Vanderbilt-Ingram Cancer Center

Vanderbilt Center for Radiation Oncology

Radiation Therapy Program Curriculum

The following courses have been designed to give the radiation therapy student a professional curriculum that provides an excellent theoretical background for a career as a radiation therapist. The American Society of Radiologic Technologists Professional Curriculum Guide was used as a basis to develop course content.

• Didactic Curriculum
• Brachytherapy
• Clinical Radiation Oncology (CRO)
• Dosimetry and Treatment Planning
• Nursing and Patient Care for Radiation Oncology
• Oncologic Pathology
• Orientation to Radiation Therapy
• Psychosocial Aspects of Radiation Oncology
• Quality Management in Radiation Oncology
• Radiation Biology
• Radiation Safety and Protection
• Radiation Therapy Physics
• Simulation Techniques in Radiation Therapy
• Technical Radiation Oncology

Didactic Curriculum

Course	Hours
Brachytherapy	20
Clinical Radiation Oncology	74
Dosimetry and Treatment Planning	72
Nursing and Patient Care for Radiation Oncology	25
Oncologic Pathology	20
Orientation to Radiation Therapy	40
Psycho-Social Aspects of Radiation Oncology	25
Quality Management	30
Radiation Safety and Protection	13
Radiation Therapy Physics	52
Radiobiology	21
Registry Review	48
Research Paper	20
Simulation Techniques	60
Technical Radiation Oncology	24
Total	544

As a multi-disciplinary tertiary care center Vanderbilt University Medical Center makes available to employees and students a wide variety of presentations and workshops. When the topic is pertinent, arrangements will be made for the Radiation Therapy students to attend. Within the department of Radiation Oncology there may also be lectures held for residents, fellows and graduate students that the therapy students will have an opportunity to attend. Unless part of a course as outlined in the following curriculum, these presentations will be used as ancillary to the students' becoming well-rounded life-time learners and students will not be tested on the content.

Brachytherapy

Brachytherapy Course Description

This course is designed to give the radiation therapist an overview of the types of isotopes and how they are used therapeutically.

Texts:

1. The Physics of Radiation Therapy. 3rd Edition. Faiz M. Kahn, Ph.D., 2003.
2. A Practical Manual of Brachytherapy. Bernard Pierquin, Ginette Marinello, 1997.

Course Instructors:

• April Tingler, B.S., R.T., (R), (T)
• Charles Coffey, Ph.D. - Chief Physicist

Brachytherapy Course Outline

1. Basic Units and Terminology
   1. Definition
   2. History
   3. Radium
      1. decay
      2. daughter product
      3. equilibrium
      4. filtration
   4. Source Characteristics
      1. construction
      2. isotropy and anisotropy
      3. active length
      4. physical length
      5. linear intensity
      6. specific activity
   5. Curie - Becquerel
      1. Meaning
      2. Conversions
   6. Half-life
      1. Explanation
      2. List for common isotopes
      3. Decay formula
      4. Sample calculations
   7. Mean-life
      1. Explanation
      2. Formula
      3. Cumulative dose formula
   8. factor
      1. definition
      2. list for common isotopes
   9. MgRaEq
      1. definition
      2. conversion to mCi
      3. sample calculation
   10. Air KERMA Rate
   11. Meisberger Coefficient
       1. explanation
       2. table
2. Implant Systems
   1. Paterson Parker
   2. Quimby
   3. Paris
3. Hand Calculations
1. Paterson Parker Method
   1. linear source
   2. planar
   3. volume
2. Dose Rate Calculations

Brachytherapy Course Objectives

The student will be able to:

1. Define the term brachytherapy.
2. Define units of brachytherapy source activity.
3. Convert between different units of activity.
4. Describe isotropy and anisotropy.
5. Explain radioactive source construction.
6. Identify active length and physical length.
7. Calculate linear and specific source activity.
8. Describe radioactive decay.
9. Define half-life and calculate activity based on an isotope's half-life.
10. Define mean life.
11. Calculate an isotope's mean-life given the half-life.
12. Define the term decay constant and identify the decay constant for radium.
13. Convert between milligrams of radium equivalent and milli-Curies of activity.
14. Explain air KERMA and Meisberger coefficient.
15. Identify the following implant systems; Paterson Parker, Quimby, and Paris.
16. Perform hand calculations for simple volume and planar implants based on the Paterson Parker calculation system.
17. Determine duration of an implant based on a specified dose-rate.

Clinical Radiation Oncology (CRO)

CRO Course Description

This course gives a comprehensive study of malignant diseases, metastases, and their management through a multidisciplinary approach. Rationale for treatment techniques such as beam type, dose fractionation, volume, simulation, beam modification devices, field arrangements, dose limiting critical structures as well as surgical and chemotherapeutic considerations are discussed. Anatomy pertaining to the related sites is reviewed.

The etiologic and epidemiological factors, related lymphatics, methods of detection, histopathology, staging, grading, treatment principles, prognosis and follow-up are all addressed for each site covered.

Texts:

1. American Cancer Society Textbook of Clinical Technology. Lenhard,Osteen, Gansler, 2001.
2. Principles and Practice of Radiation Therapy, Second Edition. Washington, Leaver, 2004.

Course Instructor:

• Michele L. Potter, A.S., R.T., (R), (T)

CRO Course Outline

1. Introduction to the multidisciplinary approach to cancer management
   1. Review of Oncologic Pathology
   2. Surgical Oncology
   3. Medical Oncology
   4. Immunotherapy
2. Principles of Radiation Therapy
   1. Rationale
   2. Time Dose Schedules
   3. Radiobiological Principles
3. Skin and Melanoma
   1. Squamous Cell Carcinoma
   2. Basal Cell Carcinoma
   3. Malignant Melanoma
4. Central Nervous System
5. Respiratory System
6. Alimentary Tract and Digestive Organs
1. Stomach
2. Small Intestine
3. Colon & Rectum
4. Pancreas
5. Gall Bladder & Bile Ducts
6. Liver
7. Esophagus
7. Lymphoma
1. Hodgkin's Disease
2. Non-Hodgkin's Lymphoma
8. VIII. Leukemia
1. ALL
2. AML
3. CLL
4. CML
9. Endocrine
1. Thyroid
2. Pituitary
3. Adrenal
10. Soft Tissue Sarcoma
1. Fibrosarcoma
2. Liposarcoma
3. Rhabdomyosarcoma
4. Leiomyosarcoma
5. Synovial Sarcoma
11. Breast
12. Head & Neck
1. Dental Oncology
2. Larynx
3. Nasopharynx
4. Paranasal Sinus
5. Oropharynx
6. Salivary Glands
7. Oral Cavity
   1. tongue
   2. floor of mouth
   3. buccal mucosa
   4. gingival
   5. hard palate
   6. lip
8. Hypopharynx
13. Eye
14. Gynecological Tumors
1. Cervix
2. Endometrium
3. Ovary
4. Vagina
5. Vulva
15. Genitourinary
1. Prostate
2. Bladder
3. Kidney
4. Testes
5. Male Genitalia
16. Pediatric Solid Tumors
1. Rhabdomyosarcoma
2. Wilm's Tumor
3. Neuroblastoma
4. Osteogenic Sarcoma
5. Retinoblastoma
6. Ewing's Sarcoma
17. Oncologic Emergencies
18. Bone
1. Osteogenic Sarcoma
2. Chondrosarcoma
   Giant Cell Tumors
   Myeloma

