NCCN Guidelines for Patients® | Pancreatic Cancer - page 28

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NCCN Guidelines for Patients
®
Pancreatic Cancer, Version 1.2014
3
Overview of cancer treatments Radiation therapy
Radiation therapy
Radiation therapy uses high-energy rays to treat
cancer. The rays damage a cell’s instructions for
making and controlling cells. This either kills the
cancer cells or stops new cancer cells from being
made. More research is needed to know the best
practice for treating pancreatic cancer with radiation.
This section explains the methods of radiation therapy
that are currently used.
For pancreatic cancer, radiation is often given with
chemotherapy. Chemotherapy may improve how well
radiation works. This combined treatment is called
chemoradiation.
External radiation
For pancreatic cancer, radiation is often given using
a machine outside the body. This method is called
EBRT (
e
xternal
b
eam
r
adiation
t
herapy). For EBRT,
your doctors will first take pictures of the tumor with
a CT scan using contrast dye. This process is called
simulation. Your doctors will use the pictures to help
target the tumor and plan radiation treatment.
Using the CT scan pictures, your doctors will plan
the radiation dose, number and shape of radiation
beams, and number of treatment sessions. Beams
are shaped with computer software and hardware
added to the radiation machine.
During treatment, you will lie on a table in the same
position as done during simulation. Devices may be
used to keep you from moving so that the radiation
targets the tumor. Likewise, methods may be applied
to control breathing. Radiation beams are aimed at
the tumor with help from ink marks on the skin or tiny,
gold seeds placed in the tumor.
You will be alone while the technician operates the
machine from a nearby room. He or she will be able
to see, hear, and speak with you at all times. As
treatment is given, you may hear noises. A treatment
session can take about 30 to 60 minutes. The types
of EBRT used for pancreatic cancer include:
• 3D-CRT (three-
d
imensional
c
onformal
r
adiation
t
herapy) – Radiation is given in
small doses for a few weeks with beams that
match the shape of the tumor,
• IMRT (
i
ntensity-
m
odulated
r
adiation
t
herapy)
– Radiation is given in small doses for a few
weeks with beams of different strengths based
on the thickness of the tumor, and
• SABR (
s
tereotactic
ab
lative
r
adiotherapy) –
Radiation is given in high doses within a few
visits and precisely targets the tumor.
Internal radiation
The other radiation method is internal radiation
therapy, also called brachytherapy. Internal radiation
therapy involves placing a radioactive object in
or near the tumor. For pancreatic cancer, internal
radiation is given during surgery through a plastic
tube that is removed before the surgical cuts are
sewn closed.
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