Introduction of Treatment Process in Department of Radiation Oncology
放射治療(即俗稱的"電療")就是用高能量的X光線或帶電粒子（如電子，質子等）來照射病灶處，以達到『殺死惡性腫瘤』或 『抑制良性腫瘤增生』為目的的一種高科技治療方式。因為需要利用到腫瘤對放射線傷害的修復能力較差而正常組織的修復能力較好的放射生物現象，以避免治療中太強烈的急性反應和晚期副作用的產生，所以臨床上多需使用分次治療以達到腫瘤治療的目的而又能儘量避免對正常組織造成傷害。通常依病情和腫瘤種類不同約需治療1週到2個月之久；每週治療5-6次，每次數分鐘至數十分鐘。 為了能提供病人最妥善的治療，需要有完善的準備工作及順暢的作業程序。雖然我們會盡力減少病人治療等候的時間，但是要接受治療的病人眾多，仍難免有需要依序等候的不便，敬請多多包涵！ 以下用圖片配合文字說明，介紹放射治療之作業程序：
Radiotherapy (RT) is a high-tech therapy which uses high-energy photon or charged particle such as electron or proton to eradicate the malignant tumors or inhibit the growth of benign lesions. Taking advantage of the better repair ability from radiation damage in normal tissues than malignant tumors, fractionated (multiple times) radiotherapy is employed to achieve the tumor control, but spare the severe acute side effects and late toxicities. The total treatment duration depends on the disease types and may take from one week to two months, 5-6 times treatment per week and 10-20 minutes for each time. To provide the best treatment quality, it needs working time for pre-treatment preparations and planning before radiotherapy. There are many patients receiving radiotherapy, therefore there will be waiting time for treatment. We will try our best effort to reduce the waiting time and your patience is highly appreciated.
The treatment process of radiotherapy is illustrated by the following pictures and annotations:
A. Physicians evaluate patient’s condition and disease status, then design treatment plan and set up schedule :
New patients first go to the nursing station and check their body height and weight. (Maintaining body weight is very important for RT because it would reduce the side effects and even improve the treatment outcomes.)
2.To see your doctor:
The doctor will evaluate your condition carefully and fully explain the indications and related considerations for radiotherapy.
3. To book the time for RT preparation:
Making an appointment at the reservation station for Computed tomography (CT) simulation and/or mold for fixation. At this moment, patients who are the first time to visit our outpatient clinics could go to cashier, and then bring the recipient back to the nursing station.
4.Orientation and education:
An orientation of the environment and education for important information such as support and care during RT will be given by our nurse.
B.Pre-RT preparation
5. Mold for fixation:
According to the sites of treatment, patients may need fixation with personalized mold, such as a cast, alpha cradle or cushion bag, to ensure the reproducibility of the same position for each treatment. You may feel mild heat sensation during the preparation.
5-A Making a mask for head and neck patients and it takes about 10~15 minutes
5-B Making an alpha cradle for the body position and it takes about 15~20 minutes
6. CT simulation:
CT images will be acquired for treatment planning and some reference lines (dark lines), which are used for daily set-up, will be marked on the body surface. Please don’t erase these marking lines, particularly when bathing. If these lines were cleaned, it might need another CT and the treatment schedule might be delayed.
7. Treatment planning & Dose calculation:
Physicians and medical physicists will meticulously make a treatment plan for each patient and it will take a few working days based on complexity of the planning. The personnel on the treatment reception counter will contact the patient as quickly as possible when the treatment schedule is ready.
C. Beginning of the radiotherapy
- 8. To visit the nursing station:
- * On the first treatment day, the patient should visit the nursing station again; to take clothes and a brief introduction for the following treatment. Then, visit the treatments reception counter and take the “treatment card”. There are bar codes and serial numbers on the card and please bring the card during the RT course.
- * Before starting the first treatment, verification images to assure treatment position will be taken., The images will be approved by in-charge physicians and the treatment is given after the approval.
- * After the first day, patient could demonstrate your arrival by checking your treatment card at the treatments counter, and then receive RT. (Note: If you request a specific time slot for treatment, please express it to treatment counter and wait until there is a treatment completion for patients in this specific time slot.)
9. There are 10 time interval with 60-80 numbers in one day. Every patient is assigned into a fixed time slot and please arrive before the assigned time. After your bar codes are read, please stay in waiting area and follow the number shown in the LED panel. To save your time, please change clothes when you are waiting for the treatment.
If you need to change the treatment time (e.g., for chemotherapy or other clinics), please tell the treatments counter and we will rearrange your treatment time
10.To receive the treatment:
Treatment time in each treatment depends on patient’s condition and the complexity of beam delivery, and usually is 10-20 minutes. There is no pain or discomfort related to the treatment and please keep in the same position during the treatment.
If you feel discomfort and are not able to tolerate the treatment, or under any emergent condition, please raise your hand and we will see it on the monitor and stop the treatment immediately
- 11. Clinics during treatment
- The reasons that you should visit your physician during RT are to monitor the progress of RT, to manage and relieve your acute toxicities by medication or other modality, and to arrange the preparation for the subsequent treatment.
- It takes longer time than only doing RT, so please allow more time at the day of clinics.
- Please measure your body weight at the nursing station before visiting the clinics.
D. Special techniques of radiotherapy
The delivery of radiation, in additional to external beam, can be from internal beam via the radioactive sources, the so-called “brachytherapy”. The brachytherapy is able to escalate the local radiation dose and decrease the dose to surrounding normal tissues, also lower the toxicity. This technique can be used in tumors such as nasopharyngeal cancers, cervical cancers, prostate cancers, brain tumors and esophageal cancers. However, the decision for brachytherapy is based on the clinical condition and details should be discussed with your attending physicians.
若有任何特殊問題，請與本院服務專線連絡：
基隆院區：02-24329292 轉 分機2046
林口院區：03-3281200轉 分機2595、2596
嘉義院區：05-3621000轉 分機2013
高雄院區：07-7317123轉 分機2607、2609
If you have any questions, please contact:
Chang Gung Memorial Hospital, at Keelung: 02-24329292 ext 2046
Chang Gung Memorial Hospital, at Linkou: 03-3281200 ext 2595, 2596
Chang Gung Memorial Hospital, at Chiayi: 05-3621000 ext 2013
Chang Gung Memorial Hospital, at Kaohsiung: 07-7317123 ext 2607, 2609
長庚紀念醫院 N361 15û21cm 2012.1.5修訂
