SBRT

What is SBRT?

Stereotactic Body Radiation Therapy (SBRT) is a precise treatment that delivers high-powered radiation to tumors in the liver. SBRT aims to destroy cancer cells by delivering radiation from multiple angles while minimizing the impact on surrounding healthy tissue.

Before the Procedure

Please bring the following documents and items with you:

• All medical records, including CT, PET, MRI, and X-ray reports, images, and CDs.
• Summaries of any previous treatments or therapies you've undergone.
• Recent blood test reports, if available.
• Pathology slides or blocks from any biopsies performed outside ILBS Hospital.
• Organized documents and scans in chronological order to expedite your consultation.
• Bills in a separate file, distinct from your medical reports.
• Medical insurance or panel cards, if applicable.
• A valid identification card (e.g., Aadhar Card, Passport, PAN Card) for Radiation Planning on the first day.

Before your actual SBRT treatment, you will attend a preparation session called mapping at the treatment center.

Mapping Session/ Simulation:

The initial phase of your radiation therapy involves a procedure called simulation. This is crucial to:

• Precisely map the treatment area.
• Ensure accurate radiation dosage.

During simulation, your skin will be marked, and a CT scan will be performed.

Preparing for Simulation

• Unless advised otherwise by your doctor, maintain your usual diet on the day of simulation.
• Wear comfortable clothing and avoid wearing jewelry.
• Bring all relevant medical records, including CT/PET/MRI/X-ray reports, images, CDs, and your most recent blood test results.

Upon arrival, a team of doctors and radiation technologists will explain the procedure to you.

The Simulation Process

• You'll be asked to change into a hospital gown.
• A radiation technologist will assist you in lying down on the CT simulation table.
• If you experience any discomfort, inform the doctor or technologist immediately.
• Throughout the process, you will also see red/green laser lights on the wall of the room, which the technologist will use to position you on the table.
• Although staff will enter and exit the room, someone will always be available to see and hear you.
• Once simulation begins, avoid speaking to maintain your position. You may speak if you feel uncomfortable or need assistance.

Positioning and Immobilization

Depending on the treatment area, devices such as frames, molds, or masks may be created to help you maintain the correct position during treatment. This process typically takes 30-40 minutes.

CT Imaging

While in position, CT images of the treatment area will be captured. These images will aid in planning your treatment. If required, you might receive oral or IV contrast. Inform your doctor if you're allergic to any contrast agents.

The technologist may mark your body with a felt pen and cover it with a transparent dressing (Tegaderm). Retain these dressings during your treatment. If they become loose, notify the technologist for replacement.

Treatment Planning

Between simulation and your first treatment, the radiation oncology team will use your CT scans and other medical information to plan your treatment and radiation doses.

Treatment Schedule

At the end of your simulation, you'll receive an appointment for your first treatment. Typically, treatments are scheduled five days a week (Monday to Friday) on an outpatient basis. The duration and number of treatments will depend on your specific condition and will be discussed with your Radiation Oncologist.

During Treatment

• "Check in" with the receptionist or staff upon arrival.
• Change into hospital gown as directed.
• A technologist will assist you onto the treatment table, position you, and apply any necessary molds or masks.
• Once positioned, the technologist will leave the room, close the door, and initiate your treatment.
• Remain still throughout the session.
• Although alone during treatment, the technologist can see and hear you at all times.
• Breathe gently but avoid movement. If you experience any issues, raise your hand or call out. The technologist will pause the treatment to assist you if necessary.
• You won't feel the radiation, but you may hear the machine as it operates.

Weekly Review

Your radiation oncologist will review your progress weekly. You'll be informed of your review day during your first treatment. Plan for an additional hour at the hospital on that day. Use this time to discuss any concerns with your oncologist.

Side Effects of Radiation Therapy

While effective, radiation therapy can affect healthy cells near the treatment area, leading to side effects. Common side effects include:

• Fatigue
• Skin redness or soreness
• Loss of appetite
• Nausea
• Mouth and throat problems
• Bowel problems
• Hair loss
• Lymphedema

Not everyone experiences all side effects, and their severity varies.

Managing Side Effects

• Fatigue is common; plan activities around your energy levels and seek support from family and friends.
• For skin irritation, use creams recommended by your radiation oncologist and protect your skin from sun exposure.
• Consult a dietician for a suitable eating plan.
• If you experience nausea or diarrhea, especially after abdominal or pelvic treatments, stay hydrated. Medications may be prescribed to help.
• Inform your treatment team if radiation to the face or neck causes swallowing difficulties or mouth dryness.
• Lymphedema or tissue hardening (fibrosis) may occur; seek treatment promptly if symptoms arise.
• Radiation therapy can affect fertility. If you plan to have children in the future, discuss options with your doctor before starting treatment.
• Avoid pregnancy during treatment.

If you have any questions or need further clarification, don't hesitate to ask your healthcare team.

Benefits of SBRT for Liver Cancer

• Non-Surgical Option: SBRT is ideal for patients who are not candidates for surgery due to the size or location of the tumor, or other health concerns.
• Effective for Small Tumors: SBRT works best for smaller liver tumors (typically up to 5 cm in size).
• Minimally Invasive: As a non-surgical treatment, SBRT avoids the risks and recovery time associated with traditional surgery.
• Few Treatment Sessions: SBRT typically requires fewer sessions than conventional radiation therapy, making it more convenient for patients.

Will SBRT Cure My Liver Cancer?

SBRT can be very effective in treating liver cancer, especially for smaller tumors or in patients who are not candidates for surgery. In some cases, SBRT can shrink the tumor or slow its growth. It may also be used in combination with other treatments like chemotherapy or liver transplant. However, for some patients, SBRT may not cure the cancer, but it can help manage the disease, alleviate symptoms, and improve quality of life.

Your doctor will discuss your specific situation and whether SBRT is the right option for you.

After Treatment Care:

• Follow up with your doctor regularly to monitor how well the treatment is working.
• Let your healthcare provider know if you experience new symptoms or changes in your health.
• Keep track of any side effects and share them with your care team.
• Take care of your overall health by eating well, staying active (if possible), and resting.

Follow-Up Care

Your healthcare team will schedule a follow-up scan 2-3 months after your final SBRT treatment. This scan will check how the tumor is responding to the radiation. The results will guide any further treatment decisions.

Key Takeaways:

• SBRT for liver cancer is a non-invasive, highly precise treatment that targets tumors with minimal damage to healthy liver tissue.
• It usually requires only a few treatment sessions, which can often be completed within a week.
• SBRT can be an effective treatment option for patients who are not candidates for surgery.
• Side effects are usually mild and temporary, with most patients feeling fine shortly after the procedure.
• While SBRT may not cure liver cancer in all cases, it can help shrink tumors and improve overall quality of life.

For more information or if you have concerns about your treatment, please consult with your healthcare team. They are here to provide support and guide you through each step of the process.

Disclaimer: Some portions of this content may be derived from publicly available sources on the internet.