Department of Radiation Oncology III: Specialty in Thoracic Tumors, and Malignant Bone and Soft Tiss

Radiotherapy Department Ⅲ, Wuwei Heavy Ion Center, Wuwei Cancer Hospital, Gansu Province

（Department of Thoracic Oncology and Malignant Bone and Soft Tissue Tumor Treatment）

Department Creed: Erudite, Exquisite, Humble, Sincere

Ⅰ. Department Overview and Positioning

The Third Department of Radiation Oncology was established in March 2020, specializing in heavy ion research and clinical application. It is currently the highest-volume center in China for annual heavy ion treatment casesand treats the most complex tumor typesusing this modality.

Building on continuous clinical experience summarization and refinement, our department has developed a systematic heavy ion treatment framework—rooted in whole-body tumor heavy ion therapy—with lung cancer, breast cancer, and bone/soft tissue tumors as its core indications. This focus has led to markedly improved efficacyof heavy ion therapy for these malignancies.

The department has pioneered and standardized heavy ion therapyfor esophageal cancer, bladder cancer, breast cancer, cardiac tumors, and other conditions both domestically and globally. We innovatively employ multiple world-first techniquesto strictly control organ motion: these include high-frequency oscillating ventilators under general anesthesia, bladder volume-pressure control devices, breast immobilizers, and the surgical placement of isolating tissue between abdominal/pelvic tumor masses and organs-at-risk (OARs) prior to heavy ion radiotherapy. These innovations achieve three key goals:

•Further increasing the local heavy ion dose delivered to the tumor;

•Better protecting normal organs;

•Fulfilling the objective of precise heavy ion radiotherapy—enhancing efficacy while reducing treatment-related side effects.

Ⅱ.Talent Team and Disciplinary Team Structure

Team Size

The department currently has 1 specialized outpatient clinic, 1 inpatient ward, and 60 beds. It comprises 8 physicians (1 Chief Physician, 1 Deputy Chief Physician, 3 Attending Physicians, and 3 Resident Physicians) and 9 nursing staff members. Senior professionals account for 25%, and intermediate professionals account for 38%.

Core Experts

Zhang Yanshan: Vice President of Wuwei Cancer Hospital. He holds a PhD from Lanzhou University (2009) and serves as Chief Physician in both Tumor Radiotherapy and Thoracic Surgery. He has been appointed as a Visiting Researcher and Supervisor at the Institute of Modern Physics, Chinese Academy of Sciences (affiliated with University of Chinese Academy of Sciences); Professor and Master's Supervisor at Shanxi Medical University; and Professor and Master's Supervisor at both Gansu University of Chinese Medicine and Northwest Normal University. With extensive experience in tumor clinical practice and research, he has led multiple major provincial/municipal special projects. Proficient in English, he has published over 30 SCI and core domestic journal articles as the first author and regularly participates in international and domestic academic exchanges. He led the team to develop multiple world-first techniques, significantly improving the precision of heavy ion therapy.

Major Academic Positions: Visiting Researcher at the Institute of Modern Physics, Chinese Academy of Sciences; Member of the Proton and Heavy Ion Radiotherapy Professional Committee of the China Association for Promotion of Science and Technology for Human Health; Executive Committee Member of the First Council of the Ion Radiotherapy Branch of the China Association of Medical Equipment; Member of the Integrated Oncology Branch of the Chinese Anti-Cancer Association; Executive Committee Member of the Gansu-Qinghai-Ningxia Sub-Committee of the First Radioimmunotherapy Working Committee of the Chinese Alliance for Radiation Oncology; Director of the Western Radiation Oncology Association; Member of the Fourth Radiotherapy Oncology Branch of the Gansu Provincial Medical Association; Deputy Director of the First Committee of the Radiation Oncology Professional Committee of the Gansu Provincial Geriatrics Society; Deputy Director of the First Committee of the Brachytherapy Professional Committee of the Gansu Provincial Anti-Cancer Association, etc.

