Flow Chart of Radiation Therapy
Consultation
When you some to the clinic, a radiation oncologist will review your
current problem, past medical history, past surgical history, family history,
medications, allergies, lifestyle and an organ system by organ system audit
making use of any relevant x-rays and lab tests that you already have had.
He/she will also perform a physical examination that will then to assess the
extent of your problem and judge your general physical condition to
estimate any influence it may have over your response to radiation therapy.
Simulation
The simulation process will help the radiation team plan a course of treatment designed especially for
you. The radiation oncologist uses the x-rays images and the
information gathered during the simulation to design and individualise
your treatment plan.
Simulators are very precise machines that can
duplicate the geometry of different types of
treatment machines and by fluoroscopy and x-
ray pictures allow us to visualise important
structures inside patients. This information is
translated into aiming points, distances and angles. With you lying on the
simulator couch and with the use of light and laser projection systems we will
place marks on your skin or on individually constructed immobilisation
devices that will help level and position you in 3-dimensional space. Marking
may be tattooed on the skin. Immobilisation devices will be constructed from
one or more materials including thermally shaped plastics, vacuum forming
beanbags, and plaster casts. You may need an appointment with the mould room for making of your
immobilisation device.
Treatment Planning
The treatment planning team includes the radiation oncologist, radiographer and physicist. Using all
available information, including that obtained from simulation, the final plan will determine the type of
radiation, its size and shape and the number of radiation beams, and how much radiation is given
through each beam. Radiation beams must be shaped to match their intended targets with the collimator
jaws. Depending on the desired shape, additional blocking of the beam may be required. The treatment
planning computer then calculates the desired dose distribution taking into account the sparing of normal
healthy tissue and the tolerance of the patient as a whole. The radiation oncologist approved the final
plan and the treatment parameters are printed in a hardcopy with the electronic version sent to the
treatment machine treatment record system via the hospital network.
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