CRO Course Objectives

The student will:

1. Relate the use and importance of diagnostic modalities in radiation oncology.
2. Describe immobilizaion techniques used for radiation therapy.
3. Demonstrate knowledge of anatomic nomenclature.
4. Identify the components and function of the lymphatic system.
5. Identify surface anatomy and bony landmarks for typical treatment ports.
6. Discuss the principles of medical, surgical and radiation oncology as used in the multidisciplinary approach to cancer management.
7. Demonstrate knowledge of epidemiology, etiology, and presenting symptoms.
8. Demonstrate knowledge of diagnostic methods used in tumor identification.
9. Identify the typical histology, staging and grading.
10. Describe the expected spread of the tumor, including local invasion patterns, lymphatic routes, and hematogenic routes.
11. Explain the treatment of choice.
12. Describe the radiation technique typically used.
13. List tumorcidal dose, tissue tolerance and possible complications of radiation therapy.
14. Give statistics for cure.
15. Identify psychological aspects involved with the disease and treatment modalities used.
16. Discuss the consequences of treatment misadministration.

Dosimetry and Treatment Planning

Dosimetry Course Description

This course is designed to give student a theoretical and practical understanding of the calculation methods utilized for radiation dose delivery.

Texts:

1. Radiation Therapy Planning, Second Edition. Gunilla Bentel, 1996.

Reference:

1. The Physics of Radiation Therapy, Third Edition. Faiz Kahn, 2003.

Instructors:

• April Tingler, B.S., R.T., (R), (T)
• Charles Coffey, Ph.D. - Chief Physicist

Dosimetry Course Outline

1. The role of the medical dosimetrist
2. Dose calculation for external beams
   1. Percent Depth Dose
   2. Tissue-Air Ratio
   3. Tissue-Phantom Ratio
   4. Dose Calculation
   5. Isodose Curves
   6. Irregular Field Dose Calculation
   7. Off-Axis Dose Calculation
   8. Tissue Inhomogeneities
3. Principles of External Beam Treatment Planning
1. Isodose Charts
2. Beam Modifiers
3. Isodose Distributions
4. Field Arrangements
5. Single Field
6. Parallel Opposed Fields
7. Multiple Fields
8. Wedged Fields
9. Moving Field Techniques\
10. Weighting
11. Wedges and Weighting
12. Moving Strip Technique
13. Adjacent Fields
14. Electrons
    1. Inhomogeneities
    2. Field Shaping
4. Practical Treatment Planning
1. Pelvis
   1. gynecological
   2. prostate
   3. bladder
   4. colorectal
2. Abdomen
   1. pancreas
   2. bile duct
3. Thorax
   1. lung
   2. mediastinum
   3. broncho-pulmonary
   4. esophagus
   5. trachea
   6. chest wall
   7. breast
4. Head and Neck
   1. nasopharynx
   2. parotid
   3. maxillary antrum
   4. orbit
   5. vocal cord
5. CNS
   1. brain
   2. spinal axis
6. Endocrine
   1. pituitary
   2. thyroid
7. Extremities
8. Lymphoma
   1. Waldeyer's Ring
   2. Mantle
   3. Total Lymphoid Irradiation
9. Total Body Irradiation
10. Total Skin Electron Therapy

Dosimetry Course Objectives

The student will:

1. State the factors affecting absorbed dose.
2. Define depth does, tissue air ratio and scatter air ratio concepts.
3. List and discuss factors affecting percent depth dose, tissue air ratio, tissue maximum ratio, and scatter air ratio.
4. Define backscatter factor.
5. Given specific information, calculate a backscatter factor.
6. State the relationship between TAR, TMR, PDD, PSF and BSF.
7. Define SSD and SAD.
8. Compare and contrast SSD and SAD techniques.
9. State the formula for equating rectangular and square fields.
10. Given rectangular fields, calculate an equivalent square field size.
11. Given irregular shaped fields, equate them to square fields using geometric approximation (effective field size).
12. Discuss the relationship of SSD/SAD and percentage depth dose.
13. State the use of Mayneord's F factor.
14. Given specific information, determine Mayneord's F factor.
15. State the effect of Mayneord's F factor on PDD.
16. Perform calculations using percentage depth dose, backscatter factor and tissue air ratio.
17. Define collimator scatter correction, phantom scatter correction, tissue phantom ratio and tissue maximum ratio concepts.
18. State the relationship between TMR and TAR.
19. List and discuss factors affecting output, phantom scatter factor, and tissue phantom ratio and tissue maximum ratio.
20. List the depth of maximum dose for Cobalt-60, 4MV, 6MV, 10MV and 18 MV photons.
21. Given treatment prescriptions, perform PDD, TAR and TMR calculations for treatment time or monitor units, entrance dose and exit dose.
22. Given specific treatment information, calculate an off-axis does, dose outside the field and dose under a block.
23. List the factors affecting geometric penumbra.
24. Compare and contrast the penumbra of a cobalt 60 unit and a linear accelerator.
25. Define physical penumbra.
26. State the effect of penumbra on dose rate.
27. Given points on isodose charts, state the dose.
28. List and describe influencing factors for an isodose chart.
29. Compare and contrast the use of isodose charts for x-rays and gamma radiation with particle beam radiation.
30. Given isodose charts, identify type of beam, beam energy, field size, penumbra, source size, SSD, SAD, SDD, normalization point, Dmax and central axis.
31. Given patient contours, perform the correction technique used to compensate for oblique incidence.
32. Discuss the purpose of wedge filters.
33. Discuss the construction and beam placement of wedge filters.
34. Define wedge angle and hinge angle.
35. State the importance of a wedge transmission factor.
36. Discuss the effect of oblique incidence on the wedge angle.

