You may have heard your radiation oncologist use the terms “treatment
protocols” or “guidelines.” Treatment protocols are
systematic methods of treating various diseases and represent recognized
methods of delivering optimal care.
In the Radiation Oncology Department we have treatment protocols that
are established by groups of physicians to standardize optimal care. Protocols
are reviewed periodically by all physicians in Radiation Oncology and
the results are compared to national norms, ensuring a high standard if
care for every patient.
We maintain relationships and participate in standardized treatment protocols
with nationally known academic institutions.
Occasionally, your radiation oncologist may suggest that your illness
may be best managed by a particular national research protocol. As opposed
to the “treatment protocol” described above, a research protocol
aims to investigate a new therapy, new ways of using existing therapies,
or tests one therapy against another. You will be given a written explanation
of the protocol describing intended benefits and possible risks. Participation
in research protocols is always voluntary.
Simulation and Treatment Planning
Because radiation can affect both normal and diseased cells in the path
of the radiation beam, your radiation oncologist must plan your treatments
so that all the abnormal areas are included in the radiation field, while
sparing as much normal tissue as possible. This usually requires a treatment
planning session called a CT simulation which identifies the exact location
of the affected area. Additional imaging procedures, such as studies using
radio-opaque dyes, MRIs and PET scans, may also be necessary to outline
the affected areas and/or to spare normal tissues.
Once the area to be treated has been delineated, the skin over this area
may be marked with small ink dots and pinpricks to serve as permanent
“landmarks.” These allow the radiation therapists to direct
the radiation beam precisely to the treatment area.
Depending on your individual requirements, the treatment planning session
(CT simulation) may last from 30 minutes to two hours.
Following the simulation, further treatment planning and calculations
are made to determine the best method of delivering the exact dose to
the affected area. Additionally, special shielding devices or blocks may
be custom made for use in your treatment. All this may take up to a week
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