Radiotherapy

A.Y. 2020/2021
8
Max ECTS
80
Overall hours
SSD
FIS/07 ING-INF/07 MED/36 MED/50
Language
Italian
Learning objectives
The aim of this teaching is:

- explain the physical basis for the use of ionizing radiation in the field of radiation oncology
- provide knowledge on the clinical role of Radiation Oncology, referring to the treatment protocols of the main neoplastic diseases
- explain the technical characteristics of the equipment used in radiotherapy
- present the different treatment techniques used in clinical practice
- explain the treatment protocols in its various phases (simulation, planning, treatment delivery)
- present the essential aspects of dosimetry and Quality Controls in Radiotherapy.
Expected learning outcomes
At the end, students must:
- having learned the physical basis for the use of ionizing radiation in the field of radiation therapy
- know the main equipment used in radiotherapy
- know the protocols and techniques used for the treatment of the major neoplastic diseases
- know how to work with the physicist for the execution of quality controls in radiotherapy.
Course syllabus and organization

Single session

Didactic methods.
Half of the students, according to pre-established shifts, will participate from time to time in face-to-face lessons in classrooms suitably equipped for the Covid emergency, where safety conditions allow it.
Furthermore, to allow them to be used both in synchronous and asynchronous mode for students not present in the classroom, the lessons will be held simultaneously on the Microsoft Teams platform and can be followed both in synchrony on the basis of the first semester and in asynchronous mode, because they will be registered and left on the same platform available to students not present in the classroom.
Lessons may also include pre-recorded materials.
If the situation worsens, the lessons will be delivered through the Microsoft Teams platform and can be followed both in synchronous according to the scheduled time and asynchronously, because they are recorded through the same platform.

Program and reference material.
The program and reference material will not change. The teaching material (slides displayed during the lectures) will be available on the Ariel platform dedicated to teaching.

Methods for verifying learning and evaluation criteria.
The exam will take place in writing in the presence or in the event of an aggravation of the pandemic, with the moodle + seb + webconference modality to be activated in collaboration with the Center for educational innovation and multimedia technologies of the University of Milan.
Prerequisites for admission
In-depth knowledge of the contents of the "Morphological and functional Basis of Life". Knowledge of tumor biology.
Assessment methods and Criteria
The assessment of learning takes place through the final exam, which verifies the acquisition of the knowledge and skills expected for the lessons of the integrated course through a written test lasting 2 hours. The test is based on8 open-end questions, 2 questions for each module. The exam is considered passed if the student has satisfactorily answered each question and achieved a minimum score of 18 points in the written test.
The booking on the UNIMIA portal, within the dates established for each appeal, is mandatory for the examination.
Radiation therapy equipment and quality control
Course syllabus
Brief notes on the principles of radiation-matter interaction.
Introduction to radiotherapy treatment; treatment simulation: a) patient positioning; b) how to carry out a simulation; c) engineering principles of the simulation equipment: the simulator, the simulation with TC.
Plesio-roentgen therapy: a) introduction to treatment; b) principles of operation of the equipment.
Therapy range: a) introduction to treatment; b) old and new generation equipment.
Linear accelerators: a) operating principles; b) treatments.
IOERT-IORT and integrated linac systems: a) operating principles; b) treatments.
Adrotherapy: a) introduction to treatment; b) old and new generation equipment.
Quality controls: a) principles; b) manuals; c) checks.
Brachytherapy: a) definitions; b) methods; c) techniques.
Teaching methods
The course is divided into a series of lectures with slide shows in Power Point. The lectures slides are uploaded to the Ariel website.
Teaching Resources
KHAN, GIBBONS -Lippincott Williams & Wilkins, 2014 (5th ed.) - Cap 4, "The Physics of Radiation Therapy"
ORECCHIA: Principi di Radioterapia - Dispense
AMALDI: Gli acceleratori nella terapia dei tumori (http://www.analysis-online.net/wp-content/uploads/2013/03/amaldi.pdf)
Treatment plans and x-ray protection
Course syllabus
Dosimetric characteristics of photon beams.
Dosimetric quantities for treatment planning with photon beams (ESTRO formalism). Photon treatment techniques.
Modality of patient positioning in isocentric treatments.
Characteristics of electron beams. Dosimetric quantities for treatment planning with electron beams. Electron treatments.
Dosimetric evaluation of treatment plans using the dose-volume histogram (DVH).
Instruments of Quantitative Radiobiology: the quadratic-linear model, the biologically effective dose (BED), comparison of different fractionation schemes, treatment interruption management.
Teaching methods
The course is divided into a series of lectures with slide shows in Power Point. The lectures slides are uploaded to the Ariel website.
Teaching Resources
DUTREIX ET AL. - Monitor Unit Calculation for High Energy Photon Beams - ESTRO, Booklet N. 3, Leuven (Belgio)
KHAN - The Physics of Radiation Therapy - Williams&Wilkins, USA
Radiotherapy
Course syllabus
Radiotherapeutic procedures.
Multimodal imaging.
IMRT.
Tomotherapy.
Cyberknife.
IGRT.
Optoelectronic systems.
Outline of hadrotherapy.
Clinical studies:
- Pediatric Cancer
- Head-Neck Cancer
- Prostate Cancer
Teaching methods
The course is divided into a series of lectures with slide shows in Power Point. The lectures slides are uploaded to the Ariel website.
Teaching Resources
ORECCHIA, LUCIGNANI, TOSI: Elementi di radiobiologia clinica e radioprotezione - Hoepli
WALTER: Cancro e radioterapia. Guida per medici pratici e tecnici Radiologia - Piccin-Nuova Libraria, 1984 - ISBN: 8829901245, 9788829901241 - 332 pagine
MILANI: Elementi di radioterapia - Idelson-Gnocchi
X-ray protection
Course syllabus
Hints on radiotherapy equipment.
Quality controls on radiotherapy equipment.
Simulation - CT and virtual simulation.
Basic techniques.
Complex 3D conformal techniques.
Stereotactic techniques.
Complex equipment.
Teaching methods
The course is divided into a series of lectures with slide shows in Power Point. The lectures slides are uploaded to the Ariel website.
Teaching Resources
ORECCHIA, LUCIGNANI, TOSI: Elementi di radiobiologia clinica e radioprotezione - Hoepli
WALTER: Cancro e radioterapia. Guida per medici pratici e tecnici Radiologia - Piccin-Nuova Libraria, 1984 - ISBN: 8829901245, 9788829901241 - 332 pagine
MILANI: Elementi di radioterapia - Idelson-Gnocchi
Radiation therapy equipment and quality control
ING-INF/07 - ELECTRICAL AND ELECTRONIC MEASUREMENT - University credits: 1
Lessons: 10 hours
Radiotherapy
MED/36 - IMAGING AND RADIOTHERAPY - University credits: 4
Lessons: 40 hours
Treatment plans and x-ray protection
FIS/07 - APPLIED PHYSICS - University credits: 1
Lessons: 10 hours
X-ray protection
MED/50 - APPLIED MEDICAL TECHNOLOGY AND METHODOLOGY - University credits: 2
Lessons: 20 hours
Educational website(s)