Nursing and Patient Care for Radiation Oncology

Nursing Course Description

This course will provide the Radiation Therapy student with basic concepts of patient care for oncologic patients, particularly those undergoing radiation therapy. This course is designed to provide an overview of clinical management of cancers and oncologic complications. Focus will be on the role of the radiation therapist in overall disease management.

Text:

1. Principles and Practice of Radiation Therapy. Washington and Leaver, 2004.

References:

1. Nursing Care in Radiation Oncology. Dos et al., 1997.
2. Law & Ethics for Clinicians. Hall, 2002. (3) Cancer Manual. American Cancer Society, 1996.

Instructors:

• Michele L. Potter, A.S., R.T., (R), (T)

Nursing Course Outline

1. Review of Medical Terminology
2. Methods of Patient Care
   1. Multidisciplinary approach
   2. Psychological considerations
   3. Patient Education
   4. Nutrition and the cancer patient
3. Review of Patient Care
1. Moving and positioning patients
2. Infection Control
3. Asepsis
4. Vital Signs
5. Medication
6. Positioning and monitoring of accessory medical equipment
7. Medical Emergencies
8. Blood Count Values
9. Principles of Medical Oncology
10. Patient Care for patients with Head & Neck Cancers
11. Patient Care for patients with Thoracic Cancers
12. Patient Care for patients with Gastrointestinal Cancers
13. Patient Care for patients with Breast Cancers
14. Patient Care for patients with Gastrointestinal Cancers
15. Patient Care for patients with Genitourinary Cancers
16. P. Patient Care for patients with Central Nervous System Tumors
4. Cancer Treatment - The Decision Process
1. Terminology
2. Choosing Appropriate Treatment
5. Cancer Management
1. Surgery
2. Chemotherapy
3. Radiation Therapy
4. Other Treatment Options
6. Medical Care - Legal Issues
1. Professional Liability
2. Medical Records
3. Financial Records
4. HIPPA
5. Consent
7. Medical Ethics
1. Ethics and Morality
2. B. Ethical Practice / Behavior
3. Hospital and Department Policies

Nursing Course Objectives

The student will be able to:

1. List four common means by which microorganisms are spread in a radiation oncology department
2. Define the terminology related to medical asepsis
3. List and describe three types of microorganisms
4. Describe six methods of controlling the spread of microorganisms by means of medical asepsis
5. Give an explanation of what a radiation therapist should do to protect the patient's belongings while in the radiation oncology department
6. Explain the purposes of the hospital chart and the radiation therapist's responsibilities with respect to the chart
7. List the purposes of a consent form and the radiation therapist's responsibility when a consent form is required before a course of treatment
8. Explain the proper method of dressing or undressing a disabled patient
9. Explain the proper manner of assisting a patient with a bedpan or urinal
10. List four signs of possible circulatory impairment
11. Demonstrate how to correctly read a thermometer
12. Accurately monitor pulse rate
13. Accurately monitor respiration
14. Accurately monitor blood pressure
15. Identify various types of oxygen administration equipment and identify precautions
16. List observable signs of shock
17. List two symptoms of respiratory failure and describe the appropriate action
18. List two symptoms of cardiac failure and describe the appropriate action
19. List the symptoms and correction of mechanical airway obstruction
20. List the emergency action that a therapist should take if a patient loses consciousness or has a seizure
21. Explain the care needed for a patient who has continuous suction
22. Explain the preparation necessary when working with a patient who has a tracheostomy tube in place
23. List the precautions needed when working with a patient with a chest tube
24. Explain the proper method of transporting a patient with a Foley catheter in place
25. Explain the important considerations in caring for a patient with an indwelling catheter
26. Explain the procedure for inserting a catheter into the urinary bladder
27. Define surgical asepsis\
28. Describe methods for sterilization
29. List the rules of surgical asepsis
30. Differentiate between disinfection and sterilization
31. Discuss maintenance of a sterile field and personnel preparation
32. Explain the principles of wound care
33. Define basic prescription abbreviations commonly used
34. List the most common routes of medication administration and precautions associated with each
35. Describe symptoms that may develop in a patient experiencing a drug reaction
36. Define the terminology that describes drug actions
37. List and define the classifications of isolation
38. Discuss and explain the utilization of isolation techniques
39. Describe sources and modes of infection transmission
40. Describe the types of chemotherapeutic drug classification and the action of each
41. Provide examples of each classification of chemotherapeutic drug types
42. Discuss administration of chemotherapeutic agents
43. List side effects of chemotherapeutic agents and precautions required in their administration

Oncologic Pathology

Course Description

This course introduces the student to the concept of disease mechanism of development and the body's response. The focus is on neoplasia, causes, signs and symptoms and patterns of spread.

Text:

• Handouts

References:

1. Pathophysiology. Price and Wilson.
2. TNM Atlas, 1982.

Instructor:

• Michele L. Potter, A.S., R.T., (R), (T)

Course Outline

1. Introduction
   1. Definition of terms
      1. Pathology
      2. Homeostasis
      3. Disease
   2. Etiology
      1. Chemical
      2. Physical
      3. Biological
      4. Inherent factors
      5. Occupational
2. Cellular Response to Injury
1. Sequential Stages of Cell Damage
2. Adaptive Changes
3. Sublethal Damage
3. Necrosis
1. Coagulative
2. Liquefactive
3. Caseous
4. Fat
5. Somatic Death
4. Inflammation
1. Cardinal signs & symptoms
   1. pain
   2. erythema
   3. edema
   4. heat
   5. loss of function
2. Acute
3. Chronic
4. Local
5. Systemic
5. Circulatory System
1. Normal Functioning
2. Abnormal Functioning
   1. edema
   2. hemorrhage
   3. thrombus
   4. embolus
   5. ischemia
   6. Syndromes
      1. superior vena cava syndrome
      2. inferior vena cava syndrome
6. The Immune System
1. Anamnestic response
2. Anergy
3. Active Immunity
4. Passive Immunity
5. Cell Populations
6. Hypersensitivity
   1. anaphylaxis
   2. cytotoxic
   3. complex-mediated hypersensitivity
   4. cell-mediated hypersensitivity
7. Disturbances of Growth, Cellular Proliferation and Differentiation
1. Smaller than normal
   1. aplasia
   2. agenesis
   3. hypoplasia
   4. atrophy
2. Larger than Normal
   1. hypertrophy
   2. hyperplasia
3. Differentiation
   1. dysplasia
   2. metaplasia
   3. anaplasia
8. Neoplasia
1. Characteristics of Benign Neoplasms
2. Characteristics of Malignant Neoplasms
3. Carcinogenesis
   1. Initiation
   2. Promotion
4. Benign Tumors
5. Malignant Tumors
   1. Carcinoma
   2. Sarcoma
   3. Hodgkin's Disease and Lymphoma
   4. Malignant melanoma
   5. Glioma
9. Diagnosis
1. Biopsy
2. Exfoliative Cytology
3. Fine Needle Aspiration
4. Chemical
10. Classification
1. Tumor
2. Node
3. Metastasis
4. Duke's Classification of Colorectal Cancer
5. Carcinoma of the Cervix
6. Hodgkin's Disease
7. Larynx
8. Malignant Melanoma
11. Complications of Radiation Therapy
1. Skin
2. Alopecia
3. Oral Cavity
4. Brain
5. Nausea and Vomiting
6. Cystitis
7. Diarrhea
8. Pain
9. Hematological\
10. Opportunistic Infections

