- IMRT: (Intensity modulated radiation therapy) different intensity in areas of tumor.
- IGRT: (image guided radiation therapy) repeated PET identify changes in tumor sixe and location.
- Tomotherapy: combined imaging and beam radiation.
- SBRT: (Stereostactic radiosurgery) delivers a high dose very accuratly.
- Brachytherapy: Internal radiation therapy
- Interstitial: radiation source is placed inside the tumor (prostate)
- intracavity: surgically placed in a cavity
- Episcleral: attached (melanoma in the eye)
Isotopes are sealed in pellets (seeds). They are placed in patients using needles/catheters. They decays in few weeks. They can be placed temporary or permanent.
- Systemic radiation therapy: swallow/inject radioactive substance. Delivered to the tumor for specific tumors. New treatments under trial. Body fluids emit low level of radiation. Limit contact with children below 18.
Type of particles:
- Photons: delivers small packets all along their path.
- Protons: deliver energy at the end of their path. (Bragg peak)
- Electrons: irradiate superficial tumors (skin cancer) Cannot travel far through tissue.
Timing of Side effects:
- Early (acute) during treatment: temporary like skin irritation, hair loss, urinary problems, salivary glands damage (can be permanent) Amifostine van help protect salivary glands.
- Late (chronic) effects months or years after treatment
Type of Side effects:
- Fatigue: common side effect.
- Nausea: common for abdomen or brain treatment. Medication are available to prevent/treat.
- Fibrosis: scar tissue
- Damage to bowels, bleeding
- Memory loss
- Infertility
- Second cancer caused by radiation exposure
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