Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11515 - Radiation Therapy

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Definition/Description
1. Radiation therapy
					 is a clinical medical specialty in which ionizing radiation is used to treat
					 patients with cancer (and other tumors or neoplasms). The objective is to
					 deliver a lethal dose of radiation to cancer cells, with minimal damage to
					 surrounding healthy tissues. The therapy can selectively treat malignant
					 tissues because cancer cells are more susceptible than other cells to the
					 damaging effects of radiation.
2.
					 Radiation therapy is increasingly referred to as "oncology" (the study of
					 tumors), stressing the relationship of the specialty to the field of cancer
					 management. There are three forms of treatment for cancer patients, all of
					 which are used individually or in combination with one another: radiation
					 therapy, chemotherapy, and surgery. Because of differences in degrees of
					 responsiveness to radiation, some tumors can be equally well treated by surgery
					 or by radiation, while others cannot be effectively treated by radiation and
					 must be treated with surgery or chemotherapy. Because of its dual curative and
					 palliative role, therapeutic radiation is sometimes used prior to surgery or
					 after surgery.
3. Approximately 60
					 percent of all cancer patients require radiation therapy at some time during
					 the course of their disease. Radiation therapy, alone or in combination with
					 other forms of treatment, will be used by only 50 percent of the cancer
					 patients because of limited access. Radiation therapy was not recognized as a
					 medical specialty, apart from general radiology, until the late 1960's, when
					 the American Medical Association recognized separate training programs for
					 radiation therapists and radiologists. The trend of separating therapeutic and
					 diagnostic radiology has continued.
4. The techniques used in clinical radiation
					 therapy are external irradiation, local irradiation, and internal or systemic
					 irradiation, ranging from low energy to megavoltage equipment. Megavoltage
					 machines are more expensive than other types of equipment, because of their
					 high initial cost and protective requirements for the treatment room. However,
					 they offer significant clinical advantages in terms of patient comfort and long
					 term survival and they have higher utilization capacity.
5. There are three types of facilities for
					 radiation therapy. The least comprehensive provides basic services and may
					 provide selected specialized services, using superficial and/or orthovoltage
					 and cobalt equipment. Facilities equipped for major clinical radiation therapy,
					 provide clinical research and training programs using superficial,
					 orthovoltage, cobalt and small linear accelerator equipment. The most
					 comprehensive type provides services of the other two types and, in addition,
					 provides major training and clinical radiation therapy, with linear
					 accelerators, computerized treatment planning, a treatment simulator, and
					 access to a CT Scanner.
6. Over the
					 years a vernacular has developed in the field of radiation therapy. Several
					 definitions unique to the field are important to an understanding of
					 utilization, need and resource goals. The more commonly needed terms are
					 defined as follows:
a.
Cancer
					 Case
-a patient treated with one course of radiation therapy regardless
					 of the number of anatomical areas treated during the course or the number of
					 fields involved.
b.
Course
-a prescribed number of treatments for a cancer case,
					 usually averaging 25 for a curative patient and 14 for a palliative
					 patient.
c.
Field
-the level of the beam used for irradiation. On the
					 average a treatment involves between 2-25 fields.
d.
Megavoltage Unit
-a
					 radiation therapy unit with a maximum beam energy at or in excess of one
					 million volts. It will usually be a modern cobalt-60 machine or low energy
					 linear accelerator (Linac).
e.
Treatment or Treatment Visit
-one irradiation regardless of the
					 number of anatomical areas treated or the number of fields involved.
f.
Treatment Load
-the total
					 number of treatments performed by a therapy unit per year.