Download - kĩ thuật xạ trị
![Page 1: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/1.jpg)
Treatment (Xạ trị)
Ian Lynch & Carol Nguyen
![Page 2: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/2.jpg)
OUTLINE
• RTT role on treatment• The treatment room • Treatment console
![Page 3: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/3.jpg)
• Checks and practices ensure SAFE, ACCURATE and EFFECTIVE treatment
• chính xác, an tòan và hiệu qủa
• Once treatment and dose is given, it cannot be reversed
• không thay đổi lại được
RTT role on treatment
![Page 4: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/4.jpg)
RTT role on treatment cont…
• Basic understanding of dosimetry recommended by IAEA
• Importance to be aware of practices & recognise possible errors
• Monitoring and side-effect
![Page 5: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/5.jpg)
The Treatment Room / Phòng điều trị
![Page 6: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/6.jpg)
RTTs working in pairs (Hai người)
• International standard to work in pairs• Positioning is easier & more efficient • Checking each other to minimise errors• I SET YOU CHECK!! • “Tôi làm , bạn kiểm tra”• Learn from mistakes
![Page 7: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/7.jpg)
Correct patient (đúng bệnh nhân)
• Full name (tên đầy đủ)• Date of birth (ngày tháng năm sinh) • Correct treatment site (chính xác điều trị)
![Page 8: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/8.jpg)
Positioning the patient (Định vị trí tư thế)
• Always take patient file with you in the room • Replicate Simulation Position (tái tạo lại vị trí)• Ensures dose (Liều lượng) delivered safely,
accurately & effectively to the correct area
![Page 9: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/9.jpg)
Straightening (Cố định thẳng)
• Palpate midline landmarks• Midline anterior tattoo• Adjust patient & align with lasers• Straight throughout entire body • Especially treatment area
![Page 10: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/10.jpg)
Levelling (bằng)
• Rotate (Cố định hai bên) patient• Match tattoos/marks with lasers• Visually check or use spirit level
![Page 11: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/11.jpg)
Reference point• Locate reference point• Measurements to anatomical landmarks
(Xác định điểm chuẩn) confirms reference point
TATTOO
![Page 12: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/12.jpg)
Iso-centre (Xác định trọng tâm)
• Move to iso-centre• Bed (giường) moved
– Lt/Rt (bên trái - bên Phai)– Sup/Inf (Mặt trên - Mặt dưới)– Ant/Post (Mặt trước - Mặt sau)
• Both RTTs check moves
![Page 13: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/13.jpg)
Check SSD (Source to skin distance)
CHECK THIS
![Page 14: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/14.jpg)
Accessories & final checksKiểm tra trước khi rời phòng• Accessories? – wedge, bolus, shielding blocks• Correct patient? (Date of Birth, Name) • Final stage before turning on radiation• Routine checks minimise errors
![Page 15: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/15.jpg)
Head and neck set up • Straighten – mid Forehead, mid Nose, SSN. • Align ATN’s (anterior Tragal notch) • Set VBL and HBL (reference marks) • Move to iso-centre• Check SSD
![Page 16: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/16.jpg)
Breast set up • Straighten – SSN and JOR• Check rotation using lateral
tattoo• Set SSD for depth• Move to iso-centre position• Check SSD, ME/PE and
overshoot at gantry angle.• Place bolus if required.
![Page 17: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/17.jpg)
Treating with Electrons
• SSD - distance from machine to patients’ skin• Skin Apposition
– Applicator flat with treatment area– Even dose
![Page 18: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/18.jpg)
Treatment Console / Phòng điều khiển
![Page 19: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/19.jpg)
Before beaming onHave Treatment file in front of you for checkingPhiếu điều trị phải đựơc kiểm tra ngay bàn điều khiển • Does it make Sense?
– Prescription (Rad/Pall) / Y lệnh– Site / disease / vùng điều trị– Correct side (Left/Right?) Trái/phải– Mu’s / Điều lựơng xạ
• Beam parameters & accessories Các chùmm thông số và thiết bị phụ
If in doubt, question. Because if you don’t, no one will!!
![Page 20: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/20.jpg)
Mistakes still can slip through………
![Page 21: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/21.jpg)
Are you happy to turn the Radiation Beam on?Bạn có thật sự hài lòng để nhấn máy?
![Page 22: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/22.jpg)
Beaming on• Monitor the patient (movement) / có di động• Monitor machine head (collision) / có va chạm• Monitor beam parameters (MLC, EDW, dose given etc.)
những thiết bị khác
If something is not rightSTOP TREATMENT!!Có điều gì không ổn,
phài ngừng ngay
Record the & verify dose (MU) when delivered.
• Writing signing and dating
![Page 23: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/23.jpg)
Remember, checking is an important part of an RTTs role
To ensure Accurate, Safe and Effective Radiation treatment delivery
![Page 24: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/24.jpg)
Patient care / Chăm sóc bệnh nhân)
• RTTs monitor & anticipate side effects (tác dụng phụ)• Advise on patient care / chỉ dẩn chăm sóc vùng điểu trị• Refer to Dr or nurse / giới thiệu tới y tá và bác sỹ
![Page 25: kĩ thuật xạ trị](https://reader033.vdocuments.net/reader033/viewer/2022051101/587411141a28abcb5b8b459f/html5/thumbnails/25.jpg)
Discussions / Questions
THANK YOU VERY MUCHCảm ơn rất nhiều