Arif Raza

Radiotherapy Department

IntroductionClinical speciality for treatment of cancerTissue destroying procedureUse of ionizing radiationSingle or combined with other therapySize of dept depends upon types of

services and sophistication of equipments

IntroductionCobalt unit – used for deep radiation

therapyLinear accelerator – wide range of oncology

casesSimulator – set telegraphy field

Treatment stepsInitial evaluationTreatment planApplicationTPS for evaluation and plan

BrachytherapyBrachy means short

distanceLocalized, precise and high-

tech radiation therapyRadio-active source is

placed in or near the tumourIncrease cure rates and

minimum side effectsRadioactive cobalt, caesium

or iridium is used in form of needles

BrachytherapyCompleted in short duration and is cost

effectiveConvenient for patientDoes not require hospitalization

Superficial therapyIonizing radiation with

energies from 8 to 140 kilovolts

Relatively soft X-raysUsed for non-infiltrating

cancers like skin cancers

Orthovoltage therapyIonizing radiation with

energies 150 to 400 kilovoltsUsed in treatment of

infiltrating surface malignancies

Intraoral, intervaginal treatment

Megavoltage therapyIonizing radiation greater than one million

voltsCobalt therapy and accelerators

LocationCarefully locatedConform to BARC’s shielding requirementThree foot thick walls and ceilings and

access for equipmentShould not block future expansion planIdeally on ground floor close to OPD and

radiologyClose to vertical transport systemNo departments shall be below radiotherapy,

thus basement is also a good option

DesignComplex and requires experts advise

during planningLegal requirements in designingTeam of experts including radiation

therapist, medical physicist, architects, engineers, equipment supplier and hospital planner shall be deployed

Shall be designed to present a warm, cheerful and pleasant atmosphere

DesignHigh density materials in walls, ceiling and

floor to contain radiationFloor loading

Facilities and space requirementsReception-controlWaiting area close to receptionDressing roomExamination roomsPhysician’s officeNurses’ stationTherapy rooms and control roomsPhysicists’ room with treatment computersStaff facilitiesPatient toiletsStorage facilities

Elements of desigingClinical examination section

Reception area with registration roomExamination and consultationRoom for medical staff and social workersWaiting areas including trolley bays, storage,

toiletsConsultation room shall be separated from

treatment areaA darkened cubicle required for examining

otolaringological patients

Elements of designingTreatment section

Treatment planning roomComputer assisted scannerSimulatorMould roomRoom for machinery

Elements of designingAccess to radiation room

Door with high lead shieldingDoor may require motor driveMaze arrangement preferable but consumes

spaceDirect viewing window can be given in

superficial or orthovolatge installation

OrganizationShall be headed by Radiotherapy Physician

assisted by other onco specialistPhysicist who shall develop detail

treatment plans for patients as prescribed by the physician

Radiotherapy technicians to calibrate therapy equipment, verify doses, position patients and operate the machines

OrganizationNurses to assist physician in examining

patients and help during treatmentDietician to plan nutritional needs of

patientsOthers – social workers, secretary, clerk,

attendants, housekeeping and security staff

Problem situationsInefficient schedulingLost chargesDown time

Regulatory ProcessesClearance of unit by AERB (Type approved

or NOC)Approval of room layout plan (1:50 scale)Construction only on basis of approved planAny modification shall be re-approvedAppointment of staffNomination and approval of radiological

safety officer

Regulatory ProcessesProcurement of personnel monitorsMeasuring and monitoring equipmentsAuthorization to procure radiation source

Thank you