How is radiotherapy givenHow is radiotherapy given

Radiotherapy can be given in two ways: from Radiotherapy can be given in two ways: from outside or inside the body. External radiotherapy is outside or inside the body. External radiotherapy is the most common method of treatment. With this the most common method of treatment. With this technique, thetechnique, the radiation is directed from a machine is directed from a machine at the cancer and surrounding tissue. In internal at the cancer and surrounding tissue. In internal radiotherapy, radioactive material in sealed radiotherapy, radioactive material in sealed applicators are put into your body, on or near theapplicators are put into your body, on or near the cancer ( (brachytherapy). In some cases, a brachytherapy). In some cases, a combination of both forms of radiotherapy may be combination of both forms of radiotherapy may be usedused..

externalexternal

In radiotherapy, a machine directsIn radiotherapy, a machine directs In external radiotherapy, In external radiotherapy, a machine directs a machine directs radiation onto the onto the cancer and and surrounding tissue. Different machines may be used: some surrounding tissue. Different machines may be used: some are better for treating cancers near the are better for treating cancers near the skin, others are , others are better for cancers deeper in the body. The better for cancers deeper in the body. The radiation oncologist will know which is the best machine to will know which is the best machine to treat your cancer. treat your cancer. radiation onto theonto the cancer and and surrounding tissue. Different machines may be used: some surrounding tissue. Different machines may be used: some are better for treating cancers near theare better for treating cancers near the skin, , others are others are better for cancers deeper in the body. Thebetter for cancers deeper in the body. The radiation oncologist will know which is the best machine to will know which is the best machine to

treat your cancertreat your cancer . .

Internal therapyInternal therapy

Radiotherapy with implants is most commonly used to treatRadiotherapy with implants is most commonly used to treat cancers of theof the cervix andand prostate but may be used in but may be used in other sites. This treatment is also known asother sites. This treatment is also known as brachytherapybrachytherapy. . Thin tubes, seeds or rods containing radioactive material Thin tubes, seeds or rods containing radioactive material are placed in your body temporarily, either directly into the are placed in your body temporarily, either directly into the cancer or close to it. In some cases the implant may be cancer or close to it. In some cases the implant may be permanentpermanent..

Your doctor may recommend internal radiotherapy alone, Your doctor may recommend internal radiotherapy alone, or combined with external radiotherapy. The treatment you or combined with external radiotherapy. The treatment you are offered will depend on the type of cancer you have, are offered will depend on the type of cancer you have, where it is, its size, your general health, test results, and where it is, its size, your general health, test results, and previous treatmentsprevious treatments..

How is the implant placed in the How is the implant placed in the bodybody

You will usually need to be admitted to hospital You will usually need to be admitted to hospital and have the implant put into your body while you and have the implant put into your body while you are underare under anaestheticanaesthetic..

Implants come in different shapes, and can Implants come in different shapes, and can contain different radioactive materials. The type of contain different radioactive materials. The type of implant you have depends on the type of cancer implant you have depends on the type of cancer you have. To get very close to theyou have. To get very close to the cancercancer doctors doctors use implants in the form of needles, wires, use implants in the form of needles, wires, capsules, and other devices. In some cases the capsules, and other devices. In some cases the doctor may use a special applicator to hold the doctor may use a special applicator to hold the implant against the surface of the cancerimplant against the surface of the cancer..

Side effects of radiotherapySide effects of radiotherapy

tirednesstiredness, , diarrhoeadiarrhoea, , cystitiscystitis, , frequency of urinefrequency of urine, , soreness of the rectum (proctitissoreness of the rectum (proctitis), ),

reddening/sore skinreddening/sore skin . .

Liner accelerator RadiotherapyLiner accelerator Radiotherapy

Internal componentsInternal components

How it WorksHow it Works

The fundamental principle of radiosurgery is that of The fundamental principle of radiosurgery is that of selective ionization of the tissue to be operated upon, by selective ionization of the tissue to be operated upon, by means of high-energy beams of radiation. Ionization is the means of high-energy beams of radiation. Ionization is the production of inorganic ions which are usually deleterious production of inorganic ions which are usually deleterious to the cells, by forming free radicals that are harmful to the to the cells, by forming free radicals that are harmful to the cellular and nuclear membranes, and even to the RNA and cellular and nuclear membranes, and even to the RNA and DNA chains of the cells, producing an irreparable damage DNA chains of the cells, producing an irreparable damage to these structures and then the cell's death. Thus, to these structures and then the cell's death. Thus, biological inactivation is carried out in a volume of tissue to biological inactivation is carried out in a volume of tissue to be treated, with a precise destructive effect. The radiation be treated, with a precise destructive effect. The radiation dose absorbed by the treated mass of tissue is what dose absorbed by the treated mass of tissue is what defines the degree of biological inactivation. It usually is defines the degree of biological inactivation. It usually is measured in units of Gray, the quantity of energy defined measured in units of Gray, the quantity of energy defined

by one joule per kg of massby one joule per kg of mass . .

