External Beam Radiotherapy (Teletherapy) Treatment Course

Lesson 1 • Photon Interactions with Matter

Examines photoelectric effect, Compton scatter, and pair production in tissue-equivalent materials. Links interaction probability to photon energy and atomic number.

Lesson 2 • Charged Particle Interactions

Describes stopping power, linear energy transfer, and range for electrons and heavier particles. Provides the physical basis for electron beam and proton therapy dosimetry.

Lesson 3 • Atomic Structure and Radioactivity

Covers atomic models, nuclear stability, and decay modes relevant to radiotherapy sources. Establishes the physical basis for all subsequent beam production concepts.

Lesson 1 • The Five Rs of Radiobiology

Analyzes repair, redistribution, repopulation, reoxygenation, and radiosensitivity as fractionation rationale. Guides schedule selection for different tumor types.

Lesson 2 • Cell Survival Curves and Models

Derives the linear-quadratic model from survival data and extracts alpha/beta ratios. Applies the model to compare fractionation schedules quantitatively.

Lesson 3 • DNA Damage and Repair Mechanisms

Explains single- and double-strand breaks, repair pathways, and misrepair leading to cell death. Connects molecular events to macroscopic dose-response curves.

Lesson 4 • Fractionation Schemes and BED

Calculates biologically effective dose for conventional, hypofractionated, and SBRT schedules. Enables evidence-based comparison of clinical fractionation protocols.

Lesson 1 • Linear Accelerator Components

Describes the electron gun, waveguide, bending magnet, and target assembly of a medical linac. Establishes the hardware basis for beam production and quality.

Lesson 2 • Imaging Systems on Treatment Units

Reviews portal imaging, kV on-board imagers, and cone-beam CT integrated into modern linacs. Connects imaging hardware to image-guided treatment delivery.

Lesson 3 • Quality Assurance and Safety Systems

Outlines interlocks, dosimetric monitoring chambers, and regulatory acceptance testing requirements. Ensures students can verify equipment readiness before patient treatment.

Lesson 4 • Beam Modification Devices

Covers primary and secondary collimators, multileaf collimators, wedges, and bolus materials. Links device selection to dose distribution shaping in the patient.

Lesson 1 • Dosimetry for Special Techniques

Addresses small-field dosimetry corrections, IMRT composite dose measurement, and SBRT detector selection. Extends standard methods to modern high-precision delivery techniques.

Lesson 2 • Reference Dosimetry Protocols

Applies internationally recognized dosimetry codes of practice to calibrate photon and electron beams. Ensures traceable, reproducible output measurements for clinical use.

Lesson 3 • Ionization Chamber Theory

Derives cavity theory, Bragg-Gray conditions, and correction factors for cylindrical and parallel-plate chambers. Provides the theoretical basis for absolute dose measurement.

Lesson 1 • MRI and PET Simulation Integration

Describes MRI simulation setup, PET/CT co-registration, and deformable image registration for target delineation. Extends simulation beyond CT to multimodality datasets.

Lesson 2 • Immobilization Devices and Techniques

Compares thermoplastic masks, vacuum bags, stereotactic frames, and body boards for different treatment sites. Links device choice to setup reproducibility and intrafraction motion.

Lesson 3 • CT Simulation Workflow

Covers patient positioning, scan protocols, contrast use, and image transfer to planning systems. Establishes the simulation process as the foundation of the planning chain.

Lesson 4 • Reference Marks and Coordinate Systems

Explains tattoo placement, laser alignment, and the relationship between simulation and treatment isocenters. Ensures accurate patient setup at the treatment unit.

Lesson 1 • ICRU Volume Definitions

Applies GTV, CTV, ITV, PTV, and OAR definitions from international reporting guidelines to clinical cases. Provides the volumetric framework for all subsequent planning steps.

Lesson 2 • 3D Conformal Radiotherapy Planning

Designs beam arrangements, applies beam modifiers, and evaluates dose distributions for 3D-CRT plans. Builds manual planning skills before introducing inverse optimization.

Lesson 3 • IMRT and VMAT Optimization

Configures objective functions, optimization constraints, and arc parameters for IMRT and VMAT planning. Develops inverse planning skills for complex target geometries.

Lesson 4 • Plan Evaluation and Dose Reporting

Interprets DVH statistics, dose homogeneity indices, and conformity indices against clinical protocol criteria. Ensures plans meet institutional and guideline-based dose objectives.

Lesson 1 • Patient Setup and Positioning

Applies immobilization devices, laser alignment, and surface imaging to reproduce simulation position. Establishes the first step of every treatment fraction.

Lesson 2 • Respiratory Motion Management

Applies gating, breath-hold, and real-time tracking techniques to manage intrafraction tumor motion. Extends IGRT to mobile targets in thoracic and abdominal sites.

Lesson 3 • Record and Verify Systems

Configures treatment parameters in record-and-verify software and interprets tolerance table alerts. Prevents delivery errors through automated parameter checking.

Lesson 4 • Adaptive Radiotherapy Workflows

Describes anatomy-of-the-day replanning, triggered adaptation criteria, and online MR-linac workflows. Prepares students for emerging adaptive delivery environments.

Lesson 1 • Thoracic and Lung Treatments

Plans lung SBRT, mediastinal, and esophageal treatments with motion management and heterogeneity correction. Addresses lung dose-volume constraints and pneumonitis risk.

Lesson 2 • Head and Neck Radiotherapy

Designs simultaneous integrated boost IMRT plans for head and neck cancers with salivary gland and spinal cord sparing. Manages complex multistructure OAR constraints.

Lesson 3 • Abdominal and Pelvic Treatments

Covers prostate, cervical, rectal, and upper abdominal radiotherapy with bowel and bladder management strategies. Applies IGRT protocols for pelvic organ motion.

Lesson 4 • Breast and Chest Wall Treatments

Designs tangential, field-in-field, and VMAT breast plans with cardiac and lung dose minimization. Includes regional nodal irradiation and post-mastectomy techniques.