Download Stereotactic Radiation Therapy

Discomfort on swallowing
Sometimes the oesophagus (food-pipe)
can become inflamed during radiation
treatment. Again this is less common
with SBRT treatment than conventional
radiotherapy. This inflammation can
result in pain or difficulty swallowing and
may necessitate a diet of soft foods and
fluid for a week or two.
Hair loss
SRS will not cause you to lose your hair
on your head permanently. SBRT can
cause some patchy hair loss on the chest
(in males). Depending on the radiation
dose, chest hair may or may not
grow back.
Nausea
SRS and SBRT do not usually make you
feel nauseous however if you do feel
nauseous there are medications to help
you control this. It is important that you
let us know if you develop any of these
side effects so we can help you
manage them.
Late side effects of
treatment
Late side effects, although uncommon
(less than 1%) can occur after your
treatment is finished. Rest assured, your
doctor will discuss with you potential
long term side effects that relate
specifically to your treatment.
Lung scarring / fibrosis / collapse
Some of the treated lung around the
cancer may be affected by the radiation
treatment. This can result in scarring and
very rarely may necessitate the use of
oxygen therapy for either a short time
or permanently. The risk of this is lower
when receiving SBRT compared to
conventional radiotherapy.
Bone pain and fracture
Radiation may weaken the bone which
can cause pain or a fracture. In extremely
rare cases, this may result in the need for
long-term painkillers.
Nerve damage
For cancers near the nerves, there is a
small chance of radiation damage. This
can result in weakness, numbness, pain
or loss of function and in some cases can
be permanent.
Our staff are trained to support
you through your treatment.
Second malignancy
It is rare for patients to develop another
cancer in the same treatment area due to
radiation.
Follow up
Questions
At the end of your SRS/SBRT treatment
you will be given a follow up
appointment to see your Radiation
Oncologist in approximately two weeks.
At this appointment, your Radiation
Oncologist will assess any side effects
from treatment and start follow up care.
If you have any questions after reading
this information write them down and
ask your Radiation Oncologist at your
next appointment.
You may also be asked to fill out a
questionnaire each time you are seen
with questions about any symptoms
following SRS/SBRT. This provides us with
valuable information to help us refine our
SRS and SBRT programs to ensure that
we are delivering the highest quality of
care to patients.
Support
Our team, including your Radiation
Oncologist, Radiation Oncology Nurse,
Radiation Therapists and administrative
staff, are trained to help you through
your cancer treatment. Whilst much
attention is paid to your physical health
we appreciate that your emotional health
is important too. Being diagnosed and
receiving treatment for cancer can be
very distressing and will commonly result
in lots of questions, anxiety, fear and
sometimes depression.
Stereotactic Radiation Therapy
Patient Information Leaflet
Please raise any side effects with our
staff. If we are not able to assist directly,
we have a wide network of health
professionals who we can refer you
to so that you can receive the
support that you need.
ROV-FRM-107 V1
www.radoncvic.com.au
This leaflet provides information for patients and
their family about Stereotactic Radiation Therapy
• What is Stereotactic Radiation Therapy?
• Your Stereotactic Radiation Therapy treatment including:
– Positioning and CT Scanning
– Treatment
• What to expect
• Side effects of Stereotactic Radiation Therapy treatment
• Follow up and support
What is Stereotactic
Radiation Therapy?
Radiation therapy is used to treat many
types of cancer. It uses high energy X-rays
to destroy cancer cells whilst causing as
little damage as possible to the normal
body cells around the cancer.
There are two different types of stereotactic
radiation therapy – Stereotactic
Radiosurgery (SRS) and Stereotactic Body
Radiotherapy (SBRT). SRS and SBRT enable
a high dose of radiation to be delivered to
the cancer cells using a precisely focused
method whilst sparing the nearby normal
tissues. The main differences between SRS/
SBRT treatment and conventional radiation
therapy treatment are:
• A higher radiation dose can be delivered
to the cancer resulting in better cancer
outcomes
• The lower radiation dose to the other
body tissues results in fewer side effects
• SRS and SBRT is delivered in 1-5 sessions
over 1-2 weeks (as opposed to 15+
sessions over 4+ weeks)
The fundamental difference between
SRS and SBRT is the number of sessions
involved and the body area where the
treatment is delivered.
SRS is used to define treatments that
involve one session only and usually
relate to treatment to tumours in the
brain. Treatments to the brain can also
be delivered over multiple sessions, this
is known as Fractionated Stereotactic
Radiotherapy (fSRT).
SBRT uses multiple treatment sessions,
usually 1-5 and delivers treatment to areas
outside the brain including the abdomen,
pelvis, lung, bone and spine.
