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بسم الله الرحمن الرحيم و قل رب زدنى علماً ﴿و قل رب زدنى علماً﴾ صدق الله العظيم.

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Presentation on theme: "بسم الله الرحمن الرحيم و قل رب زدنى علماً ﴿و قل رب زدنى علماً﴾ صدق الله العظيم."— Presentation transcript:

1 بسم الله الرحمن الرحيم و قل رب زدنى علماً ﴿و قل رب زدنى علماً﴾ صدق الله العظيم

2 Advanced Radiotherapy (RT) Dr. Ahmed Al Far, M.D. Professor of Radiation Oncology RAD 462

3 Technical Aspects of Radiotherapy

4 Educational Objectives By the end of this lecture you will be able to:  Describe how patients are referred for radiation oncology department.  Explain the stages of health care management for patients undergoing radiotherapy.  Demonstrate knowledge of the terms and concepts commonly used in radiotherapy practice.

5 Educational Objectives (cont.,)  Identify and describe parameters of radiotherapy prescription.  Discuss causes failure of radiotherapy.  Explain role of quality assurance program in preventing errors.  List characteristics of successful radical course of radiotherapy.

6 Outlines  Stages leading to radiotherapy  Radiotherapy process  Data in radiation oncology charts  Success or failure of radiotherapy

7 Symptoms/Screening/Referral Staging / investigations Multidisciplinary Team surgery or chemotherapy RadiotherapyPlanning Radiotherapy Treatment Treatment Stages Leading to Radiotherapy Diagnosis/ Primary surgery

8 Clinical Evaluation (Path., stage,etc..) Therapy Decisions Radiotherapy Identify tumor extent and sensitive organs Decision about: (a) Goal (cure/palliation) (b) Modality (External Beam ± Brachytherapy) Other modality Multimodality therapy Position, immobilization Patient data acquisition (CT, MRI, Simulator) Treatment Planning Decision about: fields, dose, beam-modifiers Treatment Simulation Radiographic verification of fields Treatment Follow-up Evaluation during therapy Flowchart for the process of RT

9 1 Data in Radiotherapy charts-1  Patient-related: age, gender, etc.  Diagnostic: clinical, pathological, TNM stage, previous treatment and concomitant medications.  Pretreatment: decision making/consent  Treatment technique: planning, simulation and delivery documentation  Acute-radiation side effects: kind and degree at weekly basis  On treatment patient education

10  Tumor response to treatment  Impact of treatment on quality of life  Recommendations and compliance with follow-up  Recurrence, survival (with or without disease), and date and cause of death. 2 Data in Radiotherapy charts-2

11  Indicators: Low tumor control rate, High side effects  Causes: Failure to deliver the prescribed dose Failure to treat the intended volume of tissue 1 Causes of radiotherapy failure-1

12  Failure to deliver the prescribed dose: Error in dose calculation or distribution Wedge filter in wrong orientation or wrong field Beam shaping block in wrong orientation or wrong field Error in measurements of the patient's dimensions Treatment machine malfunction (output) 2 Causes of radiotherapy failure-2

13 3 Causes of radiotherapy failure-3  Failure to treat the intended volume of tissue: Errors in determination target volume Errors in localization of target volume Errors in repositioning:  Field displacement,  Patient motion. Role ofquality assurance program Role of quality assurance program.

14 Successful Radical Course of RT  Accurate localization of target volume (TV)  Effective patient immobilization  Uniformly high dose of radiation to the TV whilst sparing radiosensitive critical structures and normal tissues  Optimum dose/fractionation schedule treatment prescription.  Accurate, consistent setting-up and execution of the treatment prescription.

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