RADIATION THERAPY

SURGERY WARD WORK

PERCEPTOR
DR. RALPH RAPACON

GROUP D, SUBGROUP 3

MEMBERS
│ Ancha, Revanth │ Selvarajan, Selsha│ Sharma, Kartik │ Thakur, Sushil │Somovarapu
Arockiasamy,Aswin │
 FLOW OF DISCUSSION

INTRODUCTION TO RT
MECHANISM OF ACTION
INDICATIONS OF RT
TYPES OF RT
SIDE EFFECTS OF RT

HISTORY
➔ Radiation has been an effective tool for treating cancer for more than 100
years
➔ Discovery of X-rays in 1895 by Wilhelm Röntgen
➔ Emil Grubbe of Chicago was possibly the first American physician to use X-
rays to treat cancer, beginning in 1896.
INTRODUCTION
➔ Radiotherapy is the treatment of disease, most usually
cancer, using ionizing radiation (Electromagnetic
Spectrum).
➔ May be used as,

CURATIVE ADJUVANT PALLIATIVE NEOADJUVANT

➔ Frequently used in combination with other treatment ● Invisible

● Silent
strategies. (Eg. Chemotherapy + RT⇾ Chemoradiation) ● Pain free to receive
➔ Radiotherapy Departments are generally based in Tertiary
Hospitals.
➔ Radiotherapy can be given as an out-patient.

https://www.youtube.com/watch?v=ZgAi4wQLqZ0
Linear Accelerator (LINAC)
➔ Photons, Protons or Electrons are generated and
delivered to the patient using a Linear Accelerator.
◆ Photon Beam (X-Ray)
● 4MV to 22MV, single or duel beams
◆ Electron Beam
● 4-22MeV, Multi-beams with energy
➔ The high energy x-rays are shaped as they exit the
machine to conform to the shape of the patient's tumor
➔ Patient lies on a moveable treatment couch which can
move in any direction
➔ The beam comes out of a part of the accelerator called a gantry, which can be rotated around the patient
➔ Radiation is delivered to the tumor from any angle by rotating the gantry and moving the treatment couch
➔ There are strict radiation protection laws governing the delivery of radiotherapy for protection of patients,
Medical health professionals.
➔ RA 5207 (Atomic Energy Regulatory and Liability Act of 1968)
➔ Updated: Published in Volume 100, No. 36 of the Official Gazette dated September 6, 2004
https://www.radiologyinfo.org/en/info.cfm?pg=linac
https://www.who.int/medical_devices/innovation/radiotherapy_system.pdf?ua=1
 ➔ Delivering an optimal dose to the tumor + Minimal damage to
surrounding organs and Tissues → GOALS of RT
➔ The absorbed dose of radiation is expressed as the unit "Gray" (Gy)
➔ Radiotherapy (RT) is commonly delivered as a series of small doses called
fractions rather than as a single dose
➔ The number of fractions and the dose given in each fraction (Gy) depends on
the treatment intent:
● Radical RI require large doses of radiotherapy overall and the total dose divided into
multiple small fractions Lie IN categoRy in 35 fractions over 7 weeks (2Gy/#)
● Palliative RT is delivered in a smaller number of fractions and to a lower total dos te
BGy in 1 fraction or 30 Gy in 10 fractions (>2Gy/#)
➔ The dose and fractionation used for each tumour type and indication may vary
from one treatment centre to another

Jaffray DA, Gospodarowicz MK. Radiation Therapy for Cancer. In: Gelband H, Jha P, Sankaranarayanan R, et al., editors. Cancer: Disease Control Priorities, Third Edition (Volume 3).
Washington (DC): The International Bank for Reconstruction and Development / The World Bank;
 MECHANISM OF ACTION
➔ A beam of ionizing radiation can cause
damage to the DNA of a cell, it is
directed at the tumor.

➔ Cancer cells have defective DNA repair

pathways and are unable to repair
radiotherapy induced DNA damage.
Subsequently undergo cell death at the
time of mitotic division or apoptotic cell
death.

➔ Normal cells can often repair the damage DIRECT ACTION

Charged Particles(electrons,
INDIRECT ACTION
Eject charged particles (X-Ray,
and therefore survive. Protons Gamma Rays, Neutron)
 INDICATIONS
● Women with metastatic disease involving four or more axillary lymph nodes
and premenopausal women with metastatic disease involving one to three
lymph nodes
● Women treated with mastectomy who have cancer at the surgical margin
● In the case of invasive cancer, adjuvant radiotherapy is in the most cases
necessary after breast conserving procedures
● In advanced local-regional breast cancer (stage IIIA or IIIB).

Schwartz's Principles of Surgery, 10th edition

 ADVERSE EFFECTS OF
RADIATION THERAPY
EARLY SIDE EFFECTS -
( occur during radiation and can last till 1 month upon completion of radiation )

● Mild to moderate fatigue , nausea and vomiting .

● It can cause erythema , skin irritation and swelling on the radiated areas .
● Hair loss.
● Lymphoedema.

LATE SIDE EFFECTS -

( Occur after 3-6 months upon completion of radiation )

● Damage to the heart, lungs ,blood vessels, subcutaneous tissue, bones and nerves .
● Heart failure is the main complication and must be taken into account when setting the indications for radiation .
● Hardening of the tissue (fibrosis).
● Other side effects - brachial plexus injury, pulmonary fibrosis , weakening of the bones .

https://breastcancernow.org/