What you need to know about:

Radiation Therapy Using VMAT

Fast Fact

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Recovery Period:

A few weeks to 2 months

Permanence:

Depends on patient condition

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Doctors

Time it takes:

20 minutes

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Overview of

Radiation Therapy Using VMAT

in Thailand

Volumetric modulated arc therapy (VMAT) is a novel radiation therapy technique that delivers the radiation dose continuously as the treatment machine rotates. This technique accurately shapes the radiation dose to the tumour while minimising the dose to organs surrounding the tumour. VMAT involves the use of external radiation therapy beams which are directed in a series of arcs or angles by a rotating machine to allow for greater access to a cancerous tumour. The arc-shaped beams allow more difficult tumours, such as ones wrapped around organs and other important structures, to be targeted more precisely. VMAT is a type of intensity-modulated radiation therapy (IMRT) in the way the radiation dose is continuously varied throughout your treatment. It is also known as Rapid Arc

Goals of

Radiation Therapy Using VMAT

VMAT can be used to treat large areas of the body with uneven boundaries and tumours located close to vital organs without fear of damage to these organs by high doses of radiation. Many different cancers can be treated using VMAT including skin cancers, head and neck cancers, brain cancers, gastrointestinal cancers, prostate cancers and lung cancers.

Price of

Radiation Therapy Using VMAT

Average Cost

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Price Range

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Pros and cons of

Radiation Therapy Using VMAT

Pros

-Radiation therapy using VMAT delivers treatment quickly and with high precision and reduces the overall amount of radiation used to treat the cancer. The rapid speed of delivery of the radiation beams makes the overall treatment time shorter than other standard treatment techniques. Radiation therapy treatments can be delivered using VMAT in just a few minutes. This can be more convenient and comfortable for patients who may feel discomfort or pain when lying down for long periods.

-Convenient for calculating the radiation dose appropriate for the irregular shape and size of the cancerous tumors.

-Makes it easier to adjust the speed of rotation of the radiation device, the amount of radiation to be delivered, the distribution of radiation and the movement of the radiation shielding, allowing the radiation to target and cover only the cancerous tumors while minimizing the exposure of the surrounding organs to the radiation. This will reduce the side effects of radiation therapy and thus enable the patient to tolerate the treatment better than before. -Allows doctors to determine the position of the tumors in the patient’s body to match the area where radiation will be focused as the radiation treatment table used for the VMAT technique can be moved up and down and side to side, allowing increased accuracy in treatment.

Cons

-Radiotherapy can cause side effects, including tiredness, sickness and diarrhea

How it works:

Radiation Therapy Using VMAT

During treatment with VMAT, you lie down on a radiation therapy bed in the treatment position that has been determined by your radiation therapist during radiation treatment planning. The radiation machine (also known as a linear accelerator) rotates around your body delivering focused beams of radiation to the cancer in uninterrupted arcs. As the radiation machine rotates around your body, the shape and intensity of the radiation beams continuously change to fit closely to the shape of the cancer that is being treated. This reduces the overall amount of radiation to healthy cells while increasing the amount of radiation delivered to the cancer. Your treatment team uses 3D imaging technology which helps them to see the cancer during your treatment and deliver the radiation more precisely.

Preparation before

Radiation Therapy Using VMAT

Pre - treatment

There are 3 general steps that you will have to go through before starting your actual radiation treatment. These include: Meeting With a Radiation Oncologist If you are considering radiation therapy, you must first meet with a radiation oncologist to see if radiation therapy is right for you. During your first visit, your doctor will evaluate your need for radiation therapy and its likely results. This includes reviewing your current medical problems, past medical history, past surgical history, family history, medications, allergies and lifestyle. The doctor will also perform a physical exam to assess the extent of your disease and judge your general physical condition. You may also be seen by a medical student, a resident (radiation oncologist in training), a nurse practitioner, a physician's assistant or a nurse. After reviewing your medical tests, including CT scans, MRI scans and PET scans, and completing a thorough examination, your radiation oncologist will discuss with you the potential benefits and risks of radiation therapy and answer your questions. For a list of questions that you may want to ask, please see the section 'What Questions Should I Ask My Doctor?' on page 20. Simulation To be most effective, radiation therapy must be aimed precisely at the same target or targets each and every time treatment is given. The process of measuring your body and marking your skin to help your team direct the beams of radiation safely and exactly to their intended locations is called simulation. During simulation, your radiation oncologist and radiation therapist place you on the simulation machine in the exact position you will be in during the actual treatment. Your radiation therapist, under your doctor's supervision, then marks the area to be treated directly on your skin or on immobilization devices. Immobilization devices are molds, casts, headrests or other devices that help you remain in the same position during the entire treatment. The radiation therapist marks your skin and/or the immobilization devices either with a bright, temporary paint or a set of small, permanent tattoos. Your radiation oncologist may request that special blocks or shields be made for you. These blocks or shields are put in the external beam therapy machine before each of your treatments and are used to shape the radiation to your tumor and keep the rays from hitting normal tissue. Multileaf collimators may also be used to shape the beam and achieve safe delivery of your radiation treatment. Treatment Planning Once you have finished with the simulation, your radiation oncologist and other members of the treatment team review the information they obtained during simulation along with your previous medical tests to develop a treatment plan. Often, a special treatment planning CT scan is done to help with the simulation and treatment planning. This CT scan is in addition to your diagnostic CT scan. Frequently, sophisticated treatment-planning computer software is used to help design the best possible treatment plan. After reviewing all of this information, your doctor will write a prescription that outlines exactly how much radiation you will receive and to what parts of your body.

Recovery after

Radiation Therapy Using VMAT

Post - treatment

Post treatment from VMAT will follow the same procedure as other forms of radiation therapy. During radiation treatment the radiologist will assess the results of the treatment weekly and manage the side effects that occur. Furthermore the patient may need to undergo blood tests as well. Patients with severe side effects from the radiation may need to stop the treatment or be admitted into the hospital for observation or may need medication to alleviate the conditions, depending on the doctor’s recommendation. After radiation therapy is completed the patient must continue to follow the same procedures they did during radiation for at least two to three weeks. Two to four weeks after treatment is completed the doctor will schedule a visit to follow up on the results of the treatment. After that visits will be scheduled every one to three months, depending on the type of treatment and its process. Follow-up visits will then be even farther apart, every four to six months, for five years. If, after five years, the patient shows no signs of the disease, follow-up visits will occur once a year.

Risks & side effects

Most of the side effects of radiation occur because of the impact of radiation on surrounding organs or normal tissue close to the cancerous tumors. This depends on the location of the tumors being targeted. Therefore the patients who are going to be treated by the VMAT technique should ask their doctors about possible side effects.

FAQs:

Radiation Therapy Using VMAT

What type of cancers is VMAT used to treat?

How is VMAT different to other radiotherapy treatment procedures?

VMAT uses 3-D imaging to allow the radiation oncologist to verify the position of the tumor immediately prior to treatment, and to monitor the treatment in real-time to ensure the dose is delivered as prescribed.

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