Zhang Yihe: Director of the Third Department of Radiation Oncology, Deputy Chief Physician, with a Bachelor's Degree. She completed advanced training in heavy ion-related fields at the National Institute of Radiological Sciences (NIRS), Japan, and Shanghai Proton and Heavy Ion Hospital. She led the team to innovatively develop multiple new technologies and projects, and has rich clinical experience in advanced radiotherapy techniques such as Carbon-Ion Radiotherapy (CIRT), Stereotactic Body Radiation Therapy (SBRT/SRS), Intensity-Modulated Radiation Therapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), as well as comprehensive treatments including targeted therapy, immunotherapy, cellular immunotherapy, and chemotherapy for various tumors. She has presided over multiple provincial/municipal scientific research projects and published over 10 SCI and core domestic journal articles as the first or corresponding author. She was elected as a delegate to the 13th Party Congress of Gansu Province and awarded the title of "Outstanding Doctor of Wuwei City" in 2019.

Major Academic Positions: Member of the Chinese Anti-Cancer Association; Member of the Professional Committee of Gansu Provincial Anti-Cancer Association; Member of the Brain Glioma Professional Committee of Gansu Provincial Anti-Cancer Association; Member of the Tumor Professional Committee of Gansu Provincial Geriatrics Society; Member of the Gansu-Qinghai-Ningxia Sub-Committee of the Radioimmunotherapy Working Committee, etc.

Talent Structure

The Third Department of Radiation Oncology currently has 1 PhD holder, 3 Master's degree holders, 3 staff members over 40 years old, and the rest are under 40. The talent team structure shows a reasonable configuration in professional titles, educational background, and age distribution, with potential for sustainable development. Senior physicians provide professional guidance and technical oversight; intermediate physicians undertake major clinical tasks and assist in training junior physicians; junior physicians inject vitality into basic medical care. This title ratio facilitates experience transfer and team collaboration. In terms of education, it demonstrates strong potential for research and professional development, driving collaborative progress in clinical treatment and academic research. The age structure is dominated by staff under 40 (a high proportion), indicating a young, learning-capable team with development potential. Meanwhile, 3 senior staff over 40 serve as technical cores, balancing experience stability and team vitality. Additionally, the appropriate nurse-to-physician ratio ensures effective clinical service delivery. Overall, the department has achieved an orderly title sequence, optimized educational structure, and balanced age distribution in talent team construction, laying a solid foundation for improving medical quality and sustainable disciplinary development.

III. Scope of Services and Technical Expertise

In terms of treatment technologies, the department comprehensively offers a range of international mainstream radiotherapy techniques. These include Carbon-Ion Radiotherapy (CIRT), Stereotactic Radiosurgery (SRS) and Stereotactic Ablative Body Radiotherapy (SABR/SBRT), Volumetric Modulated Arc Therapy (VMAT) and Intensity-Modulated Radiation Therapy (IMRT), Image-Guided Radiation Therapy (IGRT), 3D Conformal Radiation Therapy (3D-CRT), as well as deep and superficial hyperthermia. Adhering to the continuously updated NCCN guidelines as the principle for comprehensive cancer care, the department has established itself as a unit that utilizes carbon-ion therapy as a key modality, fully integrated with targeted therapy, immunotherapy, cellular immunotherapy, chemotherapy, and other comprehensive treatments. This ensures our diagnostic and comprehensive treatment technologies remain synchronized with global standards.

Pioneering Technical Expertise

1.Carbon-Ion Therapy for Breast Cancer:

•Compared to conventional photon radiotherapy, Carbon-Ion Radiotherapy (CIRT) offers distinct advantages. Its Bragg Peak energy deposition pattern allows higher doses to be concentrated precisely within the tumor target while significantly reducing radiation exposure to surrounding healthy tissues. This physical characteristic is particularly beneficial for breast cancer patients (given the breast's proximity to the heart and lungs), offering superior protection for critical organs. Furthermore, the enhanced biological effectiveness of carbon ions (e.g., greater efficacy against hypoxic tumor cells) can lead to higher local control rates, an advantage difficult to achieve with conventional radiotherapy.

•A Breakthrough in Non-Surgical Breast-Conserving Therapy:Current breast-conserving therapy typically involves surgical tumor resection followed by radiotherapy. Our approach explores using CIRT as a primary treatmentto achieve non-invasive breast conservation, potentially offering a less traumatic, faster-recovery option with improved quality of life, especially suitable for elderly patients or those contraindicated for surgery.

