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Змістduring all lesson a teacher pays attention to importance of deontological, ethics moments of radiotherapy of oncological patient
V. Plan and organization of practical lesson
L = ii-iii
5.2.2. Basic stage
6.1. Place of conducting of lesson
6.3. Materials of control of basic (initial level) preparation of students
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:
2.2. To Be Able:
ІІІ. Educate purpose:
IV. Intersubject integration.
5.1. Duration of lesson - 2 hours.
5.2. Stages of lesson (table):
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.
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 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:
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.
^ class room, department of radial therapy.
6.2. Material providing of lesson:
The Pererelic tests for determination of initial level of knowledges
1. To the contact methods of radial therapy belongs:
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:
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?
в) static and mobile.
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