When performing radiation therapy or radiotherapy, tumours are treated with ionising radiation. During this treatment energy, calculated by a physicist, targets and destroys the tumour or possible secondary tumours (metastases). Because of the rapid development of imaging and computer efficiency, radiation therapy can now be administered in an accurately targeted way. This allows us to treat the tumour area with higher doses of radiation while the surrounding tissue is protected. In this way, larger tumours can be destroyed whilst reducing side effects.
When performing radiation therapy or radiotherapy, tumours are treated with ionising radiation. During this treatment energy, calculated by a physicist, targets and destroys the tumour or possible secondary tumours (metastases). Because of the rapid development of imaging and computer efficiency, radiation therapy can now be administered in an accurately targeted way. This allows us to treat the tumour area with higher doses of radiation while the surrounding tissue is protected. In this way, larger tumours can be destroyed whilst reducing side effects. Radiation therapy is an outpatient treatment. After the initial consultation with the radiation oncologist, an individual treatment plan is drawn up including dosimetry, treatment schedule and weekly assessments for each case, based on the total radiation dose which is delivered in fractions over a specific number of days. Good clinical practice dictates that courses of radiotherapy treatment should not be interrupted. There is evidence that treatment interruptions increase the risk of local recurrence. Any interruptions or prolongation of radiotherapy treatment may adversely affect patient outcome. To minimise unscheduled interruptions, timely delivery of radiotherapy treatment needs to be maintained, therefore it is necessary that the whole course of the patient’s treatment is approved, and the intended prescription delivered, prior to the start of the treatment. This will assure the best outcome for the patients. As a result, the insurance team at Mediclinic City Hospital will request approval for the entire radiotherapy treatment before the treatment begins. Radiotherapy Modalities The CCC offers all types of treatment from percutaneous radiotherapy and palliative emergency radiotherapy to high-precision, low volume, hyper fractionation therapy with IMRT (intensity-modulated radiotherapy) and Volumetric Modulated Arc Therapy - VMAT. Particularly important is the positioning and reproducibility of daily radiation. The “on-board imaging” system, used in all patients, provides a tool which permits the routine use of IGRT (image-guided radiotherapy), leading to even more precise planning and daily administration.
Brachytherapy has proven to be a successful treatment for cancers of the cervix, endometrium, prostate and other types of cancers. Brachytherapy treats cancer by placing radioactive sources directly into or next to the area requiring treatment. This enables clinicians to deliver a high dose with minimal impact on surrounding healthy tissues. Brachytherapy primarily uses two different techniques:
With any radiotherapy technique, the goal is the same: to conform the dose to the size and shape of the target while limiting side effects by sparing the surrounding healthy anatomy. In brachytherapy, radiation falls off very rapidly from the target area, easily accomplishing this objective.
Stereotactic radiosurgery (SRS) is a non-surgical radiation therapy used to treat functional abnormalities and small tumours of the brain. It can deliver precisely-targeted radiation in fewer high-dose treatments than traditional therapy, which can help preserve healthy tissue. When SRS is used to treat body tumours, it’s called stereotactic body radiotherapy (SBRT). SRS: Stereotactic radiosurgery (SRS) is a non-invasive treatment that uses radiation beams to accurately target brain tumours with a single high dose of radiation. SRS is not a surgical procedure and does not require an incision or anaesthesia. The radiation is administered by two to three RapidArc radiation beams. This allows radio-surgeons to target the tumour without affecting delicate structures nearby. SRS is performed as an outpatient session. Stereotactic radiosurgery is effective for treating tumours in small areas in the head and neck that cannot be reached by surgery. Indication for SRS treatment Brain/neurological conditions, including:
SBRT: Stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy, administers very high doses of radiation using several beams of various intensities aimed at different angles to precisely target the tumour. Stereotactic body radiation treatments are usually given as a single dose or up to five doses once a day, although this can vary depending on the type and location of the tumour and the patient’s physical condition. This procedure is chosen for patients with small, well-defined tumours who cannot tolerate surgery. For some patients, SBRT may be able to replace surgery as a primary cancer treatment. Indications for SBRT treatment Extracranial conditions and other malignant and benign tumours (lung, liver, spine etc. |
||
Treatment Pathway |
|
|
Individual Treatment Side Effects The doctor will also discuss the possible side effects of the therapy. He will try to explain the entire treatment process. He will also give the patient information on any further examinations, check-ups or treatments after the radiotherapy. Possible Side Effects All types of therapy have their side effects, and this to radiotherapy. However, as a result ofmore precise radiation techniques and better supportive measures, these have been significantly reduced in recent years. Skin Reactions A skin reaction may occur depending on the type of radiotherapy (location, volume, single dose and total dose). With radiotherapy targeting a tumour in the mouth or throat region, or with breast cancer treatment, the skin is relatively severely affected. After two to three weeks of treatment, patients may experience a skin reaction similar to sunburn. Patients experiencing such symptoms should contact the nursing staff who will coordinate further treatment with the doctor. Household remedies should not be used without prior consultation with the doctor. Many common skincare lotions and creams contain traces of heavy metals. The use of such creams causes the radiation to be scattered into the surface of the skin andleadsto even higher skin exposure. Reactions of the Mucous Membranes With radiotherapy of the throat and thorax areas (e.g. for lung or oesophageal cancer), parts of the mucous membranes of the mouth, throat and oesophagus are often treated simultaneously. These membranes develop an inflammation which may beginto manifest itself in the second or third week of radiotherapy. Any inflammation causes redness, swelling and particularly pain, which mainly affect the patient while eating. In case such symptoms occur, the patient should notify the nursing staff. The nursing staff will coordinate further treatment and care, for example the prescription of a painkiller, with the doctor. Diarrheoa and "Radiation Hangover" With radiotherapy in the stomach and abdomen areas, side effects often include diarrhoea. Treatment of the rectum often causes increased urge to defecate (however, without the actual defecation). Such symptoms are also caused by inflammation in the treated intestinal area as a result of the radiotherapy. Occasionally, patients who receive radiation targeting the intestinal area may feel slightly nauseous an hour or two after treatment. This frequently occurs at the start of a radiotherapy course during the first sessions and is also known as “radiation hangover”. Such symptoms mostly disappear after one to two weeks of treatment and can be easily treated with medication. Such symptoms should also be discussed with the specialisednursing staff. Individual Reactions are Difficult to Predict In general, the severity of the side effects varies from individual to individual and dependson the volume and type of radiotherapy. Each person reactsslightly differently to the treatments and unfortunately it is impossible to predict which side effects mightactually occur. |
||
Technology |
|
|
Radiotherapy Advantages |
|
|
Since the late 1970s, radiotherapy has advanced mainly as a result of developments in computer technology. While the basic technology of the linear accelerator has remained the same, the planning options for treatment and the precision of irradiation have become more accurate. Thanks to the use of computer tomography, it is now possible to depict tumours within the body. The regions requiring radiotherapy can be marked on the CT layers, and the tumour can be recorded as a three-dimensional area. |