Name of the Procedure:

3-dimensional radiotherapy plan (3D-CRT)
Common name(s): 3D conformal radiotherapy, 3D CRT, three-dimensional conformal radiation therapy

Summary

3-dimensional radiotherapy plan (3D-CRT) is an advanced form of radiation therapy that uses detailed imaging to create a three-dimensional model of the tumor. This allows for precise targeting of the cancerous area with high doses of radiation while minimizing exposure to surrounding healthy tissue. Dose-volume histograms are utilized in the planning process to ensure the optimal dose distribution.

Purpose

The primary purpose of 3D-CRT is to effectively treat cancer by directing concentrated radiation precisely to the tumor. The goals include shrinking the tumor, killing cancer cells, and minimizing damage to nearby organs and tissues. Expected outcomes are tumor control and potential cure, with reduced side effects compared to traditional radiotherapy.

Indications

• Cancer located in anatomically complex or sensitive areas such as the prostate, lungs, brain, or head and neck.
• Tumors that require precise radiation delivery to maximize effectiveness and minimize side effects.
• Patients who have certain types of cancers like breast cancer, colorectal cancer, or gynecological cancers that benefit from conformal radiation techniques.

Preparation

• Patients may need to undergo imaging tests such as CT, MRI, or PET scans to map the tumor's exact location.
• Fasting is not usually required, but specific instructions on diet or fluid intake may be given.
• Patients may be advised to adjust medications, stop smoking, or avoid certain activities before the procedure.

Procedure Description

1. A simulation session is conducted where the patient is positioned and immobilized using custom molds or masks to ensure accuracy.
2. Detailed imaging scans are taken to visualize the tumor and surrounding anatomy.
3. Oncologists and medical physicists design the 3D treatment plan using advanced planning software, incorporating dose-volume histograms to optimize radiation delivery.
4. The patient undergoes multiple radiotherapy sessions where they lie on a treatment table, and the linear accelerator (LINAC) delivers targeted radiation beams to the tumor.

5. The entire process is non-invasive and does not involve anesthesia.

   Duration

   A typical session of radiotherapy lasts about 15 to 45 minutes.

Setting

The procedure is performed in a hospital or outpatient radiotherapy center equipped with advanced radiation therapy technology.

Personnel

• Radiation oncologist
• Medical physicist
• Dosimetrist
• Radiologic technologists
• Nurses

Risks and Complications

• Fatigue is common during radiotherapy.
• Skin irritation or blistering at the treatment site.
• Rare risks include radiation pneumonitis, secondary cancers, or damage to surrounding healthy tissues.
• Management includes supportive care, medications, and monitoring by healthcare professionals.

Benefits

• Precise targeting of the tumor results in a high likelihood of tumor control and potential cure.
• Reduced side effects compared to traditional radiotherapy.
• Improved quality of life during and after treatment.

Recovery

• Most patients can resume normal activities soon after each session.
• Post-procedure care includes regular follow-up visits to monitor response to treatment.
• Patients are advised to maintain good nutrition, hydration, and follow any specific instructions provided by their healthcare team.

Alternatives

• Traditional radiotherapy: Less precise and may result in more side effects.
• Stereotactic body radiotherapy (SBRT): Suitable for smaller tumors but involves higher doses over fewer sessions.
• Chemotherapy: Often used in conjunction with radiotherapy but has a different side effect profile.
• Surgery: Sometimes an option depending on the tumor location and stage.

Patient Experience

• During the procedure, patients must remain still but should not feel pain from the radiation itself.
• Post-procedure, mild discomfort or fatigue is common.
• Pain management includes over-the-counter pain relievers or prescription medications if necessary.
• Emotional support and counseling are available to help patients cope with the treatment process.