Simulation for proton therapy

In order to set up an individual treatment plan, you will first get an appointment for the CT-simulator. A CT-simulator (CT = computer tomography) is a CT-scanner that will make a three- or four-dimensional image, during which you will positioned exactly as during the radiation. A CT-simulation is painless.

When you enter the CT-simulation area we will automatically ask you to tell us your last name, first name and date of birth. This is for the nurse an important check to avoid misunderstandings.

It is important that for every radiation you are positioned on the treatment table in the exact same manner. The nurses and the physician will therefore first determine which position will be best suited for the radiation. They will choose a position that is most comfortable for you as well as best for the treatment. The manner in which you will be radiated, strongly depends on the location of the tumour.

For patients that are radiated on the chest, stomach or limbs, we usually make a number of pinpoint tattoos. The nurse will apply the points on your skin with a little injection. The dots are very small and permanent which is why they are called tattoo dots. The nurse will let you know in advance where the dots will be applied.

Sometimes additional markings need to be made with special red ink or a black felt pen. It is important that these red markings remain visible during the entire series of radiation sessions, so that nurse can see which area needs to be radiated. The black markings we no longer need during the further series of radiation sessions. You are of course allowed to wash or shower but try not to wash away the red markings. If during the course of the radiation treatment the lines become less visible, the nurse responsible for your radiation will draw them again.

For patients that have to be radiated on the head or the neck, an individual head support and radiation mask will be made for the simulation. If this is the case for you, you will be provided with the necessary information. In case of a radiation mask, no marks (lines) are made on the skin itself. The lines are put on the mask. It is possible that a tattoo dot is necessary as a direction marker on the chest or stomach.

The duration of the simulation can vary between an hour to an hour and a half. If we want to administer contrast fluid intravenously you need to be nil-by-mouth. This will be discussed in advance. If this is the case you're not allowed to eat or drink anything four hours in advance. You are allowed to take medication.

At the end of the simulation the nurse will give you your appointments for the radiation (day, hour) and the number of the radiation device.

After the simulation, your GP will be informed about your treatment.

To obtain optimal imaging, additional examinations may sometimes be necessary. It may for example be possible that the physicians needs another PET-CT or MRI ... before the treatment can start.

Treatment plan

With the help of these images and advance computer software the radiotherapist-oncologist and the medical physicist will draw up an individual treatment plan. This plan will determine the number and direction of the proton beams required to target the tumour as accurately as possible and to safeguard the surrounding healthy organs as much as possible.

Last edit: 19 April 2021