| Syllabus Home |
| DIPLOMA IN RADIOTHERAPY TECHNOLOGY (TWO YEAR) (FINAL YEAR) |
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| Paper 1 | HOSPITAL PRACTICE AND CARE OF PATIENT. |
| Paper 2 | PHYSICS OF RADIOTHERAPY AND EQUIPMENT. |
| Paper 3 | PRINCIPLES OF RADIOTHERAPY, ONCOLOGY AND RADIOTHERAPY TECHNIQUE. |
| Paper 1 - HOSPITAL PRACTICE AND CARE OF PATIENT |
Suggested number of teaching hours 70 including tutorials and demonstrations
This section is intended to emphasize to the student technologist the importance of patient are. Many of the patients included are necessarily considered during teaching of other subjects but it is strongly urged that specific teaching and as much practical demonstration and instruction as possible should be given in this section.
Modern hospital treatment is based on team work. It is essential that the student should appreciate the technologists’ role. The importance of co- operation with words and other department should stressed. The student should be attached to wards and accident & emergency department for a definite training period, the length of time being suited to the individual hospital.
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| I. | HOSPITAL AND DEPARTMENTAL PROCEDURES |
| | Introduction to medical terminology Hospital staffing and organisation. Records relating to patients and departmental statistics. Professional attitude of the technologists to patients and departmental statistics. Professional attitude of the technologists to patients and other members of the staff. Ethical aspects, Medico legal aspects: accidents in the x-ray, radiotherapy or nuclear medicine department. Appointments organization. Minimising waiting time. Out – patient and follow- up clinics. Stock taking and stock keeping. |
| II. | DRUGS IN THE DEPARTMENT |
| | Storage; classification; labelling and record keeping, checking.Regulations regarding controlled and other drugs. Units of measurement. Special drugs, antidepressive, antihypertensive etc, disposables. |
| III. | COMPUTER BASICS |
| | Basics of Computer, operating systems, internet, MS Office, Hospital Information System (HIS). |
| IV. | CARE OF THE PATIENT |
| | First contact with patients in the department. Management of chair and stretcher patients and aids for this. Management of the unconscious patient. Elementary hygiene; personal cleanliness; hygiene in relation to patients( for example clean linen and receptacles). Nursing care temperature, pulse and respiration. Essential care of the patient who has a tracheostomy. Essential care of colostomy patient. Bed pans and urinals. Simple application of a sterile dressing. Management of wheel chair patient, BP patients, patients with drainage catheter, preparation and aftercare of patients for mammography, USG, CT, and MRI. Psychology of infant; paediatric, adult and geriatric patients. |
| V. | LANGUAGE (ENGLISH) COMMUNICATION SKILLS & INTERPERSONAL RELATIONSHIPS (IPR) |
| | Listening, Reading, Speaking and writing modules in English Language. Process & methods; Establishing & maintaining good IPR & communication with family staff and colleagues; Multidisciplinary team & role of technologists; knowledge of breaking bad news; Guidance & Counseling |
| VI. | FIRST AID: |
| | Aims and objectives of first aid; wounds and bleeding, dressing and bandages; pressure and splints, supports etc. Shock; insensibility; asphyxia ; convulsions. Resuscitation. Use of suction apparatus. Drug reactions. Prophylactic measures . Administration of oxygen. Electric shock; scalds, Haemorrhage; pressure points; compression band. Fractures; splints; bandaging; dressing. Foreign bodies. Poisons. |
| VII. | INFECTION: |
| | Bacteria, their nature and appearance. Spread of infection; auto infection or cross infection. The inflammatory process; local tissue reaction, general body reaction; ulceration. Asepsis and antisepsis. Universal precautions, hospital acquired infections HIV, hepatitis B, C, MRSA etc. |
| VIII. | PRINCIPLES OF ASEPSIS: STERILISATION |
| | Methods of sterilisation. Use of central sterile supply department. Care and identification of instruments. Surgical dressings in common use, including filamented swabs. Elementary operating theatre procedure. Setting of trays and trolleys in the radiotherapy department (for study by radiotherapy students only). |
| IX. | PREPARATION OF PATIENTS FOR GENERAL RADIOTHERAPY PROCEDURES |
| | Departmental instructions to out- patients or ward staff. Use of aperients , Enemas and colonic irrigation. Flatulence and flatus; causes and method of relief. Principles of catheterisation and intubation. Premedication; its uses and methods. Anaesthetised patients, nursing care before after and special examinations (for example in neurological, vascular and respiratory conditions). Diabetic patients; special attention to food; hazards of trauma, care of chemotherapy patients.
Preparation of the patients biopsy and trolley set up. Trolley set - up for ENT examination. Preparation of the patients for pelvic examination and trolley set-up.
