Methodical Instruction of practical lesson №4 icon

Methodical Instruction of practical lesson №4

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Methodical Instruction of practical lesson № 4

Theme: Contact methods of radial therapy. Roentgenotherapy. Distant gamma-therapy. Radial therapy by the sources of high energies.

I. Actuality of theme:

Ionizing radiation – is powerful medical factor and it is needed to be able exactly into the tumour with optimum of dose. For this purpose there are various methods, sources and technical devices.

ІІ. Training purpose:

2.1. A student must know:

  • basic principles of radial therapy;

  • methods and methodicss of radial therapy;

  • of principle structure of roentgeno- and gamma-therapeutic devices

  • contact methods of radial therapy;

  • kinds and forms of radionuclids which are used for contact methods (closed and opened);

2.2. To Be Able:

  • to make the plan of rentgenotherapy for medical treatment of cancer diseases of skin and (on a depth more than 2 sm);

  • to determine the indications for contact methods of radial therapy;

  • to make the plan of radial therapy with the use of contact methods.

ІІІ. Educate purpose:
  • ^

    during all lesson a teacher pays attention to importance of deontological, ethics moments of radiotherapy of oncological patients

IV. Intersubject integration.

The name of discipline and proper department

To Know

To Be Able

Physics (department of medical and biological physics)

Structure to the atom, physics of electromagnetic waves

Physiology (department of normal and pathological physiology)

Metabolic processes in a mew, physiology of exchange of matters and crovotvorennya

To be able to determine the pathological changes in the organism coased by radiation

Topographical anatomy

Anatomy of organs, their topography

To project a location of organ on body surface

V. Plan and organization of practical lesson

5.1. Duration of lesson - 2 hours.

5.2. Stages of lesson (table):

№ p.p.

Basic stages of lesson

Educational purpose in the levels of mastering

Methods of control



Preparatory stage:

-organization of lesson;

-determination of educational purpose and motivation;

-control of initial level of knowledges, abilities and skills;

^ L = II-III

Frontal questioning, test control (sets of tests).



Basic stage:

forming of professional abilities and skills:
teaching of a new material and work in the department of radial therapy;

б) a teacher explains controlled from distance and contact methods of radial therapy, their principles, possibilities.

в) in the department of radial therapy students meet with its structure, modes of operations, devices of anti-radial defence, with the of principles of structure and work of rentgen- and gamma-therapeutic devices for the radial therapy controlled and from distance and usage of contact methods of radial therapy.


In written form to name:

  • basic methods of radial therapy;

  • sources, doses of radioactivity, quantity of sessions and duration of course, the expected results during different methods of radial therapy.

60 min.


Final stage:

- control and correction of level of professional skills and knowledges;

- general result of lesson;

- homework.


L = ІІ

Individual control of results of writing works.

Solution of tests.

Tests and standards of answers.

15 min.

5.2.1. Preparatory stage:

At the beginning of lesson a teacher acquaints students with the basic tasks of lesson, plan. For the control of initial level of knowledges of students to each of them the list of tests is offered. The analysis of basic properties of ionizing radiation is conducted.


5.2.2. Basic stage:

Forming of professional abilities and skills is conducted by exposition of different methods and methods of radial therapy, principles, possibilities and medical effect at the oncologic diseases.

Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). Radiotherapy may be used for curative or adjuvant cancer treatment. It is used as palliative treatment (where cure is not possible and the aim is for local disease control or symptomatic relief) or as therapeutic treatment (where the therapy has survival benefit but is not curative). Total body irradiation (TBI) is a radiotherapy technique used to prepare the body to receive a bone marrow transplant. Radiotherapy has a few applications in non-malignant conditions, such as the treatment of trigeminal neuralgia, severe thyroid eye disease, pterygium, prevention of keloid scar growth, and prevention of heterotopic ossification. The use of radiotherapy in non-malignant conditions is limited partly by worries about the risk of radiation-induced cancers.

Radiotherapy is commonly used for the treatment of malignant tumors (cancer), and may be used as the primary therapy. It is also common to combine radiotherapy with surgery, chemotherapy, hormone therapy or some mixture of the three. Most common cancer types can be treated with radiotherapy in some way. The precise treatment intent (curative, adjuvant, neoadjuvant, therapeutic, or palliative) will depend on the tumour type, location, and stage, as well as the general health of the patient.

Radiation therapy is commonly applied to the tumour. The radiation fields may also include the draining lymph nodes if they are clinically or radiologically involved with tumour, or if there is thought to be a risk of subclinical malignant spread. It is necessary to include a margin of normal tissue around the tumour to allow for uncertainties in daily set-up and internal tumor motion. These uncertainties can be caused by internal movement (for example, respiration and bladder filling) and movement of external skin marks relative to the tumour position.

