Clinical Practice 4
RADIOTHERAPY
LECTURE 6
Techniques for Delivering Radiation Therapy
1.Three-dimensional conformal radiation therapy (3D-
CRT) .
2.Intensity Modulated Radiation Therapy (IMRT)
3.Image-guided Radiation Therapy (IGRT)
4.Stereotactic Body Radiation Therapy (SBRT)
3D Conformal Radiation Therapy
3D conformal radiation therapy is a cancer treatment that shapes the
radiation beams to match the shape of the tumor.
In the past, radiation beams only matched the height and width of the
tumor — exposing healthy tissue to radiation. Advances in imaging
technology have made it possible to locate and treat the tumor more
precisely.
Conformal radiation therapy uses the targeting information to focus
precisely on the tumor, while avoiding the healthy surrounding tissue.
This exact targeting makes it possible to use higher levels of radiation in
treatment. More radiation is more effective in shrinking and killing
tumors.
3D conformal therapy is — in many ways — like
intensity-modulated radiation therapy (IMRT). They both target cancer
while sparing healthy tissue.
The radiation oncologist will decide which therapy is best for you, based
on your tumor’s shape and location.
Types of External Radiation Therapy
The type of equipment used will depend on the location,
size and type of cancer.
Three-dimensional conformal radiation
therapy (3D-CRT)
A technique where beams of radiation used in
treatment are shaped to match the tumor and
are delivered accurately from several
directions.
Intensity modulated radiation therapy
(IMRT)
A form of 3-D CRT in which the physician A multileaf collimator is used to
designates specific doses of radiation that the shape the radiation beam to
match the tumor, sparing
tumor and normal surrounding tissues receive. surrounding healthy tissue
Before treatment, the patient will have a
radiation planning (or simulation) session, where a therapist will make a
custom-fit mold.
The radiologist will take a 3D image of your tumor, often using one of the
following imaging methods:
•CT (computed tomography) scan.
•MRI (magnetic resonance imaging).
•PET (positron emission tomography) scan.
•PET-CT scan.
Then, a computer program analyzes the 3D image and designs radiation
beams that conform to the shape of the tumor.
A number of cancer types have seen improved outcomes from 3D
conformal radiation therapy, including:
•Brain cancer.
•Head and neck cancer.
•Liver cancer.
•Lung cancer.
•Prostate cancer.
Image-Guided Radiotherapy (IGRT)
Image-Guided Radiotherapy (IGRT), the all-digital
treatment system, allows physicians to see a patient’s
tumor in real- time at treatment, even if a tumor has
moved - because of a patient's breathing, heartbeat,
gastrointestinal changes or other activities. Tumors also
change their position and their size during the course of
radiotherapy treatment, which typically consists of
multiple treatments over several weeks.
At the start of radiotherapy, technicians take a CT scan of a
tumor and enter that data into a treatment-planning system.
Image-Guided Radiotherapy IGRT software produces a three-
dimensional, digitized image of the patient's tumor, sharply
identifying the slightest contour.
Once that image is captured, it can be recalled for every
treatment session.
If significant tumor movement has occurred, physicians can
then adjust the patient's position or, if required, re-do the
treatment plan, minimizing damage to surrounding healthy
tissue.
IGRT is a radiation
therapy with a help of
imaging. This is useful
because of the
variation of tumor
after each treatment
and the difference of
patient position.
Stereotactic Body Radiation Therapy (SBRT)
Stereotactic Body Radiation Therapy (SBRT) is a treatment procedure similar to central nervous system
(CNS) stereotactic radiosurgery, except that it deals with tumors outside of the CNS. A stereotactic
radiation treatment for the body means that a specially designed coordinate-system is used for the exact
localization of the tumors in the body . in order to treat it with limited but highly precise treatment
fields. SBRT involves the delivery of a single high dose radiation treatment or a few fractionated
radiation treatments (usually up to 5 treatments). A high potent biological dose of radiation is delivered
to the tumor, improving the cure rates for the tumor, in a manner previously not achievable by standard
conventional radiation therapy
Similarly, because this specialized form of radiation involves the use of multiple radiation beam angles,
expert Radiation Oncologists specialized in this technique are able to safely deliver high doses of
radiation, with very sharp dose gradient outside the tumor and into the surrounding normal tissue .
Thank You
PROF DR OMAR SHEBL ZAHRA