General well-being of the patients during and after the treatment including the care of any intercurrent diseases (diabetes, tuberculosis, arthritics). Diet and fluid intake.
The observation and reporting any change in the signs and symptoms of patients receiving treatment. The use of blood count in the control of certain treatment. The care of blood counts, the care of local and systematic reaction. Local reaction showed including those in the ear, nose, throat and eye and those arising from treatment given to the pelvis. Instrumentation.
The absolute necessity for accuracy in every aspects of each individual treatment. The terminal care of dying patients. |
| REFERENCE BOOK |
| 1 | Ansell: Notes on Radiological Emergencies (Churchill) |
| 2 | Haugher & gardener : First Aid (Hamlyn) |
| 3 | Ring : Care of the injured (Livingstone) |
| 4 | Ross & Wilson : Practical Nursing and first aid (Livingstone ) |
| 5 | St. Jon’s Ambulance : First Aid Manual. |
| 6 | Deeley: A guide to Radiotherapy Nursing (Livingstone) |
| 7 | Alder Carlton : Radiologic Sciences and patient Care |
| 8 | BIO manual for English language, communication skills and Basics in Computer |
| PAPER-II: PHYSICS OF RADIOTHERAPY AND EQUIPMENT |
Suggested number of teaching hours is 80 including tutorials and demonstrations.
The following syllabus is intended to be comprehensive in the range of subjects to be covered without being detailed. Student should possess a sound knowledge of the subjects and those of practical procedures which technologists might be called up on to undertake.
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| I. | ATOMIC STRUCTURE AND RADIOACTIVITY |
| | Radioactivity, natural and artificial radioactivity, radioactivity decay, radioactive series. Half–life, mean-life, modes of radioactive decay, nuclear reactions. Radioactive equilibrium. Production of artificial radioactive isotopes. Radiological terms and units, exposure, absorbed dose, Kerma, equivalent dose. |
| II. | PRODUCTION OF X- RAY AND GAMMA RAY BEAMS FOR THERAPEUTIC PURPOSES |
| | Tubes and high tension circuits for the production of x – rays up to 500kV. Insulation and cooling problems in radiotherapy tubes. Mains voltage compensation. Control of tube voltage. The control panel and controls. The filament circuit, timers. Safety devices and inter locks. Basic principles of mega voltage x –ray machines. Distribution of radiation around the target. Gamma ray beam units. Linear accelerator. |
| III. | INTERACTION OF X AND GAMMA RAYS WITH MATTER |
| | Photoelectric absorption; Compton scattering; pair production. Dependence on the nature and atomic number of the absorber and on the radiation energy. Range of secondary electrons and its practical importance. Principles of filtration, protection And beam definition. Filters, beam – flattening devices ,diaphragms and applicators. |
| IV. | MEASUREMENT OF X AND GAMMA RAYS |
| | The roentgen and the rad. Quality, Half – value thickness and its measurement. Methods of measurement; ionization; photographic; scintillation; calorimetric; thermoluminescense, their relative advantages. Ionisation dosimeter, dose- rate, integrating and capacitor type. The Geiger – Muller counter. Scintillation counters and dosimeter. |
| V. | PRACTICAL DOSAGE MEASUREMENTS AND CALCULATIONS |
| | Initial calibration. Size of focal spot or source; alignment of applicator or diaphragm turn & able of applicator or diaphragm .Variation of dose rate across the beam in all Phantomas and phantom material s. Bolus materials. Air surface and depth doses; facto affecting them. Calculation of treatment time isodose curves. The effect of focal – spot source size; penumbra. Energy absorption in body tissues and its effect on depth dose . Integral dose. |
| VI. | TECHNICAL ASPECTS OF X AND GAMMA RAY THERAPY |
| | Tumour localization and verification. Principles of simulators. Field combinations and treatment planning. Beam direction devices, Compensating filters (for example wedges) Physical principles of moving field and grid therapy. Special aspects of radiotherapy using Megavoltage radiation, including electron beam therapy. |
| VII. | TECHNICAL ASPECTS OF THE USE OF RADIOACTIVE SOURCES IN THE BODY |
| | Constructions, measurements, testing and properties of small sealed radioactive sources. Dose calculations involving the inverse square law. Physical principles of moulds and implants. Superficial beta ray therapy. Measurement of beta ray dose. Clinical beta ray appliances. Physical principles of the clinical use of unsealed radioactive sources such as caesium 137, iridium 192 etc. |
| VIII. | RADIATION PROTECTION: |
| | Historical development. Dose equivalent limit. International reconditions and current code of practice for the protection radiation workers and the public against ionizing radiation arising from medical and dental use. Care and custody of small sealed radioactive sources (for example radium, caesium 137, strontium 90, Iridium -) Protective materials, lead impregnated substances. Building materials, protective materials in common use. Lead equivalent of protective materials and dependence on energy of radiation. Room protection. Radiation survey of departments, Personnel Monitoring: film badge, POCKET DOSIMETER, TLD BADGES and their uses and relative merits. Radiation safety concerns in day- today working. Precautions to be taken in the use and dispensing of radioactive solutions. Relevant protection, recommendations and current code of practice. |
| REFERENCE BOOK |
| 1 | Faiz M. Khan: The physics of Radiation Therapy (Williams & Wikins ) |
| 2 | Johns, Harold & Cunningham: Physics of Radiology (USA Charles C. Thomas) |
| 3 | Rees D.Y.: Health physics, Principles of Radiation Protection (London & Butterworth) Schall W. E: X – ray s, Their Origin, Dosage and Practical Application (Bristl, John & Son Ltd.) |
| 4 | Massey and Merdith : Radiology Physics |
| PAPER III - PRINCILPES OF RADIOTHERAPY, ONCOLOGY AND RADIOLOGY AND RADIOTHERAPY TECHNIQUE |
Suggested number of teaching hours is 200 inclusive of tutorials and demonstrations.
