Patient treatment path in the radiotherapy department at ST. Marina University Hospital - Varna

Abstract

Since the first implementation of radiotherapy in 1896, high technology progress has been achieved in that field. The aim of radiotherapy is precise delivery of certain radiation dose in clinical target volumes with minimal damage of healthy tissues. The result is high tumor control with good quality of life and prolonged survival.

The radiotherapy workflow at the Radiotherapy Department at the St. Marina University Hospital - Varna has the following specific stages: clinical and biological planning; anatomical topographic planning; treatment planning and delivering the plan, control of the symptoms and follow-up of the patients. During the consultation the radiation oncologist defines the aim of the treatment according to the cancer type and stage and an appointment for virtual simulation (planning CT) is given.

During the simulation according to the selected protocol, the radiation technology technician (RTT) immobilizes the patient on the CT table and performs the CT scanning. The simulation is part of the anatomical topography planning where technicians contour organs at risk and the physician defines the target volumes and prescribes the daily and total radiation dose. At the next stage, the medical physicist per forms treatment planning, applying precise radiation techniques - 3 DC, IMRT, and VMAT. After the radiation oncologist approves the plan, the physicist prepares a preliminary verification plan running from the RTTS before the first fraction of irradiation. During the first patient irradiation a radiation oncologist, physicist and RTT are present at the linear accelerator. Then the following irradiation procedures of the patient are responsibility of RTT. In all patients to accurately implement the plan image guided radiotherapy (IGRT) is applied - verification of the position of the patient by radiographs and CBCT. At all stages a radiological nurse takes care of the patient and infuses the chemotherapeuticals. During and after treatment, the radiation oncologist follows up the patient. These stages could be repeated in case of boost or fast shrinking tumors.
The aim of the present report is to demonstrate the patient treatment path at the Radiotherapy Department at the St. Marina University Hospital - Varna.