Radiotherapy Techniques and procedure stages

Learn all about radiotherapy

Techniques and stages of radiotherapy.
High Energy Center is the only private medical facility of this kind. Our center makes conducts all the possible techniques in the area of radiological treatment. The main cluster of doctors consists of six radiotherapists, including Professor Rene-Jean Bensadoun, Dr. Canova Charles-Henry, Dr. Francois Fauchon, Dr. Nathalie Pinto, Dr. Thomas Olivier and Dr. Idriss Troussier.
 

Existing radiotherapy techniques

External radiotherapy

External radiotherapy is the most popular and most used. With this type of therapy, the radiation source is located outside the patient. Cobalt bombs emitting radioactive rays in Cobalt 60 were one of the first radiotherapy machine. Today, it is probably difficult to find a country or clinic that would use this type of equipment. Old cobalt bombs were replaced by linear electron accelerators, which produce high-energy X-Rays and electron rays. Among the new types of radiotherapy, there are different devices and types of therapy: conventional radiation therapy, three-dimensional radiotherapy, intensity modulation radiotherapy (step and shoot, sliding windows and arc therapy). Innovative radiotherapy techniques such as tomotherapy and stereotactic radiosurgery are not yet very common around the world, but they are already available in the leading medical centers of the world.

Curietherapy, Brachytherapy

The difference between curietherapy and external radiotherapy is that in case of curietherapy the source of radiation is inside the patient. Radioactive balls are implanted in the patient forever or for some time. Radioactive prostheses can be installed in the tumor itself or in the cavity of its location. There are three main methods, which are divided into sub-methods depending on the dose rate (low level and high level) and the type of load (manual or delayed). These are interstitial brachytherapy, intracavitary brachytherapy, and endoluminal brachytherapy.


Metabolic Radiotherapy

Metabolic radiotherapy is carried out using a radioactive capsule or liquid, which is injected and directed towards the target, that is, the tumor. This therapy is not carried out by a radiotherapist, but by a specialist in the field of nuclear medicine.

Radiosurgery

Radiosurgery is a special method of external radiation therapy, the indications for which are specific. This mode of radiotherapy requires special equipment with the presence of ultra-focus rays.

Intraoperative Radiotherapy

Since the 2010s, this technique allows you to simultaneously remove the tumor and carry out the irradiation. It is carried out in the operating room using a mobile x-ray generator. The patient is operated on and irradiated simultaneously while he is under general anesthesia. It allows to reduce the duration of treatment.

 

Stages of radiotherapy

1. Introductory consultation with an oncologist, radiotherapist
  • Clinical examination and analysis
  • Biological analysis with tumor markers and screening for MRI, PET
  • Tumor biopsy analysis with disclosed anatomical and pathological analysis for the analysis of possible mutations EGFR, KRAS (to assess the goal) and the severity of receptors (PDL-1, to assess the possible conduct of immune therapy)
  • Help stop smoking and drinking alcohol
2. Discussion of the case at the multidisciplinary meeting of specialists of various profiles with a presentation of the available elements of the medical dossier. Oncologists, surgeons and anatomical pathologists choose the optimal treatment strategy based on European recommendations.

If the radiotherapy treatment is confirmed, then the following stages are followed:

 
Rtp etape 1
Stage number 1
Discussion of treatment methods and treatment protocol at a meeting of doctors of different profiles. For this, all the information about the patient’s illness and his medical record is needed: MRI PET CT screenings, detailed biopsy with mutation and expression. Based on this set, a decision is made.
 
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Stage number 2
Dosimetry scanning and pre-therapeutic reference. Patient positioning for upcoming procedures with position memorization.
 
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Stage number 3
The contouring of the organs at risk to protect against radiation.
 
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Stage number 4
Dosimetry scan performed by medical physicists to create the best possible ballistics with a maximum dose to target tumor volumes and minimize the dose to healthy organs. The use of Monaco software, as well as methods of radiation therapy with stereotactic radiosurgery, radiosurgery or arc therapy.
 
Rtp etape 5
Stage number 5
Radiation therapy sessions, with weekly consultations with a doctor. Important! A radiation therapy session lasts approximately 30 minutes (with preparation and positioning). Usually, one session per day is carried out, that is, 3 sessions per week (in case of stereotactic radiosurgery) or 5 sessions per week in case of conventional treatment.
 
Rtp etape 6
Stage number 6
Final consultation with a radiotherapist, summarizing the treatment.
 
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Stage number 7
After 8 weeks, repeated tests are performed along with screening (PET, CT, MRI), biological blood tests, and a clinical examination. The results of the follow-up inspection will predetermine further actions.
 
Our technical equipment allows us to provide patients from all over the world the most innovative and latest technologies for the treatment of oncology (irradiation using intensity modulation to provide maximum protection for healthy organs, using stereotactic radiosurgery for extra and intracranial irradiation, for delivering very high doses with unprecedented accuracy). Radiotherapy allows impacting tumor cells, destroying its DNA, the higher the dose, the greater the chance to eliminate the tumor.

In France, over 200,000 patients are treated with this treatment technique every year.

Radiotherapy can be used in conjunction with surgery, such as for breast cancer. This can significantly increase the chances of recovery. However, more and more types of oncology can be treated without resorting to surgery, using only radio and chemotherapy (These cancers are lung or cervical cancer).

Some types of cancer can only be cured with the use of radiotherapy, with the necessary equipment, this applies to prostate cancer. With the advent of new technologies for radiotherapy, this treatment is used for many types of oncology.

This treatment allows you to increase the therapeutic index, which includes the BENEFIT / RISK. Unlike conventional surgery, radiosurgery allows us to avoid the risks associated with conventional surgery and maintain the quality of life after treatment as it does not have side effects in the long term.

So, for example, take an inoperable lung tumor, stereotactic radiosurgery makes it possible to gain control over the disease (recovery) in 80-90 percent of cases in 3 to 10 procedures without risk of toxicity to the body.

The radiotherapist doctor is responsible for the doses delivered to the patient and for determining the target volumes. Most of the protocols used in our center originate in clinical trials and are approved by national and international competent authorities. Evidence-based medicine is an essential element in oncology. This allows the patient to access the latest protocols based on the latest scientific research.
For some types of oncology, joint chemotherapy is used for the effect of synergy (oncology of ENT organs, cervical cancer, cancer of the anus, malignant formations of rectum). Thus, the treatment is even more effective.

During the treatment at our center, we offer supportive therapy to better tolerate the treatment:

- The general conclusion of the oncologist to select the optimal diet
- Work on the psychological state of the patient with the possibility of attracting a hypnotherapist
- Consultations with specialists in onco-esthetics to improve the condition of the skin, hair, and nails
- Photobiomodulation for biotherapy, allows quick healing of tissues
- Regular help from nurses on any issues
- Art therapy - sculpture and drawing in group classes

All of the above is called supportive therapy. This therapy helps to better tolerate the treatment and increases the chances of remission.
 
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