The student should have a knowledge of various diseases which come within scope of radiotherapy. This knowledge includes pathology and epidemiology. A general knowledge of the disease process, including knowledge of normal cell structure and life cycle, is necessary basis for an understanding of the abnormal.
Students should have a knowledge of the behaviour of various radiation in tissues; the effect on the cell; the tissues, the body as a whole; a general understanding of the importance of linear energy transfer and relative biological effectiveness; and a broad knowledge of drugs and other agents which can be used in conjunction with radiation; such as sensitizing or protective agents; the effects of oxygen etc.
The student should have an understanding of principles underlying the choice of treatment and the relative place of radiotherapy with surgery, chemotherapy and hormone therapy in treatment of malignant diseases. This understanding should include a sound knowledge of principles of radiation dosage, effect of fractionation, sensitivity and relative biological effectiveness of the radiation used.
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| I. | INFLAMMATORY PROCESS : DEFINITION AND EXAMPLES. |
| | The inflammatory process, local tissue reaction, general body reaction, ulceration. |
| II. | ENDOCRINE DISORDERS. |
| III. | BIOPSY : PURPOSE AND METHODS. |
| IV. | TUMOURS : |
| | Definition, formation of tumours, characteristics of benign and malignant tumours, spread of tumours. Types of benign tumours (such as adenoma, haemangioma etc.). Types of malignant tumours (such as epithelial tumours, tumours of connective tissues, tumours of nervous tissues, myeloproliferative disease, tumours of childhood etc) Classification of T.N.M. staging, grading. General pathology of each type, incidence, epidemiology, aetiology. |
| V. | BIOLOGICAL EFFECTS OF RADIATION : |
| | The cell: cell cycle, effects of radiation on normal cell and abnormal cell, effects on inflammatory processes. Radio sensitivity of normal and tumour cells, Radiological effectiveness of different radiation. Effects of radiation on the body: early, late, somatic and genetic. Principles of sensitising and protective agents; and their mode of action. |
| VI. | PRINCIPLES AFFECTING THE TREATMENT OF BENIGN CONDITIONS. |
| VII. | PRINCIPLES AFFECTING THE TREATMENT OF MALIGNANT DISEASE: |
| | Methods of treatment of malignant disease chemotherapy, hormone therapy, radiotherapy and surgery in the management of malignant disease. Relative value of each method for individual tumours or tumours sites. Choice of treatment: Anatomical site, relation to other tissue, general conditions of the patient to include intercurrent diseases, extent of tumour and histology, place of previous treatment. Place of radical and palliative therapy. Choice of treatment: tumour sensitivity, anatomical site, relation to other structures, availability of equipment. Method of radiation treatment: Interstitial, intracavity, plesiotherapy, Teletherapy and unsealed radioactive substances. |
| VIII. | FACTORS AFFECTING TUMOUR DOSE: |
| | Radio sensitivity, fractionation, dose-rate, radiobiological effectiveness of the radiation used. |
| IX. | EXTERNAL BEAM THERAPY: |
| | Fixed beam treatment – single fields, multiple Fields, regional fields, grids. Recent developments: SRT, SRS, IORT, IMRT & IGRT. |
| X. | APPLICATION OF RADIOTHERAPY TECHNIQUE IN THE TREATMENT OF DISEASE: |
| | Sensory organs. Systems: alimentary, respiratory, urinary, reproductive (including breast), endocrine, haemopoietic and reticuloendothelial, nervous, skeletal and locomotive. |
| XI. | PREPARATION FOR TREATMENT: |
| | Localisation of tumours: methods of localization, radiographic investigations and use of contrast agents. Treatment planning: Use of simulators, verification of treatment plan, isodose distribution, calculation of doses- incident, skin and tumour dose, interruption of prescription, treatment records. |
| XII. | MOULD ROOM TECHNIQUE: |
