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Radiation Therapy Treatment Techniques and Treatment Planning Systems

This informative article explores diverse radiation therapy techniques for various cancer types, emphasizing the critical role of treatment planning systems. Learn about treatment steps and technologies, including IMRT and SBRT, crucial for precise cancer treatment around the world.

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Radiation Therapy Treatment Techniques and Treatment Planning Systems

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  1. Accelerating the Future: Designing a Robust and Affordable Radiation Therapy Treatment System for Challenging Environments Radiation Therapy Treatment Techniques and Treatment Planning Systems Jacob (Jake) Van Dyk Professor Emeritus Western University, London, Ontario, Canada and Past-President, MPWB

  2. Cancer Incidence 2018 Africa Botswana World Data Source: GLOBOCAN 2018 Frequency of different cancers varies around the globe

  3. Cancer: Clinical Sites RT treatments involve most body sites From: http://2.bp.blogspot.com/-J2GpKl2IRdc/Ta4IKpAyqWI/AAAAAAAAAMs/lhveE-NfmkI/s1600/Types+of+Cancer.jpg

  4. Steps in Radiation Treatment Process • Multiple steps • Complex

  5. Treatment Techniques: Head & Neck Cancers Photons Electrons Patient immobilization for reproducible set-ups http://www.aboutcancer.com/neck_simulation_images.gif https://www.valleymed.org/uploadedImages/valleymedorg/Our_Services/Cancer_Treatment_and_Support/Cancer_Services/Radiation_Oncology/head%20and%20neck%20setupa1.jpg?n=8095&n=8095

  6. Breast Techniques Photons Electrons https://www.breastcancercare.org.uk/information-support/facing-breast-cancer/going-through-breast-cancer-treatment/radiotherapy-primary#what is radiotherapy

  7. Lung Cancer Conventional 2-field technique Stereotactic Body Radiotherapy (SBRT)

  8. Anterior-Posterior View Prostate Cancer Conventional treatment 4-field box Lateral View

  9. Intensity Modulated Radiation Therapy (IMRT) • Define objectives • Use inverse planning • Determine beam intensities

  10. 5-Field S&S IMRT Single 360 RA

  11. Components of Modern TPS • Hardware • CPU • High resolution graphics • Mass storage (hard disc) • CD/DVD • Keyboard & mouse • Printer • Backup storage facility • Network connections ElektaXio

  12. Components of 3-D TPS • Software • Input routines • Anatomy modeling • Beam geometry (virtual simulation) • Dose calculations • Dose volume histograms/evaluation tools • Digitally reconstructed radiographs • Output [hardcopies, network, web connection (RTOG)] TPP Nucletron https://n7.alamy.com/zooms/82cdbbb3db54491bbafe48cb70aed145/dosimetrist-calculating-dosimetry-for-radiation-therapy-of-head-and-e5rh3d.jpg

  13. Beam Kernel Slab Kernel Pencil Kernel Point Kernel Calculation Methodologies • Methods • Pencil beam • Convolution/superposition • Boltzmann transport • Monte Carlo • Radiobiological models • Issues to consider • Accuracy • Speed of calculation • User friendly • Ease of commissioning and QA • Options • Price Point Kernel Pencil Kernel Beam Kernel Slab Kernel

  14. National/International Protocols 300 pages • IAEA TRS-430, 2004 Figure 2 Figure 3 Available in pdf format from: http://www-pub.iaea.org/MTCD/publications/PDF/TRS430_web.pdf

  15. ±7% 4mm Auditing Accuracy for IMRT, IROC Calculated Measured

  16. Various Phantoms… for Commissioning/QA/QC Standard Imaging Inc. Euromechanics Medical GmbH Gammex RMI CIRS Inc. Modus Medical Devices Inc. Med-Tec

  17. IROC Audit Phantoms Pelvis (10) Thorax (15) SRS Head (4) H&N IMRT (31) Liver (2)

  18. Summary • Incidence of different cancers varies around the world • Radiation therapy techniques cover the entire body • Each site requiring its own details • While different techniques have some commonality • They are developed uniquely for each department • Treatment planning systems are at the core of the treatment planning process • Treatment planning requires imaging • Clinical implementation requires commissioning, verification and QA procedures

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