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J Canc Educ (2013) 28:547553 DOI 10.1007/s13187-013-0501-1
Radiation Oncology: a Primer for Medical Students
Abigail T. Berman & John P. Plastaras & Neha Vapiwala
Published online: 27 June 2013# Springer Science+Business Media New York 2013
Abstract Radiation oncology requires a complex understanding of cancer biology, radiation physics, and clinical care. This paper equips the medical student to understand the fundamentals of radiation oncology, first with an introduction to cancer treatment and the use of radiation therapy. Considerations during radiation oncology consultations are discussed extensively with an emphasis on how to formulate an assessment and plan including which treatment modality to use. The treatment planning aspects of radiation oncology are then discussed with a brief introduction to how radiation works, followed by a detailed explanation of the nuances of simulation, including different imaging modalities, immobilization, and accounting for motion. The medical student is then instructed on how to participate in contouring, plan generation and evaluation, and the delivery of radiation on the machine. Lastly, potential adverse effects of radiation are discussed with a particular focus on the on-treatment patient.
Keywords Radiation oncology . Cancer treatment . Medical students
Introduction to Cancer Treatment and the Use of Radiation Therapy
Cancer, or malignant neoplasm, refers to deregulated new growth of cells that is capable of metastasis and invasion. The three main branches for the treatment of cancer are radiation oncology, medical oncology, and surgical oncology. Radiation can be used for cancer treatment by itself (e.g., prostate cancer), after surgery or adjuvantly (e.g., breast
cancer), and before surgery or neoadjuvantly (e.g., rectal cancer). Combined modality therapy, the combination of radiation and systemic therapy, is used for many malignancies to improve outcomes; chemotherapy can be given at the same time as radiation (concurrent), prior to radiation (induction), or afterwards (consolidation). These are all examples of treating the primary tumor, or the site of the tumor origin. Radiation can also be used to treat a metastatic lesion that resembles the primary tumor histologically, but is in a new, separate location. Although the goal of radiation therapy in treating the primary tumor is usually to produce a cure(i.e., curative intent), the goal when treating a metastasis is to reduce symptomatic disease burden without the intended goal of cure (palliative intent).
Radiation...