Radiation Therapy Treatment Procedure, when patient come in OPD

When a patient comes in the Radiotherapy OPD, then the patient treatment is followed the following Radiation Therapy treatment procedure –

♦ Hospital Registration:

• First, the Patient has to register for the particular hospital.

• The patient will go to Radiation Oncology OPD.

• The patient will be diagnosed for that particular treatment site, based on his/her symptoms, and pains.

♦ Patient Simulation:

• Now, patients will be simulated (means, patients will be imaged in 3-dimensional through a CT scanner machine) using Computed Tomography (CT) Machine, using all the immobilization devices (to restrict the patient motion during CT scan) and particular patient’s position.

• After CT scanning, the exact patient position is marked to reproduce the same position during treatment (standard procedure).

• If required, the patients are imaged by other imaging techniques such as Magnetic Resonance Imaging (MRI), or Position Emission Tomography / Computed Tomography (PET/CT) to precisely identify the disease.

• Now, the patient CT scan images will be exported through the Local Area Network (LAN) system to the treatment planning system (TPS, these are special systems, which are completely connected to the treatment machine).

♦ Contouring or Segmentation, Treatment Planning & Finalization of Planning:

• Radiation Oncologists will contour the target area and normal organs at risk (Organs at risk are healthy tissues or organs, which are placed nearby the target area) on TPS.

• The Radiation Oncologist will decide the treatment modalities, total dose prescription, number of fractions etc.

• A Medical Physicist will generate the plans for treatment as per the oncologist’s suggestion, to give the complete dose to the target area and spare organs at risk.

• The Radiation Oncologist will finalize the plan and approve the plan.

• Now, the patient treatment printout will be taken out after verifying all the treatment-related parameters.

♦ Treatment Plan Verification:

• Patient-specific quality assurance or delivery quality assurance is performed on the phantom, for each patient plan before starting the actual treatment for treatment plan quality verification.

• When the patient specific quality assurance pass, then that particular plan is allowed to treat the patients.

♦ Patient Treatment of First Day and Remaining Day:

• After getting the printout, the Radiation Therapist will do the treatment approval after verifying all the parameters.

• The patient is called for treatment.

• First, the patient is counselled about the first day and remaining day treatment.

• There is a treatment unit, generally named Linear Accelerator, from which the Radiation beam comes out.

• Patient lying down on treatment couch as the same during simulation along with all immobilization devices.

• Patient setup verification is performed by the whole Radiation Oncology Team such as Radiation Oncologist, Medical Physicist and two Radiation Therapists.

• The setup shifts are applied, and pretreatment patient images for verifying the same day patient position are taken.

• Image is verified with simulation image.

• After that when the patient image is matched. Then patients got treated.

• Now the patient is counselled for everyday fractions treatment.

• The patient has to meet with Radiation Oncologist every week for review throughout the treatment.

• After the completion of treatment, the patients’ treatment is finally concluded, and the patient is called for follow up after a certain time period.

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