Your SRS/SBRT treatment
You will need to attend your radiation
oncology department for a specialised
planning appointment prior to starting
your treatment. This appointment will take
between 1-3 hours.
Positioning and CT Scanning
SRS / fSRT - requires your head to be as still
as possible. This immobilisation is achieved
by making a customised head support and
a plastic mask. These are made during your
CT simulation appointment.
The mould is made first using a foam
product which forms around the head,
neck and shoulders – maintaining the
position and angular rotation of the head
and neck for every SRS / SRT treatment.
The mask is then made using a
thermoplastic mesh which is warmed and
placed over the face, hardening as it cools.
The thermoplastic mask is shaped so as to
give the exact impression of your face and
head. There are holes in the mask so you
can breathe easily.
SBRT also requires the area of your body
that is being treated to be as still as
possible. Special vacuum cushions are used
to maintain your body in a position that is
ideal for treatment delivery; this positioning
varies depending on the area of the
body you are having treated. You may be
required to have your arms up above your
head, on your chest or by your side. In each
case your arms will be supported by the
moulded vacuum cushions. In most cases,
your knees and feet will be supported by
knee and foot position modules.
For SBRT cases, after the completion of
the CT scan, you will be given several
permanent tattoos (small dots on your
skin), which assist us to set you up in exactly
the same position for your treatment.
It is important that you are comfortable
in your scanning position, as you will lie in
the same position for the duration of your
planning and treatment sessions.
A custom made thermoplastic mesh worn by patient.
A treatment plan is created, based on your
CT scans and other important information.
On the first day of treatment our nursing
staff will conduct a patient interview. Skin
care and treatment for potential side effects
will be discussed.
Your Radiation Therapists will coordinate all
appointments with you.
What to expect
If you are not comfortable, please advise
the Radiation Therapist.
Once the mould and thermoplastic mask
are made for your head and neck or the
vacuum cushions have been moulded
to your body shape, a CT scan of the area
you are having treated is performed. If you
are having treatment for lung cancer, your
breathing is taken into consideration due
to its impact on the position of the tumour.
During the scanning process you may be
given instructions on how to breathe.
Once the session is complete you can go
home. The images obtained during this CT
scan along with any MRI/PET scans of your
tumour are used by specialists to carefully
plan your radiotherapy.
After the CT/Planning session, it takes our
treatment team 1–2 weeks to create your
treatment plan.
Treatment
During treatment, you will be asked to lie
on the treatment table in the same position
as you were for your planning CT scan. The
Radiation Therapist will help you get into
the correct position and add any moulds or
equipment that you may require.
Scans are then taken of your position and
adjustments are made to achieve submillimetre accuracy prior to
treatment delivery.
• SRS/SBRT treatment is usually given on
1-5 separate occasions over 1-2 weeks.
Each treatment will last for about 30-60
minutes.
• For each treatment you will be positioned
in the same way as in the planning scan.
• Scans will be taken prior and sometimes
during the treatments to ensure that the
radiotherapy is delivered accurately.
• Once your setup is complete, the
treatment staff will leave the room but
they can still see you and speak to you via
a 2-way intercom and closed circuit TV
camera.
• It is very important during the treatment
that you breathe in a steady pattern and
remain very still.
• You will see the treatment machine
moving around you and hear it ‘buzzing’
but it will not touch you. You will not feel
anything during the treatment.
Regular check-ups with your
Nurse and Doctor are scheduled.
Early side effects of
treatment
Early side effects of treatment can occur
whilst receiving and up to 12 weeks after
the completion of your treatment. Your
Radiation Oncology Nurse will talk to you
about what side effects to expect and
how you can look after yourself during
treatment. Early side effects are usually
temporary and can include:
Tiredness / fatigue
Radiotherapy can make you feel more
tired than normal, particularly in the weeks
following the treatment. This is normal and
will gradually settle. Make sure you have
plenty of rest, although light exercise can
often make you feel better.
Skin reaction
The skin in some areas around your body
may become slightly dry, itchy and red. If
your cancer is very close to the skin, this
reaction may be more prominent.
Shortness of breath
Sometimes when lung tissue is being
irradiated it can become inflamed. This
is referred to as “radiation pneumonitis”
and can result in shortness of breath, a
dry cough, wheezing and sometimes a
fever. It usually develops 6-12 weeks after
completing treatment.
Radiation pneumonitis can be treated by
medication.
Chest / rib pain
If your cancer is close to the chest wall /
ribs then you may develop pain following
SBRT treatment. This is usually mild and
temporary although occasionally can be
more significant or persist for longer. It can
usually be managed with pain medications.