Radical vs Palliative and Treatment Techniques Flashcards
Palliative treatment aim
Aims to relieve distressing symptoms of advanced disease
Radical Treatment Aim
Aims to cure patient of disease
Palliative treatment schedule time and side effects
Short treatment schedules with fewer/minimized side effects
Radical treatment schedule time and side effects
Long treatment schedules to eliminate tumour and spare normal tissue but more side effects
Palliative Doses and fractions
Lower total doses with higher fractions
8Gy in a single dose
20Gy in 5 fractions
Radical Doses and fractions
Higher total doses (eliminate tumour) with smaller fractions (preserve normal tissue)
40.05Gy in 15 fractions = breast
50.4Gy in 28 fractions = cervix
Palliative Side Effects
- minimal upset from treatment
- side effects vary with site
- abdomen, oral and perineum have poor tolerance
Radical Side Effects
- more side effects
- acute, chronic and late side effects
- risk vs benefit
- Planning used to minimize
- usually resolve after treatment but chronic can be disruptive to daily life
- Endpoint avoided
Palliative Treatment Techniques
- Simple set up and plan
- Single field or POP, sometimes more complex (VMAT, IMRT, SBRT)
Radical Treatment Techniques
- Complex positioning and plan
- 3D conformal, IMRT, VMAT, stereotactic, brachytherapy
EBRT
External Beam Radiation Therapy
3DCRT
3D Conformal Radiation Therapy
Step and shoot, MLC’s shape to tumour.
VMAT
Volumetric Modulated Arc Therapy
Continuously rotating around patient, MLC’s continually shaping.
3DCRT Key Points
- Conforms high dose (95%) as closely as possible to PTV
- PTV may be irregular shape
- Avoids OAR
- Multi leaf collimators shape beams around PTV
VMAT Key Points
- Advanced form of IMRT
- Delivers dose to tumour in 360 rotation
- Single arc, multiple arc or split arcs
- Multi leaf collimators continuously shape beam as it moves around body
- LA changes intensity of beam as it moves around body