Oncologic Pathology Objectives

The student will be able to:

1. Define pathology, disease and homeostasis
2. Define and list the types of disease etiologies.
3. Describe the cell's response to injury, including the sequential stages of cell damage.
4. Define and list types of sublethal cell injuries.
5. Identify changes in the cell as adaptive or maladaptive.
6. List and describe the four types of necrosis
7. Identify and briefly describe the changes associated with somatic death.
8. List and describe the five cardinal signs and symptoms of inflammation.
9. Identify inflammatory changes as acute or chronic.
10. List the cells or substances in the body associated with inflammation and how they work.
11. Identify signs and symptoms associated with systemic response to injury.
12. Demonstrate knowledge of the complex relationship between radiation therapy and inflammation.
13. Describe the wound healing / repair process.
14. Describe the normal functioning of the circulatory system.
15. Demonstrate knowledge of the disturbances in the circulatory system and the resultant changes, including: edema, hemorrhage, thrombus, embolus and ischemia.
16. Demonstrate an understanding of the basic functioning of the immune system.
17. Identify different types of immune responses.
18. List and describe the four types of hypersensitivity reaction.
19. Discuss neoplasia including causative and identifying factors.
20. Describe the process of carcinogenesis.
21. Be able to identify cellular characteristics as benign or malignant.
22. Given the name of a tumor type, be able to identify the tissue of origin and if the tumor is benign or malignant.
23. List and describe the four types of diagnostic procedures used for tumor cell cytology.
24. Given specific information about cancer staging and grading, tell the extent of the disease in general terms and specifically for carcinoma of the cervix, Hodgkin's Disease, laryngeal cancer and malignant melanoma.
25. Demonstrate knowledge of the potential complication of radiation therapy to the following area: skin, oral cavity, brain, abdomen, genito-urinary system, intestinal tract and hematopoietic system.

Orientation to Radiation Therapy

Orientation Course Description

This course will provide the student with an overview of radiation oncology and its role in the management of cancer and associated diseases. The student will be oriented to academic and administrative structure, key departmental personnel, and to the profession as a whole. Safety procedures, universal precautions, and patient therapy concerns will be discussed.

Texts:

1. Handouts

Instructor(s):

• Michele Potter, A.S. RT(R)(T)
• Dennis Hallahan, M.D.
• Jack Nyiri, MBA
• April D. Tingler, B.S., RT(R)(T)

This course will also involve group discussion of professional topics as related to radiation therapy, including departmental administration, educational administration, and professionalism.

This course will prepare the radiation therapy student to deal with selected professional matters more effectively, based on an improved understanding of various legal responsibilities, available patient services, and professional practices and conduct. The student is encouraged to analyze situations from the perspective of a clinical supervisor or educator as well as a staff therapist. The course is intended to help the student develop into a well-rounded therapist.

Orientation Course Outline

1. Introduction
   1. Review Student Handbook
   2. VUMC Orientation
      1. mission
      2. credo
      3. vision
      4. service and performance
      5. Tour of campus
   3. Safety
      1. Infection Control
      2. Fire
      3. OSHA
2. The Role of Allied Health Professionals
   1. Legal considerations
   2. Professionalism
   3. Professional Code of Ethics
   6. Orientation to the Vanderbilt Center for Radiation Oncology
      1. Introduction to departmental personnel
      2. Introduction to radiation oncology
      3. Overview of the patient chart, informed consent and radiation therapy treatment record
      4. Performance evaluation
   7. Introduction to the Health Care System
   1. Components of the system
   2. Definition of terms
   3. Structure of hospitals
   4. Allied health
   8. Education Administration
   1. Establishing a program
   2. Program design and resources
   3. Accreditation
   4. Instructional technology
   5. Certification, credentialing and accreditation
   6. Overview of ARRT exam content specifications
   7. Professional organizations
   9. Computer Theory and Application
   1. Introduction
   2. History
   3. Computer application
   4. Hardware
   5. Programming and operations
   6. Interfacing fundamentals
   7. Telecommunications
   8. Record and Verify Systems
   10. Clinical Orientation
   1. Morning quality assurance check
   2. Emergency off procedures
   3. Location of fire safety equipment
   4. Treatment machine console
   5. Treatment unit
      1. hand controls
      2. couch movement
      3. laser/patient alignment

Orientation Objectives

The student will be able to:

1. State the rules and regulations of the educational program as outline in the student handbook; attendance, grading, vacation/sick leave, appeal procedure, etc…
2. Discuss hospital and departmental rules and regulations that directly or indirectly affect students
3. List the major duties and responsibilities of the radiation therapy student
4. Identify basic radiation safety procedures for staff and patients
5. Identify other associated health science professions and describe their relationships to the care of the radiation therapy patient
6. Discuss the philosophy and role of the hospital
7. Identify hospital administrative personnel and discuss their interactions with the radiation oncology department
8. Locate major departments and offices in the cancer center
9. Identify and discuss departmental personnel and their responsibilities
10. Outline department chain of command
11. Describe the role of radiation therapy in cancer management
12. List radiation therapy treatment techniques
13. Identify the purposes of credentialing and accreditation
14. Identify the national credentialing agency for radiation therapists
15. List the prerequisites for credentialing in radiation therapy
16. Define the purposes and activities of professional organizations
17. Identify the professional organizations that have direct input into radiation oncology activities
18. Identify national/regional/state/local professional organizations for radiation therapists
19. Identify avenues for career advancement
20. Identify ARRT examination content specifications
21. Identify major components of the radiation therapy treatment record
22. Identify the legal considerations concerning informed consent
23. List morning quality assurance procedures and describe the purpose of each
24. Identify universal precautions and define their purposes
25. Discuss fire safety precautions in the radiation oncology department
26. Discuss social issues involving the radiation therapy patient
27. Properly describe the process of CPR and perform the necessary skills using manikins
28. Describe how a computer works and their capabilities
29. Discuss the history and recent development in computer technology
30. Discuss the role of computers in medical imaging and radiation oncology
31. Discuss the administrative application of computers in patient billing, medical records, and scheduling
32. List and describe the components of the computer
33. List the components of a good patient education program
34. Define informed consent
35. List the process and consideration in the establishment of an educational program in radiation therapy
36. List and define the components of the health care system and its operation
37. Describe the structure of a radiation therapy department’s organization
38. List the personnel and characteristics of radiation therapy departments
39. Describe the importance of continuing education
40. Describe the components of an employee evaluation
41. Define professionalism
42. List the characteristics of a professional
43. Describe the transition from student to radiation therapist

Psychosocial Aspects of Radiation Oncology

Psychosocial Aspects Course Description

This course will involve group discussion of professional topics as related to radiation therapy including thanatology, patient-professional communication, patient education, ethical issues in cancer care, stress and disease, and professionalism.

