radiation planning steps
Post on 18-Oct-2014
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Process of Radiotherapy planning and execution.at Ba L C Parikh Cancer Centre, Navsari.TRANSCRIPT
Important Steps for Important Steps for Radiation PlanningRadiation Planning
Dr Surendra Singh Solanki MDDr Surendra Singh Solanki MDConsultant, Radiation OncologyConsultant, Radiation Oncology
““BA” Smt. L. C. Parikh Cancer CentreBA” Smt. L. C. Parikh Cancer CentreNavsari, 396445 Gujrat.Navsari, 396445 Gujrat.
Worked At – Worked At – Rajiv Gandhi Cancer Institute & Rajiv Gandhi Cancer Institute &
Research Centre, New DelhiResearch Centre, New Delhi
Day 0Day 0
1.1. OPD RegistrationOPD Registration
2.2. File Process (History + Examination)File Process (History + Examination)
3.3. Radiation Treatment DiscussionRadiation Treatment Discussion
4.4. How the work is done in this Hospital?How the work is done in this Hospital?
Day Day 0-0- File Process- History File Process- History
Original complaintsOriginal complaints Past history, AddictionsPast history, Addictions First examination from record First examination from record Previous CT/MRI Scan, X- ray, USGPrevious CT/MRI Scan, X- ray, USG Biopsy reportBiopsy report Previous treatment details- Surgery, Previous treatment details- Surgery,
Chemotherapy, RadiotherapyChemotherapy, Radiotherapy Histo-Patho-Report Histo-Patho-Report
Doctor is writing your details in file
Day 0- Patient’s ExaminationDay 0- Patient’s Examination
..
Doctor is doing patient’s examination
Day 0- Radiation Treatment Day 0- Radiation Treatment DiscussionDiscussion
External Beam Radiation TherapyExternal Beam Radiation Therapy.. Indication to give Radiation TherapyIndication to give Radiation Therapy Post OP SettingPost OP Setting: 60 Gy/30# @ 1.8 -2Gy/# : 60 Gy/30# @ 1.8 -2Gy/#
once a dayonce a day Radical EBRTRadical EBRT: 66-70Gy/33-35# @ 1.8-2Gy/# : 66-70Gy/33-35# @ 1.8-2Gy/#
once a dayonce a day Palliative EBRTPalliative EBRT: 30 Gy/10# @ 3Gy/#: 30 Gy/10# @ 3Gy/# All plan in phased manner-PH1, PH2, PH3 etcAll plan in phased manner-PH1, PH2, PH3 etc
Mon to Fri 5 days a week for 6 to 7 weeksMon to Fri 5 days a week for 6 to 7 weeks Daily Treatment time 10 to 30 minutes. Daily Treatment time 10 to 30 minutes.
(Depending on plan and calculations)(Depending on plan and calculations) New patient set up- 1 hour approxNew patient set up- 1 hour approx
Day 0- Radiation Treatment Day 0- Radiation Treatment DiscussionDiscussion
Expected Results – To reduces the chance of Expected Results – To reduces the chance of recurrence to minimal levelsrecurrence to minimal levels..
Side effects- Mucositis, Skin reactions, Dry Side effects- Mucositis, Skin reactions, Dry mouth, Alopecia (starts from 3mouth, Alopecia (starts from 3rdrd week week onwards, better managed with specific onwards, better managed with specific medications)medications)
Day 0- Radiation Treatment Day 0- Radiation Treatment DiscussionDiscussion
Weekly OPD Visit with Blood test. Weekly OPD Visit with Blood test. (after every 5#) (after every 5#)
Management of Side effects.Management of Side effects. Weekly Chemotherapy as required.Weekly Chemotherapy as required. Radiation Therapy in Day care only.Radiation Therapy in Day care only.
Day 0- Radiation Treatment Day 0- Radiation Treatment DiscussionDiscussion
When Radiation Therapy is When Radiation Therapy is decided.decided.
CT Scan Room- Immobilization cast + scan CT Scan Room- Immobilization cast + scan
Three RoomsThree Rooms
Treatment Planning Room. –Treatment Planning Room. – Tumor marking by Radiation Doctor and Tumor marking by Radiation Doctor and Radiation beam planning by Medical Physicist Radiation beam planning by Medical Physicist
Linear Accelerator Room: Treatment delivery Linear Accelerator Room: Treatment delivery by Radiation Technologist by Radiation Technologist
CT Scan Room (9AM- 12PM)CT Scan Room (9AM- 12PM)
Day 1 - Cast MakingDay 1 - Cast Making
Thermoplatic Material
Day 1 - Cast MakingDay 1 - Cast Making
30 min to 1 hour30 min to 1 hour
Day 1 - Cast MakingDay 1 - Cast Making
30 min to 1 hour
Day 1- Marking and CT ScanDay 1- Marking and CT Scan
Day 1- Marking and CT ScanDay 1- Marking and CT Scan
Day 1-2 Day 1-2 ContouringContouring
“Your Old CT Scan is must for Marking Tumour”
Day 1-2 Day 1-2 ContouringContouring
Day 1-2 Day 1-2 Planning- Beam Arrangements Planning- Beam Arrangements
Day 1-2 Day 1-2 Planning- Total plan sum Planning- Total plan sum
Day 1-2Day 1-2 Planning- Total Dose Distribution Planning- Total Dose Distribution
Maximum Dose to Tumor and minimum dose to normal structure
Varian’s Clinac iX Linear Varian’s Clinac iX Linear Accelerator with IMRT Accelerator with IMRT
•Working from 9AM to 6PM evening •New Patient :- 2PM to 3PM
Varian’s Clinac iX Linear Varian’s Clinac iX Linear Accelerator with IMRT Accelerator with IMRT
Day 3 or 4 Day 3 or 4 Set up for New PatientSet up for New Patient
Time 2PM to 3PM
Mr Amol. Mr Vinayak(heart of this centre)
Every patient one CastEvery patient one CastMonday to Friday (5 days a week)Monday to Friday (5 days a week)Treatment time 10 to 30 minutes.Treatment time 10 to 30 minutes.
““Let’s we all people of Let’s we all people of Radiation unit help you Radiation unit help you
in this centre”in this centre”