In order to perform optimal therapy, the neurosurgeon, assisted by In order to perform optimal therapy, the neurosurgeon, assisted by physicists specialized in nuclear medicine, chooses the best type of physicists specialized in nuclear medicine, chooses the best type of radiation to be used, and how it will be delivered. Usually, the total radiation to be used, and how it will be delivered. Usually, the total dose of radiation required to kill a tumor, for example, is not delivered dose of radiation required to kill a tumor, for example, is not delivered in a single, massive section, because this would cause collateral, in a single, massive section, because this would cause collateral, undesirable effects on the patient. Instead, it is divided into several undesirable effects on the patient. Instead, it is divided into several sessions of smaller duration and energy dose, in a procedure calledsessions of smaller duration and energy dose, in a procedure called dose fractioningdose fractioning. . Even when administered with intervals of several Even when administered with intervals of several days between them, the ionizing effect accumulates in the tissue. thus days between them, the ionizing effect accumulates in the tissue. thus achieving the same results with less undesirable consequences for the achieving the same results with less undesirable consequences for the patient. In order to plan the radiation incidence and dosage, the patient. In order to plan the radiation incidence and dosage, the physicistsphysicists draw a mapdraw a map portraying the lines of equal intensity of portraying the lines of equal intensity of radiation upon the patient's head (this is called aradiation upon the patient's head (this is called a isodose mapisodose map). ). Information about the tumor's location is obtained from a series of Information about the tumor's location is obtained from a series of computerized tomograms, which are then feed to specialcomputerized tomograms, which are then feed to special planning planning computer softwarecomputer software..

There are two types of radiations used in radiosurgeryThere are two types of radiations used in radiosurgery: : neutronsneutrons andand gamma raysgamma rays..

Parts of acceleratorParts of accelerator

Known for bringing advanced Known for bringing advanced technology to Lexington for over 20 technology to Lexington for over 20 years, United Radiation Oncology years, United Radiation Oncology has taken a giant step into the has taken a giant step into the future of radiotherapy with the future of radiotherapy with the installation of the Synergy installation of the Synergy accelerator. This is the world's first accelerator. This is the world's first kvp CT image-guided radiation kvp CT image-guided radiation therapy system, designed to more therapy system, designed to more aggressively battle cancer, targeting aggressively battle cancer, targeting and treating tumors with and treating tumors with

unparalleled accuracyunparalleled accuracy . .United Radiation Oncology patients United Radiation Oncology patients

are the first in the nation to be are the first in the nation to be treated with image-guided radiation treated with image-guided radiation therapy and, with fewer treatments therapy and, with fewer treatments required in selected cases, even required in selected cases, even patients who live a long distance patients who live a long distance from Lexington will have the option from Lexington will have the option

of this revolutionary technologyof this revolutionary technology . .

linear acceleratorlinear accelerator A modern radiotherapy treatment machine. A modern radiotherapy treatment machine.

X rays are produced by bremsstrahlung X rays are produced by bremsstrahlung when electrons, accelerated by a linear when electrons, accelerated by a linear accelerator to energies between about 4 accelerator to energies between about 4 and 25 MeV, strike a thick target. The x and 25 MeV, strike a thick target. The x rays are then shaped by a contoured rays are then shaped by a contoured flattening filter that makes uniform the flattening filter that makes uniform the originally spread-out, but forward-peaked, originally spread-out, but forward-peaked, x-ray flux. The accelerator, beam transport x-ray flux. The accelerator, beam transport system, and beam-shaping devices are all system, and beam-shaping devices are all mounted on a so-called gantry that can mounted on a so-called gantry that can rotate a full 360° about a horizontal axis. It rotate a full 360° about a horizontal axis. It typically takes about a minute to complete typically takes about a minute to complete a rotation. The patient lies on a couch, a rotation. The patient lies on a couch, mounted here on an accordion structure. mounted here on an accordion structure. The couch can move in all three The couch can move in all three translational directions and can also rotate translational directions and can also rotate about a vertical axis through the point at about a vertical axis through the point at which the central axes of all beams cross. which the central axes of all beams cross. With the appropriate combination of gantry With the appropriate combination of gantry and couch adjustments, the radiation and couch adjustments, the radiation beam can be pointed at the tumor along beam can be pointed at the tumor along almost any direction. The traylike object almost any direction. The traylike object extending from near the bottom of the extending from near the bottom of the machine is an imaging detectormachine is an imaging detector