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Radiation therapy or radiotherapy is the use of various forms of radiation to safely and effectively treat cancer, to control the growth of the cancer or to relieve pain. The goal of radiation therapy is to get enough radiation into the body to kill the cancer cells while preventing damage to healthy tissue. Depending on the location, size and type of cancer, high-energy particles or waves, such as X-rays, gamma rays, electron beams or protons are used to destroy or damage cancer cells. Radiation therapy works by damaging cancerous cells. Normal cells are able to repair themselves, whereas cancer cells cannot.
Radiotherapy uses high-energy rays that can be given both externally and internally to treat the disease.
Radiation may be used to make your primary treatment more effective.
Radiation therapy is safe and effective & has been used successfully to treat patients for more than 100 years. Treatment is carefully planned to focus on the cancer while avoiding healthy organs in the area. Special computers are also used to monitor and double checking of the treatment machines is done to make sure that the proper treatment is given.
IMRT is an advanced mode of high precession radiation. In IMRT the radiation beams are subdivided (modulate) into many beamlets aimed at the tumour, from various directions. Also, intensity of each of these beamlets can be adjusted individually. Thus, it is specialized form that allows radiation to be shaped exactly to fit the tumour. Using IMRT, it is possible to further limit the amount of radiation that is received by healthy tissues near the tumour as compared to 3D-CRT. In many situations this may also allow relatively higher dose of radiation to be delivered to the tumour, increasing the chance of cure. As this method of treatment delivery is very accurate, proper positioning of the patient becomes crucial. The planning of IMRT procedure takes 2-4 days after the immobilization and the imaging procedure. With a good computer based inverse planning methodology and rigorous OA, IMRT is complete.
Image Guided Radiation Therapy or IGRT helps to improve the delivery of radiation. IGRT involves conformal radiation treatment guided by a CT scan (called Cone Beam CT), taken in the treatment room just before the patient is given the radiation treatment. IGRT is one of the most advanced form of radiotherapy. The imaging information from the planning CT scan done earlier is overlapped on this Cone Beam CT. With this technique, movements of tumour breathing or reduction in size can be tracked. Also, even the variation in millimeters in daily positioning of the patient is detected and corrected instantly. Treatment with respiratory gating is used for tumours that move during respiration such as lung and liver.
Stereotactic Body Radiotherapy or SBRT is an immerging image guided radiation method. SBRT is directed to extremely well defined targets within the body. SBRT delivers very high doses of radiation precisely to tumours sites within the body with the purpose of improving local control and limiting side effects. SBRT is appropriately used for small lung cancers or metastasis, small liver tumours or bony tumours and tumours in other sites that may not be appropriate for surgical resection or in patients who would not be candidates for surgery. SBRT is generally completed in 3-5 treatment fractions. At times, small gold fiducial markers are implanted with minimally invasive techniques to provide Stereotactic image guidance during radiation therapy. 3D imaging (CT, CT/PET, CT/MR) is used to construct very precise plans minimizing radiation dose to normal structures.
Tumours are not regular, they come in different shapes and sizes. Three dimensional conformal radiation therapy, or 3D-CRT, uses computers and high definition software with special imaging techniques to map the size, shape and location of the tumour. Computer Assisted (CT scans), Magnetic Resonance Imaging (MR scans) and/or Positron Emission Tomography (PET scans) are used individually or by fusion to create detailed three dimensional representations of the tumour and the surrounding organs. This therapy uses a multileaf collimator (MLC) to precise radiation beam to targeted area. As the radiation beams are very precisely directed, adjacent normal tissues receives less radiation and are able to heal quickly.
This is conventional treatment offered using linear accelerator where patients undergo CT scan based planning and port film with the technique which has the latest high resolution amorphous silicon portal imager for this purpose.
Brachytherapy also known as known as internal radiation, involves placing radioactive material into a tumour itself or into its surrounding tissue. As the radiation sources are placed close to the tumour cells, a large dose of radiation can be delivered with CT-Scan-image-based 3D planning. Brachytherapy may cause fewer side effects than does external beam radiation and the overall treatment time is usually shorter with brachytherapy. Brachytherapy can be used alone or in conjunction with other cancer treatments.
Proton beam therapy is a form of external beam radiation treatment that uses protons rather than X-rays to treat certain types of cancer and other diseases. The physical characteristics of the proton therapy beam allow doctors to more effectively reduce the radiation dose to nearby healthy tissue.
Like proton therapy, neutron beam therapy is a specialized form of external beam radiation therapy. It is often used to treat certain tumors that are radio-resistant, meaning that they are very difficult to kill using conventional X-ray radiation therapy. Neutrons have a greater biologic impact on cells than other types of radiation. Used carefully, this added impact can be an advantage in certain situations.
Certain cancers may be treated by swallowing radioactive pills or receiving radioactive fluids in the vein (intravenous). This type of treatment is called systemic radiation therapy because the medicine goes to the entire body. Radioactive iodine capsules are given to treat some types of thyroid cancer or to treat pain due to cancer that has spread to the bone.
Radiosurgery is a now a proven alternative to conventional surgery in the treatment of Brain Tumours. Brain Tumour does not necessarily mean cancer. Only 50% of the Brain Tumours are malignant, the rest are benign. Most Brain Tumours need to be treated with surgery or by opening the head. This procedure is done with techniques known as Stereotactic Radiosurgery and Radiotherapy (SRS / SRT).
The superior efficacy of Radiosurgery offers lower risk of complications, shorter hospital stay, reduced morbidity and improved quality of life as compared to the conventional methods of treatment. Stereotactic radiotherapy is a technique that allows to precisely focus beams of radiation to destroy certain types of tumors. In addition to treating some cancers, radiosurgery can also be used to treat malformations in the brain's blood vessels and certain noncancerous (benign) neurologic conditions.
Radiation therapy is usually well tolerated and many patients are able to continue their normal routines but sometimes it causes side effects. Many of the side effects of radiation therapy are only in the area being treated. These side effects are usually temporary and can be treated by your doctor or other members of the treatment team. Side effects usually begin by the second or third week of treatment and they may last for several weeks after the final radiation treatment. Information about how to manage them and prescribed medicines or changes in your eating habits helps relieve discomfort.
Stay out of the sun. If you must spend time outdoors, wear a hat or clothing to protect your skin. After treatment, use sunscreen with an SPF of at least 15.