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Radiotherapy in ENT

Radiotherapy in ENT. The main target is the DNA which, when hardly damaged, can lead to cell death and therefore tumour necrosis. . Ionise air Pass through matter which is generally opaque to light Affect photographic plates. Electromagnetic Particulate

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Radiotherapy in ENT

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  1. Radiotherapy in ENT

  2. The main target is the DNA which, when hardly damaged, can lead to cell death and therefore tumournecrosis. 

  3. Ioniseair • Pass through matter which isgenerally • opaque tolight • Affect photographicplates

  4. Electromagnetic • Particulate •  Electromagnetic wave of wavelength less than 1 angstromare • calledphotons. •  They have neither mass nor charge. Measuredinelectron volt. eg x- rays and gammarays. •  Particulate radiation have mass and arechargednegatively (electrons), positively ( protons, alpha particles) or are neutral (neutrons)  Twocategories

  5. Injury to cellularstructures • Breakdown of cellularproteins • Radiosensitivity • Lymphocytes • Granularleucocytes • Epithelialcells • Endothelial cells of blood vessels, pleura.Peritoneum • Connective tissuecells • Musclecells • Bonecells • Nervecells

  6. External beamradiotherapy Brachytherapy-moulds, interstitial implants, intracavitaryimplants

  7. Kilo voltage machines – 50 – 400kV Cobalt 60 –1.2mV Linear accelerator, netatron or microtron– 4.25mV 4. Radioactive material likecesium137, iridium 192, gold 198 and iodine125

  8.  Size oftumour  Relative depth in thebody  The anatomicalsite  Its relativeradiosensitivity  The period of itsevolution  Composition of the tissues of the tumourbed

  9.  Radiation therapy is delivered in theseries of treatment orfractions. “Conventionalfractionation”  total dose - 6500 to7200cGy  daily fractions-180-200cGy  period-7weeks  given Monday throughfriday

  10. Allows regular reoxygenation of the tumor during the course of treatment, making it more radiosensitive. • Offers radiation to effect more tumor cellsduring • the radiosensitive phase of their cellcycle. • Normal cell seems to recover more completely between fractions from sublethal damage than do tumorcells.

  11.  Method of radiation treatment inwhichsealed radioactive source is used to deliver the dose to a short distance by interstitial(direct insertion into tissue), intracavitary(placement within a cavity) or surfaceapplication(molds). (Boost for advanced tumors or primarily forsmall lesions)

  12.  Most commonly used radioisotopeinhead and neck regions are iridium 192, cesium137 and radium226.  Radiation sources may be formofneedles, narrow tubes, wires or smallbeads.

  13.  Inhomogeneity.  Requires the operator to haveadequatetechnical and conceptual skills to achieve good dose distribution.  Exposure to room personnel and totherapist specially with the use of radiumneedles.

  14. Supportive Curative Palliative Symptomatic

  15.  Decision regarding the use of radiationand/orsurgery for the control of primary lesion is a function of the location and extent of thetumor.  carcinoma of nasopharynx, base of tongue,softpalate, tonsillar fossa radiation therapy is the treatment of choice because of surgical morbidity, difficult access, and high risk of regional lymph nodeinvolvement.

  16.  Carcinoma of salivary gland andalveolarridge should be treated surgically followed by radiotherapy due to potential for bony infiltration.  Early carcinoma of glottic larynx andtongueare equally well controlled by radiation or surgery but radiation offer a better functionalresult  Hard deeply infiltrated carcinomas oftongueare less likely to be controlled by radiation. (superficial / exophytic lesions have higher cure rate with radiation than deeply infiltratedlesions)

  17. Nutrition • OralHygiene • Skincare • Eyecare

  18. THANK YOU

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