The purpose of this course is to prepare the radiation therapy student to deal with selected professional matters more effectively, based on an improved understanding of various legal responsibilities, available patient services, and professional practices and conduct. The student is encouraged to analyze situations from the perspective of a clinical supervisor or educator as well as a staff therapist.

Text:

1. Handouts.

References:

1. Cancer Manual. American Cancer Society, 1996

Instructor:

• Michele L. Potter, R.T., (R), (T)
• Guest Speakers

Psychosocial Aspects Course Outline

1. Introduction
   1. Personal attitudes about life and health
   2. Work values
2. Overview of Health Professional - Patient Communication
1. Relationship between the health professional and the patient
   1. Models of the professional to patient relationship
   2. Assumptions made by and about patients that affect the relationship
   3. Patient dissatisfaction with the professional relationship
2. Communication Problems
3. Therapeutic Communication
   1. Listening
   2. Understanding
   3. Responding
   4. Communication blocks
4. Understanding Anger
5. Patient's Bill of Rights
3. Verbal and Nonverbal Communication
1. Behavior cues
2. Social rule and patterns of communication
3. Body movements/posture and attitudes
4. Vocal cues
5. Space and privacy
6. Cultural patterns
4. Body Image and Emotions in Illness and Treatment
1. Concept of body image
2. Development of body image
3. Alterations in body image
4. Adaptation to changes in body image
5. Life stress and disease
6. Emotional reactions directly related to illness or treatment
7. Loss of self-esteem and depression
8. Family-friend relationships
9. Effects of positive emotions
5. Hospice Concept
1. Historical development
2. American adaptation
3. Concept as a program
4. Distinguishing characteristics
5. Role of team professionals
6. Financial considerations
6. Thanatology and Bereavement
1. Definitions
2. Concepts of death and dying
   1. Social and personal attitudes
   2. Stages
   3. Hopes
   4. Family and friends
3. Description of life threatening experiences
4. Psychosocial management of the dying patient
5. Grief responses - normal and abnormal
6. Funerals - purpose, process, financial considerations
7. Aging and Pain
1. Process of aging
2. Sensory changes
3. Mental awareness
4. Special needs of the elderly
5. Alternatives to institutional care
6. Types of pain
7. Responses to pain
8. Medications
9. Alternatives to medications
10. Role of the health professional
8. Patient Education
1. Purpose
2. Legal responsibilities of the Radiation Therapist
3. Organization of patient education in the hospital structure
4. Format and timing
5. Determination of specific patient education programs
9. Legal and Ethical Issues in Cancer Care
1. Informed consent
2. Right to refuse treatment
3. Constitutional right of privacy
4. Life/death decisions - medical, legal, and financial considerations
5. Research considerations
10. Employment process
1. Initial contact, responding to advertisements
2. Resume, references
3. Interview
   1. Preparation
   2. Actual interview
4. Salary/Benefit packages
5. Follow-up negotiations
11. Professionalism
1. Definition of terms
2. Characteristics of a professional
3. Role of a professional
4. Change in role from student to therapist

Psychosocial Aspects Course Objectives

The student will be able to:

1. Verbalize about personal attitudes about life, health and the cancer patient
2. Define work values and their relevance to the radiation therapist
3. Discuss the communication process between a health care provider and a patient
4. Discuss attitudes of health professionals and patients and the effect on patient care
5. List types of communication
6. Identify items in the Patient's Bill of Rights
7. Define and list types of non-verbal communication and how they are positively and negatively employed in the treatment of cancer patients
8. Define verbal communication and associated problems
9. Discuss the impact of stress and diagnosis on disease perception
10. Describe the impact of body image changes on the therapy patient
11. Describe common emotions seen in patients undergoing radiation therapy and the health providers working with these patients
12. Describe the process of aging and its impact on health care management
13. Define pain and discuss pain management in the cancer patient
14. Describe the stages of death and dying and their impact on the patient, family and health care providers.
15. Describe care management considerations specific to the dying patient
16. Describe the hospice concept
17. Describe the need for the bereavement process
18. Discuss the importance of patient education
19. Describe the legal considerations for patient education as they pertain to the radiation therapist
20. List the components that lead to job satisfaction
21. Describe the importance of continuing education
22. List the components of a good patient education program
23. Define informed consent
24. Prepare a resume
25. Describe the job seeking process
26. Describe the importance of follow-up correspondence when seeking employment
27. Define professionalism
28. List the characteristics of a professional
29. Describe the transition from student to radiation therapist

Quality Management in Radiation Oncology

Quality Management Course Description

This course provides the student with an insight into the principles of quality assurance procedures and standards from a practical viewpoint.

Text:

1. The Physics of Radiation Oncology, Third Edition. Faiz Kahn, 2003.

References:

1. Comprehensive Quality Assurance for Radiation Oncology: Report of AAPM Radiation Therapy Task Group 40. 1993.

Instructors:

• Ben Welch, III, BA, RT(R)(T)

Quality Management Course Outline

1. Introduction - Evolution of Quality Improvement
   1. Radiation Measurement
      1. Photon beam parameters
      2. Electron beam parameters
      3. Dose Calculations
   2. Hospital Peer Review and Accreditation
   3. Definitions
2. Components of Quality Assurance/Improvement
   1. Development of Quality Improvement Plan
      1. consultation and informed consent
      2. treatment planning
      3. treatment delivery
      4. documentation of treatment delivery
      5. patient outcomes
   2. Quality Improvement Team
      1. Radiation Oncologist
      2. Radiation Physicist
      3. Radiation Therapist
      4. Medical Dosimetrist
      5. Oncology Nurse
      6. Support Staff
   3. Practical Application of Quality Assurance/Improvement Process
      1. Clinical Aspects
         1. chart checks
         2. port films
      2. External Beam Equipment
      1. Daily checks
      2. Weekly checks
      3. Monthly checks
      4. Annual checks
      3. Brachytherapy Sources
      1. Source calibration
      2. Source inventories
      4. Remote Afterloading
      1. Source calibration
      2. Source inventories