| | Materials in common use. Construction of casts, jigs and applicators for small sealed sources. Construction of protective devices. Mould Room Technology: (a) Planning a mould room, size staffing requirement situation, and design of equipment. (b) Technical consideration of some of the most commonly used compression casting and moulding materials. (c) Making shielding blocks for lungs, kidney protection. (d) Use of styrofoam cutter. Preparation of immobilisation devices. Tissue compensators. Radiosensitisers. Hyperthermia. Electrotherapy use of linear accelerator. (e) Port film. |
| XIII. | INTERACTIVITY AND INTERSTITIAL TREATMENTS: |
| | Methods of use to include after loading techniques. Advantages and disadvantages of various radio nuclides used. Dosage, fractionation and overall treatment time. Cleaning, sterilisation, and care of small sealed radioactive sources. |
| XIV. | CARE OF PATIENT: |
| | General well being of the patient during and after treatment, including the care of any intercurrent disease (for example diabetes, tuberculosis, arthritis) or disabilities (such as Tracheostomy). Diet and fluid intake. The observation and reporting of any change in the signs and symptoms of patients receiving treatment. The use of blood counts in the control of certain treatments. The care of local and systemic reactions. Local reactions should include those in the ear, nose, throat and eye, and those arising from treatment given to the lower part of the pelvis. The absolute necessity for accuracy in every aspect of each individual treatment. Keeping of records and their significance. |
| XV. | THE CARE AND USE OF EQUIPMENT: |
| | Observation of all apparatus (including timing and measuring devices). The reporting of faults. Care and use of accessory equipment. Beam directional devices. Application and diaphragms. Lead rubber. Skin-marking ink. Bolus bags. Immobilisation devices. Special care of children and woman. |
| XVI. | CARE AND CUSTODY OF SMALL SEALED RADIOACTIVE SOURCES : |
| | Detailed practical knowledge of the ways in which they are ordered, stored, distributed for use and returned for safe keeping. |
| XVII. | PROTECTION: |
| | Study of the regulations and their practical application to patients and staff in the current code of practical for the protection of persons against ionizing radiation arising from medical and dental use. Protection surveys. Radiation hazards from external sources to the whole body, gonads, skin (hands and eyes). Hazards from ingestion or inhalation of radioactive material. Long and short-term decontamination methods for unsealed radionuclides. Emergency procedure. |
| REFERENCE BOOK |
| 1 | Bames & Rees: Concise Textbook of Radiotherapy ( Lee & Febiger ) |
| 2 | Capra: Care of the Cancer Patient (Heinemann ) |
| 3 | Deeley: A Guide to Oncological Nursing (Livingstone) |
| 4 | Deeley: Modern Radiotherapy in Gynaecological cancer (Butterworth ) |
| 5 | Fletcher,Gilbert: Radiationtherapy in the Management of Cancers(U.S.A. Charles C. Thomas ) |
| 6 | Griffith: Radiation Therapy treatment Planning. |
| 7 | Jane Dobbs and Barret: Practical Radiotherapy treatment and planning. (Arnold Hodder Headline Groups) |
| 8 | Meredith W.J. (et al): Radium Dosage the Manchester System (London, E & S Livingstone ) |
| 9 | Mos. Williamt: Therapeutic Radiology (St. Louis, C.V. Mosby co.) |
| 10 | Moss: Radiation Oncology Rationale Techniqu Results (Mosby) |
| 11 | Murphy & Waltar: Radiation Therapy (London, W.B. Saundrs ) |
| 12 | Palersion & Ralston: Treatment of Malignant Diseases by Radium & X – rays , being a Practice of Raditherapy (London, Edward Arnold ) |
| 13 | Swith, Ivan H (et al) Cobalt – 60 Teletherapy, (New York Hoeber,Medical Division) |
| 14 | Silver & Solomon: Radioactive Isotopes in Medicine & Biology.(London, Henry, Kumpton). |
| 15 | Sulton & Maurice: Cancer Explained ( Lonon, Erans Brothers ) |
| 16 | Sutton P.M.: Nature of cancer (London, English University press) |
| 17 | Wachsmann: Felisc & barth Gunther Moving Field Radiation Therapy (University of Chicago Press ) |
| 18 | Walter: Cancer & Radiotherapy (Churchill Livingstone ) |
| 19 | Walter & Miller: Short Textbook of Radiotherapy (Churchill, Livingstone. |