To spare normal tissues (such as skin or organs which radiation must pass through in order to treat the tumour), shaped radiation beams are aimed from several angles of exposure to intersect at the tumour, providing a much larger absorbed dose there than in the surrounding, healthy tissue.

Radiation Therapy is in itself painless. Many low-dose palliative treatments (for example, radiotherapy to bony metastases) cause minimal or no side effects. Treatment to higher doses causes varying side effects during treatment (acute side effects), in the months or years following treatment (long-term side effects), or after re-treatment (cumulative side effects). The nature, severity, and longevity of side effects depends on the organs that receive the radiation, the treatment itself (type of radiation, dose, fractionation, concurrent chemotherapy), and the patient.

Most side effects are predictable and expected. One of the aims of modern radiotherapy is to reduce side effects to a minimum, and to help the patient to understand and to deal with those side effects which are unavoidable.

Radiation therapy as cancer treatment should be used in conjunction with anti-aging strategies such as immunotherepy for best results in prolonged life. Observations suggest these tools may convert "anecdotal" remissions or cures to a more comprehensible and more rational causal basis. A hypothesis that anomalously superior survival may correlate meaningfully with an increase in Natural killer cells (NK), and that SB and NK% determinations contribute to an objective basis for a science of clinical immunotherapy applicable to individual patients. If unusual remissions in carcinoma patients are more often found to be associated with extraordinarily high NK%, it is believed that elevated NK% will prove to be useful as prognostic indicator. Several case histories which show a correlation between a rise in natural killer cells with the use of individually tailored regimens of immunotherapy Historically, the three main divisions of radiotherapy are external beam radiotherapy (EBRT or XBRT) or teletherapy, brachytherapy or sealed source radiotherapy and unsealed source radiotherapy. The differences relate to the position of the radiation source; external is outside the body, while sealed and unsealed source radiotherapy has radioactive material delivered internally. Brachytherapy sealed sources are usually extracted later, while unsealed sources may be administered by injection or ingestion. Proton therapy is a special case of external beam radiotherapy where the particles are protons. Introperative radiotherapy[4] is a special type of radiotherapy that is delivered immediately after surgical removal of the cancer. This method has been employed in breast cancer (TARGeted Introperative radioTherapy), brain tumours and rectal cancers.


5.3. Control questions to the theme of lesson:

  1. Methods and methodics of radial therapy.

  2. Principle of structure of roentgtherapeutic and gammatherapeutic devices.

  3. Methods and methodicss of radial therapy of cancers of different localizations

  4. Intracaval radial therapy. Method of the united radial therapy at medical treatment of cancer of neck of uterus.

  5. Contact methods of radial therapy.

  6. Types of radiation and beams which are used at contact methods.

  7. Independent, united and combined contact and other methods, their efficiency.

  8. Preparation for contact methods of radiation therapy.

Final stage.

The control of solution of tasks and eventual level of knowledges is conducted by their verification and raising of questions of practical direction. Rating of mastering the material of theme is depends on theoretical knowledges, practical skills, independent work of studrnt.

In a result a teacher considers typical errors which are assumed by students at implementation of self-education work and assigns to a next lesson. A teacher sets the homework, recommends literature after the theme of the following lesson^: basic and additional.

VІ. Materials for the methodical providing of lesson.

^ 6.1. Place of conducting of lesson: class room, department of radial therapy.

6.2. Material providing of lesson:


  • types of radial therapy;

  • methods ofrradiation;

  • principles of planning of radial therapy at patients with the malignant tumours of uterus.

^ 6.3. Materials of control of basic (initial level) preparation of students


The Pererelic tests for determination of initial level of knowledges

1. To the contact methods of radial therapy belongs:

а) intracaval;

б) short distant;

в) controlled from distance.

2. To the contact methods of radial therapy belongs:

а) roentgentherapy controlled from distance;

б) shortdistant roentgentherapy;

в) controlled gamma-therapy from distance;

г) application method.

3. More frequent the contact methods of radial therapy are used:

а) independently;

б) in combination with the second radial methods;

в) at complex medical treatment;

г) at the combined method;

4. Voltage, power of current, filters for half-deep roentgentherapy:

а) 30-60 kV., 10 mA, 0,5-2,5mm Al;

б) 180-250 kV., 10 mA, 1,0 mm Al + 1,0 mm Cu;

в) 100-160 kV., 10 mA, 1,0 Al + 0,5 mm Cu;

5. What methods of radiation of patients are used for rentgenoterapii?

а) static;

б) mobile;

в) static and mobile.

VІІ. Literature

7.1. Basic:

  1. Lecture.


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