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Treatment & challenges of uh breast radiotherapy
- 1. SIMULATION,TREATMENT & CHALLENGES OF BREAST CANCER PATIENTS Sunil M Maurya Radiation Therapist Sir H N Reliance Foundation Hospital & Research center Mumbai
- 2. • Simulation • Planning • Treatment
- 3. SIMULATION PROCESS: Identification & Diagnosis Verification of Document’s Explaining entire Simulation Process Collection of Required Documents Allotment of Treatment appointment slot
- 4. SIMULATION FOR ULTRA HYPO-FRACTIONATION BREAST CANCER Intact breast Chest wall e~ boost marking
- 5. E~BOOST CT SIMULATION: Why: to give Radiation dose to tumor bed How: Alignment of patient done in Civco Breast Board / Orfit AIO B/P with blue breast board setup Positioning (flat surface) Marking of treatment area (mammography scans) CT scan 1mm Defining surgical clips Appropriate field size and energy is defined by the clinical reference by the doctor during simulation
- 6. PLANNING………
- 7. TREATMENT
- 8. TREATMENT Verification ofTreatment Approval (treatment approvals ofT1 &T2) OSMS data import (import structure) Patient preparation for treatment (explaining procedure ) Plan implementation (Delta shifts) Plan verification & approval (orthogonal images) Plan execution
- 10. OSMS DATA IMPORT 1 Selection of patient 2 Site & Diagnosis 3 Appropriate ROI 4 Maximum clearance for OSMS coverage.
- 12. PATIENT PREPARATION FORTREATMENT Explaining treatment process Machine movements and OSMS Immobilization devices
- 14. PLAN IMPLEMENTATION (DELTA SHIFTS)
- 16. PLAN IMPLEMENTATION (OSMS GUIDED)
- 17. PLANVERIFICATION & APPROVAL (ORTHOGONAL IMAGES)
- 19. PLAN EXECUTION
- 20. CHALLENGES FORTHE PATIENTS • CoViD -19 pandemic • Loneliness in hospital waiting area • Loss of human connection (PPE ALIEN) • Extended time for day 1 • Anxiety of short course of treatment • Covid RT-PCR weekly tests • Continuation of treatment without gaps
- 21. CHALLENGESTOTHERAPIST • CoViD -19 pandemic • PPE (long hours) • Loneliness in department • Shifts &Travelling to hospital due to lockdown • Chances of CoViD -19 infection (to family) • Communication • Covid RT-PCR weekly tests • Quarantine during Covid-19 infection
- 22. COVID -19 PANDEMIC – CHALLENGES Battles faced by Patients Emotional, Physical, financial, social, problems of Family & most importantly CoViD-19 situation. Role of Radiation Therapist Emotional support Explaining procedure in detail Allow patients to express emotion Respond in an empathetic manner Improve patients satisfaction , reduces distress & anxiety, better treatment environment.
- 23. THANKYOU
Editor's Notes
- Reference image – CT body Map of ~20,000 points of patient’s external anatomy Multiple ROIs ROI size can be optimised for maximum performance Only the region of interest is monitored during treatment Deformable tissue can be ignored if necessary Areas of movement (e.g. eyelids in SRS patients) can be excluded from the ROI to give higher targeting accuracy