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External Beam Therapy

When radiation therapy is delivered by technology outside the patient's body, it is called external beam radiation therapy (EBRT).
 
External beam radiation therapy uses a linear accelerator to focus powerful beams of X-rays to kill cancer cells. These X-rays interact with the atoms of living cells in a different way than the X-rays used to detect broken bones or dental problems. They are just as painless, however. These treatment X-rays are carefully focused to inflict lethal damage to the tumors while minimizing any injury to the surrounding normal tissues.

3D Conformal Radiation Therapy
3D conformal radiation therapy (also called three-dimensional radiation therapy) uses computer technology to create a three-dimensional picture of the tumor so that multiple radiation beams can be shaped exactly (conform) to the contour of the treatment area. This is particularly useful when the tumor has an irregular shape. It allows doctors to give the highest possible dose of radiation to the tumor, while sparing the surrounding normal tissue to the greatest extent possible.

Intensity-Modulated Radiation Therapy (IMRT)
CentraState's Radiation Oncology Department offers the most sophisticated method of radiation delivery through intensity-modulated radiation therapy. Intensity-modulated radiation therapy (IMRT) uses a highly precise system to deliver meticulously calculated beams of radiation directly to the targeted tumor.
 
Cancers are rarely uniform, and portions of tumors that are thicker need more radiation than thinner areas. Using IMRT, we can vary the amount of radiation that goes to each area, which results in increased accuracy.
 
Successful IMRT implementation demands the specialized equipment and experienced team of physicians, physicists and technologists that you will find at CentraState.

Stereotactic Radiosurgery (SRS)
Stereotactic radiosurgery (SRS)is not surgery at all—at least not in the conventional sense, as it does not require an incision.
 
SRS is a one-day outpatient procedure. It uses a computer-guided radiation therapy system to aim highly focused beams of radiation directly into a tumor orabnormality. This nonsurgical approach relies on the BrainLab computer system to deliver high doses of radiation precisely to specific areas within the brain or other areas of the body. With this technique, all the radiation is focused directly on the area of the tumor or abnormality and very little radiation reaches the surrounding normal tissue.
 
Cranial radiosurgery is a technique of delivering radiation to smaller lesions of the brain, usually those in close proximity to critical structures. It is performed as an alternative to open craniotomy resection, an open surgical procedure. The treatment allows for a very precise delivery of multiple, tightly focused radiation beams to a small volume of tissue that spares the normal, often critical, surrounding area. It is used to treat brain malignancies as well as acoustic neuromas, meningiomas and arteriovenous malformations. Fractionated radiotherapy (daily treatment for up to seven weeks) is similar to radiosurgery and is used primarily when a larger area needs to be treated.
 
Body radiosurgery is similar to cranial radiosurgery in that it allows the physician to tightly conform a small treatment volume in areas other than the brain. It is typically used for liver, lung, spine and head & neck lesions that may be close to critical structures.
 
CentraState's radiosurgery team includes neurosurgery specialists, radiation oncologists, radiologists, medical physicists, and physicians in other specialties.

Image-Guided Radiation Therapy (IGRT)
CentraState's Radiation Oncology facility broadened the range of therapeutic treatments available to cancer patients with the addition of image-guided radiation therapy (IGRT) capabilities in 2005.
 
We are the first hospital in New Jersey to offer the On-Board Imager by Varian, a new technology designed to improve the precision and effectiveness of cancer treatments by giving doctors the ability to target and track tumors more accurately. An automated system for IGRT, the On-Board Imager enables clinicians to obtain high-resolution three-dimensional images to pinpoint tumor sites, adjust patient positioning when necessary, and complete a treatment, all within the standard treatment time slot.
 
Up to now, radiation oncologists have had to contend with daily variations in patient positioning including internal organ motion by treating a margin of healthy tissue around the tumor. IGRT enables doctors to locate the tumor before each dose is administered while the patient is in the treatment position. This minimizes the volume of healthy tissue exposed to radiation during treatment.

What to Expect
Several appointments are necessary before you can begin your actual external beam radiation therapy (EBRT) treatment. Here is an overview of what you can expect:
 
Consultation
During the consultation visit, you will meet with your radiation oncologist who will spend 1 to 1-1/2 hours with you reviewing any tests or studies you may have had and discussing the specifics of your diagnosis and treatment options. If external beam radiation therapy is the recommended course of treatment for you, the doctor will discuss what to expect during treatment and possible side effects. The primary goal of this consultation is to make sure that all of your questions are answered fully. You will continue to meet with the radiation oncologist weekly throughout your treatment.
 
Simulation
On your next visit, you will meet with the radiation oncologist and a radiation therapist for simulation, which is a planning session. During this session, the doctor will use a three-dimensional CT simulator to pinpoint and measure the tumor(s). This valuable information will be used to determine exactly where to direct the radiation beam during treatment. Immobilization devices may be created to help assure reproducibility (accurate patient positioning) during your course of treatment.
 
Treatment Plan
Between the simulation and your first external beam radiation therapy treatment session, the radiation oncologist will write a prescription for a treatment plan, working in conjunction with the medical physics team that specializes in the accurate measurement and safety of radiation.
 
Assessment & Verification
The nurse will provide you with patient education material and meet with you weekly to provide support. She/he also will provide you with specific instructions regarding your treatment and may refer you to other healthcare professionals, such as social workers and dietitians, as needed.
 
After your nursing assessment, you will have a treatment verification session. The radiation therapist will check the accuracy of your treatment area during a practice session on the linear accelerator, the equipment used for external radiation therapy. The radiation oncologist will compare the films taken during the practice session with films taken previously during the planning session and approve your treatment area or make adjustments as necessary.
 
Treatment
Treatment usually involves a 10- to 15-minute session, five days a week for a number of weeks, but treatments may vary. The treatment itself is painless. Throughout, you will be seen at least weekly by the radiation oncology physician and nurse, who work closely to coordinate your care.
 
Follow-up
After you have completed treatment, you will see your radiation oncologist for a follow-up appointment and evaluation.

Specialized Equipment
Our comprehensive radiation oncology facility houses an advanced linear accelerator for external beam radiation therapy, a specialized CT (computed tomography) simulator, and state-of-the-art three-dimensional computer planning equipment. The technology allows our radiation oncologists to design treatments that specifically target the area while limiting the exposure of normal areas to radiation.

Contact Us
To contact the Radiation Oncology Department at CentraState Medical Center, call (732) 303-5290.