Name of the Procedure:

Thoracic Target(s) Delineation for Stereotactic Body Radiation Therapy (SRS/SBRT), Photon or Particle Beam

Summary

Thoracic target delineation for SRS/SBRT is a highly precise radiation therapy technique used to treat tumors in the chest area. It involves mapping out the exact location of the tumor to ensure that high doses of radiation can be delivered accurately while minimizing exposure to surrounding healthy tissues.

Purpose

This procedure is used to treat cancers and tumors located in the thoracic region, including the lungs, esophagus, and chest wall. The goal is to maximize radiation dose to the tumor for effective treatment while protecting nearby healthy tissues to reduce side effects.

Indications

• Non-small cell lung cancer (NSCLC)
• Small cell lung cancer (SCLC)
• Metastatic tumors in the thoracic area
• Other thoracic malignancies
• Patients unsuitable for surgery due to health conditions or personal choice

Preparation

• Detailed imaging, such as CT, MRI, or PET scans, to visualize the tumor.
• Consultation with the oncology team to establish a treatment plan.
• Instructions to avoid certain medications and foods before imaging.
• Possible fasting before particular scans, as directed by the healthcare team.

Procedure Description

1. Consultation and Imaging: Initial consultation with oncologists and imaging studies to locate and size the tumor.
2. Delineation: Using advanced imaging technology, the radiation oncologist delineates or maps out the exact boundaries of the tumor.
3. Planning: The mapped-out tumor is used to create a customized radiation treatment plan.
4. Simulation: A simulation session to position the patient correctly and mark the setup to ensure repeatable accuracy.
5. Treatment Delivery: The patient undergoes SRS/SBRT, where precise radiation beams are directed at the mapped-out tumor from multiple angles.

Tools: CT/MRI/PET scanners, radiation planning software, linear accelerators, proton therapy machines (for particle beam treatments).

Anesthesia: Usually, anesthesia or sedation is not required, but it may vary based on patient comfort and treatment setup.

Duration

The entire course of SRS/SBRT typically involves several sessions over a period of one to two weeks, with each session lasting about 30-90 minutes.

Setting

This procedure is typically performed in a hospital or specialized outpatient clinic equipped with advanced radiation therapy technology.

Personnel

• Radiation oncologists
• Medical physicists
• Radiologic technologists
• Oncology nurses
• Dosimetrists

Risks and Complications

• Fatigue
• Skin irritation at the treatment site
• Cough or shortness of breath
• Esophagitis
• Rarely, radiation pneumonitis, heart problems, or rib fractures

Benefits

• High precision targeting of tumors allows for better control and outcomes.
• Minimizes damage to surrounding healthy tissue.
• Non-invasive with fewer side effects compared to surgery.
• Shorter treatment duration compared to conventional radiation therapy.

Recovery

• Minimal downtime; most patients resume normal activities shortly after each session.
• Follow-up appointments to monitor treatment effectiveness and manage any side effects.
• Regular imaging scans to assess the tumor’s response to treatment.

Alternatives

• Conventional radiation therapy: Less precise, longer treatment duration.
• Surgery: Preferred for some patients but involves more risks and recovery time.
• Chemotherapy: Systemic treatment with different side effects.
• Immunotherapy: Stimulates the immune system to fight cancer but can vary in effectiveness.

Patient Experience

During the procedure, patients lie still on a treatment table. They should not feel pain from the radiation itself but might feel discomfort from lying still. Post-procedure, they might experience mild side effects like fatigue or skin irritation, which are manageable through prescribed medications and care instructions.