances are especially relevant for paediatric radiation therapy, since precision strategies are even more important in children. We treat 80% of children in Catalonia, as well as handling complex cases from elsewhere in Spain.
Technological development has allowed us to improve the whole process of planning and treatment using radiation.
The Intensity Modulated Radiation Therapy Programme (IMRT) and the Stereotactic Radiosurgery/Radiotherapy Programme (SRS) were both started at the Hospital's Radiation Oncology Department in 2008. Initially, IMRT was used to treat prostate tumours, and later for the treatment of cancer of the breast, head and neck, and paediatric tumours. It is now also used in gynaecological and digestive tumours, and we are able to apply it in all cases where it might represent a significant improvement in treatment.
We are the centre that performs most treatments using intensity modulated radiation therapy (IMRT) in Catalonia for genitourinary pathologies, tumours in the head, neck and breast neoplasias, where advanced technology has been fully integrated to improve care.
Our dedication to offering quality and safety in care has made us pioneers, as we have established various internal control committees, as well as developing our own protocols for image guided radiation therapy (IGRT). We are a young, dynamic team that is part of a range of scientific organisations, both nationally and internationally.
The Radiotherapy Oncology Service treats many patients and handles cases of complex pathology every day. It stands out for its assistance work in different areas, such as pediatric oncology, stereotactic techniques such as SBRT and radiosurgery, in addition to pathology benign (ablation of cardiac arrhythmias, trigeminal neuralgia, keloids, arteriovenous malformations). We are part of more than 10 multidisciplinary tumor committees that take place at our center and participate in our own research projects as well as national and international ones. During the residency, the professional and human development of the resident is encouraged, facilitating participation in different research projects and attendance at different types of training courses, in addition to rotation at the international external center. We have a great track record in the continuing education of residents, and many of those who have passed through our unit hold positions of responsibility in international hospitals. We get residents and professionals from all over the state who do rotations in our specific units to learn the techniques we have in place.
Radiotherapy Oncology training itinerary
The Radiation Oncology Teaching Unit is provided by the Radiation Oncology Department, with the involvement of Haematology, Internal Medicine, Medical Oncology, Radiology, Radiophysics, A&E, and Palliative Care. In Radiation Oncology we attend to patients at the hospital and in the Vall d’Hebron healthcare area of influence, but we are also active in other parts of the country as we are a leading centre for several complex diseases.
We offer a training programme in radiation oncology that includes learning in research. This means taking part in multidisciplinary committees that analyse different pathologies and generate hypotheses for future research projects. Residents integrate into a line of research when they join the programme, assisted by a consultant.
We are part of the Vall d’Hebron Research Institute (VHIR) and the Vall d'Hebron Institute of Oncology (VHIO). We actively participate in different national and international research groups, such as the European Organisation for Research and Treatment of Cancer (EORTC), the International Society of Paediatric Oncology (SIOP), and the Radiation Oncology Clinical Research Group (GICOR).
The Hospital Radiophysics Teaching Unit is made up of hospital radiophysics specialists and senior technicians specialising in radiotherapy and/or radiodiagnosis.
Hospital radiophysical training itinerary
The Medical Physics and Radiation Protection Department was accredited as a teaching unit in 1995 and is one of the first to receive accreditation in Spain. Some of our former residents now hold important positions in hospitals throughout Spain. Being part of Catalonia’s biggest hospital, with a technology park that is updated constantly, allows us to offer state-of-the-art training in all the areas of the speciality: radiotherapy, nuclear medicine, radiodiagnosis, and radiation protection in healthcare. It is unique, thanks to its extensive experience in advanced radiation oncology techniques in adult and paediatric patients, along with the scope of the radiation protection operations it carries out within the hospital, in both clinical and research facilities. The department has a laboratory where the hospital’s radiation detectors can be calibrated.
Additionally, the Vall d'Hebron Campus offers the possibility of actively participating in national and international research projects and clinical trials linked to its two research institutions, the Vall d'Hebron Institute of Oncology and the Vall d'Hebron Research Institute.
Why specialise at Vall d’Hebron?
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