Radiation Therapy Overview Danielle Carroll MRT(T) & Jessica Dubinsky MRT(T) Patient Education Steering Committee February 26, 2016
What is Radiation? Radiation uses high energy x-rays to destroy cancer cells Instead of a single treatment consisting of a high dose, fractionation divides the dose to be delivered over a period of time Tumour cells do not possess the same repair enzymes necessary to keep up with the repairs like normal cells and as a result the cell is overwhelmed and destroyed
Types of Radiation: External Beam Radiation Therapy Internal Radiation Linear Accelerators (photons/electrons) Internal Radiation Brachytherapy (HDR)
Aim of Radiation Therapy: Maximize dose to tumour Minimize dose to normal tissue Minimize dose to critical structures
Treatment Decision: Type of Disease Stage of Disease General Health of Patient
In any combination Radiation Therapy Surgery Hormonal Therapy Immunotherapy Chemotherapy Hormonal Therapy Surgery
Meet the Radiation Therapy Team: Radiation Oncologist Radiation Oncologist Secretary Reception staff/Radiation Nurse clerk Radiation Oncology Nurses Radiation Therapists and Students Radiation Therapy Assistant Treatment Planners Physicists/Physics Assistant Medical Physics Associates Mechanical Technologist
Radiation Therapy at a Glance: CT simulation with patient Education CT scan Treatment planning without patient Beam arrangement Dose distribution RO approval Radiation Therapy with patient Imaging (IGRT) Treatment Radiation Therapy at a Glance: Cancer Care Ontario wait time target is 14 days
CT Simulation: 1 hour appointment Patient education (30 minutes) Radiation Therapy experience from start to finish, appointments, side effects, RO review 1 x week, consent CT simulation (15-30 minutes) PET/CT scanner
CT Simulation: Optimal treatment position Stable and reproducible Immobilization devices Reference marks placed on patient (tattoos) IV contrast Help aid in visualization of anatomy
3-Dimensional CT Planning Scan: Show 3D image (coronal, sagittal and axial)
Urgent (weekends/evenings) Radical 15-40 Treatments Monday- Friday Palliative 1-10 Treatments Urgent (weekends/evenings)
CT Simulation: Contouring Contouring to outline the critical structures
CT Simulation: Beam Placement
Treatment Planning
Treatment Planning Target volume Beam configuration/arrangement Computerized plan of dose distribution within and outside target volume
Physics: Final check before plan is released to treatment unit Verify the treatment plan matches the RO’s prescription
Machine Shop and Electronics
Linear Accelerator (L5/L6) 4 radiation therapists/ machine Paper work/treating patients
Radiation Reception Located on the second floor TBRHSC CT Simulation/ Radiation Bookings Check in patients
Radiation Therapy Treatment: Review treatment education Align patient in correct position
Image Guided Radiation Therapy (IGRT) Electronic images (X-Rays/CBCT) to confirm correct positioning
After Treatment Care: Side effects will continue to escalate for another 7-14 days and then begin to decline Any problems- call Radiation Therapy Department Next Appointment: Radical patients 4-6 weeks post RT Palliative patients followed more closely