Quality Management Course Objectives

The student will be able to:

1. Define quality assurance and quality improvement
2. Identify the components of a quality improvement plan
3. Outline the accreditation process for healthcare organizations
4. Identify the scope and role of the members of a quality improvement team
5. List the components of a radiation therapy treatment plan
6. Identify items in the Patient's Bill of Rights
7. Identify components of a patient communication system
8. Identify sources of patient communication system malfunction
9. State the function of treatment unit panel instrumentation and indicator lights
10. Describe the impact of body image changes on the therapy patient
11. Demonstrate knowledge of quality assurance tests for treatment unit panel instrumentation
12. Describe and identify examples of the following safety devices: over-ride switches, emergency off switches, limit switches, and collision rings.
13. Identify the location of the energy off switches for each treatment unit in the department
14. List the potential sources of malfunction in the optical distance readout
15. Identify three sources of misalignment of the light field and radiation beam and five examples
16. Describe the physical and potential clinical effects of light field, collimator rotation and radiation field misalignment
17. List four factors that may affect dose rate of a supervoltage or megavoltage treatment unit
18. Explain the difference between dose as specified per unit of time and per monitor unit
19. Identify the depth for 50% depth dose for the machines in the department for a standard field size and distance
20. Define field symmetry and flatness
21. Define reasons for and methodology of checking flatness and symmetry
22. Identify and describe the mechanical and electronic sources of malfunctions affecting field symmetry and flatness
23. List patient support assembly motions on an isocentric treatment unit
24. Describe the devices and means utilized to demonstrate vertical distance from the isocenter
25. List two sources of malfunction of the gantry rotation readout devices
26. List the most common malfunctions of automatic processor which affect image quality
27. Identify the factors that affect radiographic and fluoroscopic image quality
28. Identify sources of error in maintaining control of brachytherapy sources and establish a mechanism for insuring inventory control
29. Describe spot checks for isocentric rotation

Radiation Biology

Radiation Biology Course Description

This course will cover the fundamentals of the biological effects of ionizing radiation n living tissue, including specific cell and tissue radiosensitivity, radiation syndromes and related effects, as well as basic biological mechanisms that bring about somatic and genetic effects. Research applications and clinical radiation biology will be highlighted.

Text:

1. Primer of Medical Radiobiology. Elizabeth Travis, 1976.

References:

1. Radiobiology for the Radiologist. Eric Hall, 1994.

Instructor:

• April Tingler, B.S., R.T., (R), (T)

Radiation Biology Course Outline

1. The interaction of radiation with matter
   1. Historical Perspective
   2. Types of Radiation (p. 3-6 Hall)
      1. Electromagnetic
      2. Particulate
      3. Excitation vs. Ionization
   3. Absorption of X-rays (p. 7-15 Hall)
      1. Compton - Photoelectric
      2. direct - indirect
   4. Absorption of Neutrons (Hall p. 7)
   5. Comparisons of different radiations
      1. LET (Travis p. 31)
      2. RBE
   6. Radiation effects on DNA
   7. Radiation effects on other cell components
2. Cell Survival Curves (p.22 Hall: Travis p. 53-59)
1. Cell kill
2. Chromosomes and Cell division
3. Dose-Response Relationship
1. Radiosensitivity -- Law of Bergoni? and Tribondeau
   1. Cell cycle
   2. Cell type
      1. Parenchymal
      2. Stromal
   3. Volume of irradiated tissue
2. Clonogenic Assays
3. OER (p. 138- Hall
   1. Tumor reoxygenation
   2. Normal Tissue tolerance
4. Dose-Rate Effect
1. Classification (p. 107-- Hall)
   1. Lethal Damage
   2. Sublethal Damage
   3. Potentially lethal Damage
2. The Four R's of Radiotherapy (p. 230 Travis)
   1. Repair
   2. Regeneration
   3. Redistribution
   4. Reoxygenation
3. Inverse Dose-Rate Effect (p. 120 Hall)
4. Very Low Dose Rates - Continuous Exposures (p. 121-- Hall)
   1. Interstitial / Intracavitary / Permanent Implants
   2. External Beam Therapy
5. Radiosensitizers (p. 179- Hall /p. 350 Hall)
   1. Hyperthermia
   2. Chemotherapy
   3. Radionuclides
6. Radiation Pathology
   1. Acute vs. Chronic Effects
   2. Individual Systems in the Body
7. Late effects & Radiation carcinogenesis
5. Radiobiology Data Acquisition
6. Systemic Response to Radiation
1. General organ changes
2. Specific Systems
3. Embryo / Fetal effects
7. Total Body Response to Radiation
1. Definition
2. Bone Marrow
3. GI
4. CNS

Radiation Biology Course Objectives

The student will be able to:

1. Discuss the historical development of radiobiology
2. List and describe the function of each of the major organelles in the cell
3. Discuss the events related to cell growth and specialization during interphase
4. Discuss the events occurring during mitosis
5. Identify the most radiosensitive stage in the cell cycle
6. Discuss differentiation as it relates to radiosensitivity
7. Explain the purpose of the cell survival curve
8. Given a survival curve, Dq, D0, and n
9. Discuss the relationships between D0, radiosensitivity and radioresistance
10. Explain the target theory
11. Discuss the probability of indirect action as opposed to direct action
12. Discuss somatic and genetic effects of exposure of living tissue to radiation
13. List and explain general factors affecting cell recovery
14. Discuss biological effects on DNA and chromosomes
15. Discuss chemical factors influencing the effect of radiation on the cell
16. Define OER and explain its importance to radiation therapy
17. Define RBE, LET, Dose fractionation and dose rate
18. Discuss physical factors influencing radiation effects on cells
19. State the Law of Bergonie and Tribondeau and relate it to radiosensitivity
20. Define mean lethal dose (LD50)
21. Discuss the application of radiobiological principles to treatment modalities
22. List the primary causes and symptoms as well as dose ranges of bone marrow, GI and CNS syndromes
23. Describe the effects of radiation on blood cells
24. Discuss the radiosensitivity of the fetus through the trimesters of pregnancy
25. List and discuss major types of gene mutations
26. Describe the effect of dose rate on mutation frequency
27. Compare and contrast genetic and somatic effects
28. Given specific tumors, state the cancercidal dose
29. Given specific tissues, state the tolerance dose
30. Define fractionation and discuss its application to radiation therapy
31. Discuss the implications of NSD in treatment planning
32. Given treatment prescriptions, calculate NSD

Radiation Safety and Protection

Radiation Safety Course Description

Introduction to the sources of radiation; detection and measurement, shielding and room design, biological effects of radiation, source handling, surveys and personnel monitoring, maximum permissible dose, and local, state and federal regulations.

