RADIATION

• background equivelent radiation time
• helps pt understand by comparison the amount of radiation that they will be recieving.

as low as reasonably achievable

• in regards to exposure of radiation to the pt and to staff
• keep radiation exposure and dose to lowest levels possible
• biological response to ionizing radiation is directly proportional to the dose

optimization for radiation protection

• TIME: wear film badge, limit amount of time exposed to ionizing radiation
• DISTANCE: recieve less radiation by standing further away from source
• SHIELDING: protective barriers and equiptment

• use of ionizing radiation to interrupt cellular growth (destroys DNA)
• chosen when the treatment goal is curative as in Hodgkin's disease
• or when tumor cannot be removed surgically

1895

• electromagnetic rays (x-rays and gamma rays)
• particles

• 20% direct effect: ionizing radiation causes break in DNA, causing cell lysis- cell death
• 80% indirect effect: can also ionize body fluids, esp water in cell, leading to free radicals which cause irreversible damage to DNA

• during DNA synthesis and Mitosis
• also tumors that are more well oxygenated are more sensative to radiation.

bone marrow, lymph tissue, GI tract, mucous membranes, gonads

• the higher the energy the deeper into the tissues it will penetrate
• kilovoltage: superficial (skin and breast)
• Gamma ray: deeper
• linear accelerators and betatron: high energy to deeper structures without harming the skin

• for hypoxic, radioresistant tumors with neutron beam theraphy, it damages target cells as well as those cells in its pathway.
• like in surgery with the tumor exposed they shoot it

• most affected tissues are those that proliferate rapidly, from tx up to 6 months later
• skin
• epi lining of GI
• bone marrow
• fatigue, malaise, h/a, NV

• keep hydrated
• gentle oral hygiene
• avoid perfumes, deoderants, loose fitting clothess
• apply topical steroids
• diphenhydramine 2.5 mg q 6 hrs
• if oozing (exudate) expose to air for 10-15 mins q 3 times daily

• high dose radiation to localized areas, relaivly few number of days for treatment
• partial breast radiation

• implants are more suitable for cancers that tend to remain LOCALIZED, can be combined with external treatment
• systemic (taken orally)

foley, bed rest, low residue diet, keep clean and dry, no peri care, flush twice

fever, late tissue breakdown, sloughing of tissue, bone necrosis, ulceration, fistulas