1. Radiation Therapy Overview
Danielle Carroll MRT(T) & Jessica Dubinsky MRT(T)
Patient Education Steering Committee
February 26, 2016

2. 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

3. Types of Radiation: External Beam Radiation Therapy Internal Radiation
Linear Accelerators (photons/electrons)
Internal Radiation
Brachytherapy (HDR)

4. Aim of Radiation Therapy:
Maximize dose to tumour
Minimize dose to normal tissue
Minimize dose to critical structures

5. Treatment Decision: Type of Disease Stage of Disease
General Health of Patient

6. In any combination Radiation Therapy Surgery Hormonal Therapy
Immunotherapy
Chemotherapy
Hormonal Therapy
Surgery

7. 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

8. 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

9. 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

10. CT Simulation: Optimal treatment position Stable and reproducible
Immobilization devices
Reference marks placed on patient (tattoos)
IV contrast
Help aid in visualization of anatomy

11. 3-Dimensional CT Planning Scan:
Show 3D image (coronal, sagittal and axial)

12. Urgent (weekends/evenings)
Radical
15-40 Treatments
Monday- Friday
Palliative
1-10 Treatments
Urgent (weekends/evenings)

13. CT Simulation: Contouring
Contouring to outline the critical structures

14. CT Simulation: Beam Placement

15. Treatment Planning

16. Treatment Planning Target volume Beam configuration/arrangement
Computerized plan of dose distribution within and outside target volume

17. Physics: Final check before plan is released to treatment unit
Verify the treatment plan matches the RO’s prescription

18. Machine Shop and Electronics

19. Linear Accelerator (L5/L6)
4 radiation therapists/ machine
Paper work/treating patients

20. Radiation Reception Located on the second floor TBRHSC CT Simulation/
Radiation Bookings
Check in patients

21. Radiation Therapy Treatment:
Review treatment education
Align patient in correct position

22. Image Guided Radiation Therapy (IGRT)
Electronic images (X-Rays/CBCT) to confirm correct positioning

23. 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