Text:

1. The Physics of Radiation Physics, 3rd Edition. Faiz Kahn, 2003.

References:

1. Atoms, Radiation, and Radiation Protection. Turner, 1995.

Instructor:

• April Tingler, B.S., R.T., (R), (T)

Radiation Safety Course Outline

1. Introduction
   1. Atoms
   2. Types of Ionizing Radiation
   3. Units and Definitions
   4. Background and Typical Exposures
2. Radiation Detectors and Survey Instruments
1. Types and Principles of Operation
2. Demonstration
3. Biological Manifestations of Radiation
4. Time, Distance and Shielding
5. Regulatory Agencies
6. Maximum Permissible Doses and Regulatory Requirements
7. Posting Requirements/Types of Areas
8. Personnel Radiation Dosimetry
9. Safety Procedures
1. External Beam
2. Brachytherapy
10. Review

Radiation Safety Course Objectives

The student will be able to:

1. List major natural and artificial radiation sources
2. Discuss relative amounts of exposure from natural and artificial radiation sources
3. Describe the protection roles of the radiation oncologist, radiation therapist, radiation safety officer and medical physicist as they pertain to patients, personnel and the public
4. Discuss inter-relationships among various units of radiation
5. Explain the theory and operation of an ion chamber
6. List and describe types of ion chambers
7. Explain the theory of operation for a proportional counter
8. Explain the theory of operation for the Geiger-Mueller detector
9. Explain the theory of operation for a thermo-luminescent dosimeter
10. Identify the radiation detection instrument of choice for various beam energies
11. List the primary considerations for radiation protection
12. Calculate exposure rates at various distances
13. List materials used for shielding
14. Discuss the relationship between half value layer and shielding
15. Define primary and secondary barriers
16. Distinguish between controlled and uncontrolled areas
17. Discuss factors influencing room design
18. Discuss physical factors influencing radiation effects on cells
19. Explain the purpose of maintaining pre and post application inventory
20. Describe the following: wipe test, leak test, and area/room survey
21. Discuss the purpose and methods of personnel monitoring
22. Given personnel monitoring reports, interpret them
23. Discuss the responsibility of the radiation therapist, department, and radiation safety officer with regard to personnel monitoring
24. List federal, state and local regulatory agencies
25. Define maximum permissible dose
26. Calculate MPD for radiation workers and the general public
27. Describe the radiation warning signs
28. Identify sites for placement of the radiation warning signs
29. Discuss the requirements for patient monitoring in the department
30. List types of emergencies that can occur and discuss procedures to be followed
31. Discuss the importance of filing radiation reports with federal, state, and local organizations

Radiation Therapy Physics

Radiation Therapy Physics Course Description:

This course provides the student with an insight into the principles of physics as they relate to radiation therapy. Included are; the structure of the atom, matter and energy, definitions of the nature of radiation, radioactivity and interactions with matter. The principal focus for the course is how these properties make radiation a useful tool in radiation oncology. After the foundations have been laid, particulate and electromagnetic interactions will receive more detailed attention. Also included are the methods and calculations for calibration of external beam teletherapy units, and brachytherapy sources.

Text:

1. The Physics of Radiation Physics, 3rd Edition. Faiz Kahn, 2003.

Instructors:

• April Tingler, B.S., R.T., (R), (T)
• Charles Coffey, Ph.D. - Chief Physicist

Radiation Therapy Physics Course Outline

1. Math Review
   1. Algebra
   2. Exponential Calculations
2. Matter, Force and Energy
1. The Atom
2. Ionization
3. Isotopes
4. Isotones
5. Isobars
6. Isomers
3. Radioactive Decay
1. Alpha
2. Beta
3. Gamma
4. Electron Capture
5. Internal Conversion
6. Isometric Transition
4. Therapy Machine Construction
1. Cobalt
2. Early X-Ray Generators
3. Linear Accelerators
4. Cyclotron
5. Radiation Beam Characteristics
1. Beam Geometry
   1. Similar Triangles
   2. Magnification
2. Inverse Square Law
6. X-Ray Beams
1. Production
2. Interaction
   1. Coherent Scatter
   2. Photoelectric
   3. Compton
   4. Pair Production
   5. Annihilation
7. Determining Radiation Intensity
1. Standardized Radiation Measurement Units
2. Detectors
3. Machine Calibrations
4. Patient Dose Verification
8. Properties of Therapeutic Photon Beams
1. Penumbra
2. Isocentric and SSD Techniques
9. Field Arrangements
1. Depth Doses
2. Techniques and Calculations
10. Properties of Therapeutic Electron Beams
11. Beam Modification Devices
    1. Uses
    2. Calculations of attenuation

Radiation Therapy Physics Course Objectives

The student will be able to:

1. Demonstrate knowledge of and ability to perform basic mathematical functions that apply to radiation therapy.
2. Discuss relative amounts of exposure from natural and artificial radiation sources
3. Define and describe the general principles relating to and the relationships between to mass and energy.
4. Discuss the relationship among types of energy.
5. Discuss and explain kinetic and potential energy and perform calculations involving conversion between potential and kinetic energy.
6. Define acceleration and velocity; solve related problems.
7. Identify the conditions necessary for the production of electromagnetic radiations.
8. Identify the characteristics of electromagnetic and particulate radiation.
9. Define frequency and wavelength and perform calculations involving them.
10. Identify and give the characteristics of elements, atoms and sub-atomic particles.
11. Describe atomic structure as defined by Bohr's theory. the nucleus and its contents orbital shells and their arrangement energy levels in the atom
12. Explain ionization.
13. Identify and define isotopes, isotones, isobars and isomers.
14. Define exposure and dose.
15. Discuss the measurement of radiation exposure and dose.
16. Define dose equivalence.
17. Define radioactivity and explain the specific processes involved.
18. Discuss the process of exponential decay and given the appropriate information, calculate exponential decay
19. Discuss the inverse square law and given the necessary information, perform calculations using this property.
20. Define and differentiate between the different photon interactions, and the predominant energy range for each.
21. Relate each photon interaction to its application in radiation therapy.
22. Describe the principles of particulate interactions.
23. Compare and contrast the beam energies and the dose rates for low energy and megavoltage units.
24. Discuss the protection necessary for proton, neutron and electron beams.
25. Define half-value layer and explaining its use in determining beam quality.
26. Compare and contrast Grenz, superficial and the orthovoltage units with regard to voltage, half-value layer and filtration.
27. Describe the design of various source housings for telecurie units.
28. Describe the operating principles of the betatron, van de graff and cyclotron.List and describe the components of a linear accelerator.
29. Describe photon and electron beam characteristics.
30. Contrast the depth dose data for various energies of linear accelerators.
31. Define beam energy characteristics.
32. Define Mayneord's f-factor and its relationship to tissue type and beam energy.
    