•Integration of Comprehensive Treatment Strategies:Combining CIRT with endocrine therapy, targeted therapy, and chemotherapy creates a multi-modal "precision radiotherapy + systemic therapy" approach. This strategy addresses tumor heterogeneity and the need for systemic treatment, potentially yielding significant survival benefits through synergies unattainable by surgery or radiotherapy alone.•Advancing Personalized Treatment:Developing individualized radiation doses and fractionation schedules based on tumor characteristics (e.g., size, grade, molecular subtype) optimizes efficacy and reduces toxicity, aligning with the "precision medicine" trend in oncology.

2.Carbon-Ion Radiotherapy Post-Surgical Placement of Spacer for Abdominopelvic Tumors:

•Radical radiotherapy for abdominopelvic tumors is challenging due to their anatomical location and proximity to intestines/rectum. Building on a 2016 Japanese study (involving 6 patients with sacrococcygeal chordoma, reporting 100% success with no adverse reactions) where surgical placement of a silicone spacer created a safety margin for CIRT, allowing dose escalation and improved outcomes, our department innovatively performs open or laparoscopic spacer insertion.

•This procedure creates a necessary safety margin for radical carbon-ion dose delivery, enhancing therapeutic efficacy, reducing side effects, and enabling CIRT application in more complex cases previously unsuitable for radical radiotherapy.

3.High-Frequency Oscillatory Ventilation under General Anesthesia for Motion Management:

•Carbon-ion beams, characterized by high Linear Energy Transfer (LET) and the advantageous Bragg Peak dose distribution (with minimal exit dose beyond the target), deliver highly effective tumor control in clinical practice. However, treating thoracic/abdominal tumors with CIRT is complicated by respiratory motion (e.g., in lungs, liver, breast), causing target displacement relative to the static beam. This motion-induced discrepancy between delivered and planned doses, along with changes in beam path length and density, distorts the Bragg Peak, compromising dose distribution.

•While conventional motion management techniques exist, they have limitations. Our department employs an innovative technique introduced from Switzerland, not yet available elsewhere in China: Non-Invasive High-Frequency Oscillatory Ventilation (NIHFOV) under general anesthesia for respiratory suppression combined with CIRT. International reports confirm the safety of this technique in hypofractionated radiotherapy.

•Applying NIHFOV under general anesthesia during hypofractionated CIRT (high dose per fraction, few fractions) ensures thoracic/abdominal tumors remain consistently within the target zone (Bragg Peak). This enhances delivery precision, mitigates motion artifacts, guarantees accurate dose deposition, and further minimizes dose to normal tissues. We are continually refining this technique to optimize its implementation, providing adequate time windows for ultra-precise radiotherapy.

IV. Hardware Facilities & Research Platform

The department's staff is proficient in English and actively engages in extensive international and domestic academic exchanges. Since its establishment, under the leadership of the department director, the team has strengthened professional learning, enhanced the department's academic and technical standards, and solidified its capacity in academic writing and research. To date, the department has registered and initiated over 10 clinical trials, presided over and participated in the completion of 11 provincial-level scientific research projects, published more than 20 papers in provincial, national, and SCI-indexed journals, and obtained 5 National Utility Model Patents and 1 National Invention Patent.

V. Service Philosophy and Patient Care

Guided by the departmental motto of "Erudition, Mastery, Humility, and Sincerity" and a culture that emphasizes "internal cultivation, conscious initiative, freedom with responsibility, and kindness towards others," all medical staff in the Third Department of Radiation Oncology are committed to providing rigorous professional and thoughtful medical services, earning consistent praise from patients and their families.

Patients receiving treatment at our department also have access to a new model of health management that concurrently integrates psychological therapy, traditional Chinese medicine physiotherapy, rehabilitation therapy, bio-immunotherapy, horticultural therapy, and cultural therapy. This allows patients from around the world to experience the health services of what is pioneeringly designed as a specialized cancer recuperation town.

VI. Contact Information and Patient Guide

Address:Third Department of Radiation Oncology, 2nd Floor, Main Building, Heavy Ion Center, Wuwei Cancer Hospital, Gansu Province, China.

Contact us:

•Director Zhang Yihe: +86-13993508641

•Dr. Pan Xin: +86-15294336950

•Dr. Wang Xin: +86-18993521798

•Dr. Yang Yuling: +86-18368918761

•Dr. Ma Tong: +86-15751948504