Simulation Techniques in Radiation Therapy

Simulation Course Description

This course will involve instruction, demonstration and participation in immobilization, positioning and simulation with the aid of an anthropomorphic phantom. Practical aspects of simulation will be taught in this didactic and lab practicum course.

The purpose of this course is to prepare the radiation therapy student to perform a variety of simulation procedures commonly encountered in a typical radiation therapy department. Coupled with the simulation rotations each student has, it will serve to further round the student's experience in the specialized therapy function

Text:

1. Principles and Practice of Radiation Therapy. Washington and Leaver, 2004.
2. Handouts.

Instructors:

1. April Tingler, B.S., R.T., (R), (T)
2. Michele L. Potter, A.S., R.T., (R), (T)

Simulation Course Outline

1. Introduction to Course
2. Simulation Design and Operation
   1. Historical Perspective
   2. Simulation Process and Design
   3. Room Design
3. Simulation Procedures - General Principles
   1. Nomenclature and Acronyms
   2. Simulation Procedure
   3. Treatment Verification
4. Immobilization Devices
5. Contours
6. Alimentary Tract and Digestive Glands
1. Anatomy
2. Colorectal
3. Pancreas
4. Esophagus
7. Genitourinary
1. Anatomy
2. Prostate
3. Bladder
4. Testes
8. Gynecological Tumors
1. Anatomy
2. Cervix
3. Endometrium
4. Vagina
5. Vulva
6. Ovaries
9. Hodgkin's Disease
1. Anatomy
2. Mantle
3. Para aortic
4. Inverted Y Pelvis
10. Head and Neck
1. Anatomy
2. Larynx
3. Nasopharynx
4. Oropharynx
5. Hypopharynx
6. Paranasal Sinus
7. Parotid
11. Thorax
1. Anatomy
2. AP/PA lung
3. Oblique lung
12. Breast
1. Anatomy
2. Intact
3. Mastectomy - chestwall
13. Soft Tissue Sarcoma
14. Bone
15. CNS
1. Anatomy
2. Bilateral whole brain
3. Craniospinal
4. Pituitary
   1. Wedge Pair
   2. Rotational

Simulation Course Objectives

The student will be able to:

1. List and describe various methods of tumor localization
2. Describe the principles of simulation
3. Identify the components and function of a simulator
4. State the purpose of simulator warm-up procedures
5. Describe the warm-up procedure for a simulator
6. State the location of emergency off switches
7. State patient support assembly functions and limits
8. Complete simulation data forms correctly
9. Describe various types of patient immobilization equipment
10. Describe the purpose and application of various immobilization devices
11. Demonstrate the use of the following patient positioning/immobilization devices:
    1. Vac Lock Bag
    2. Aquaplast
    3. Taping
    4. Belly board
    5. Breast slant board
    6. Wing board
    7. Angle sponges
12. State the importance of skin marks
13. Desribe the various methods of applying skin marks
14. List the advantages and disadvantages of various methods of skin marking
15. List the materials necessary to tattoo a patient
16. List and describe the various types of patient contour methods
17. Discuss the purpose of obtaining contours
18. Demonstrate ability to produce an accurate contour
19. Demonstrate knowledge of topographic anatomy pertinent to each body area discussed
20. Demonstrate knowledge of dose limiting structures pertinent to each body area discussed
21. State pertinent landmarks for setting field delineation for each body area discussed
22. Identify different types of immobilization necessary for each body area discussed
23. Demonstrate overall knowledge of simulation procedures for each body area discussed
24. Demonstrate accurate documentation of all field parameters set during each simulation procedure

Technical Radiation Oncology

Technical Radiation Oncology Course Description

The focus of the course will be on the physical parameters of patient treatment. First covered will be the structure and function of the simulator and treatment machines. The process involved in preparing for patient treatment will follow this.

Text:

1. Varian Clinical User Guide.
2. A Primer on Theory and Operation of Linear Accelerators in Radiation Therapy. U.S. Department of Health and Human Services, 1981.

Instructors:

• Michele Potter, A.S., R.T., (R), (T)
• Curtis McAvoy

Technical Radiation Oncology Course Outline

1. Clinical Radiation Generators
   1. Conventional
   2. Linear Accelerators
   3. Machine construction
   4. Cobalt-60 Units
   5. Particle Beams
2. Treatment Planning
1. Terminology
2. Dose Specifications
3. Calculations
4. Personnel
3. Principles of Radiation Oncology
1. Data Acquisition
2. Beam/Field Arrangement
4. Anatomical Sites and Field Arrangements
1. CNS/Head & Neck
2. Thorax/Mediastinum
3. Pelvis

Technical Radiation Therapy Objective

The student will be able to:

1. Evaluate the scope of cancer and its impact on society
2. Recognize and understand the etiology and epidemiology of cancer
3. Apply prevention and education measures in addressing the cancer problem
4. Assess the statistical measures used in cancer and its management; incidence, examination, detection and screening.
5. Distinguish several varieties of abnormal growths
6. Define cancer as a pathological variation of normal growth
7. Define and differentiate various methods of classifying tumors
8. Categorize tumors into benign and malignant classes
9. Describe and differentiate between tumor and histopathological grading
10. List various factors involved in carcinogenesis and cellular differentiation
11. Distinguish between the management techniques for palliative, prophylactic and curative treatment
12. Identify patterns of failure in cancer management
13. List the types of conventional radiation units and describe their designs and uses
14. Describe the construction and operation of megavoltage teletherapy equipment, both linear accelerators and radioisotope units
15. Describe the construction, design and uses for stereotactic radiosurgery treatment units
16. Describe the construction, design and uses for intraoperative treatment units
17. Describe the construction, design and uses for heavy particle beam treatment units
18. Describe the construction, design and uses for radioisotope teletherapy treatment units
19. Describe the construction, design and uses for remote after loading brachytherapy treatment units
20. List and describe the half-life properties of radioisotope units
21. List and analyze various types of beam shaping and beam directing equipment
22. Describe the construction, types and operation of the patient support assembly
23. Describe the various means of patient immobilization
24. Evaluate the role of the radiation therapist in the use of ionizing radiation equipment and prescriptions