Radiation simulation

Prior to receiving any radiation therapy, many measurements and technical x-rays are taken to map the precise area to be treated. This preparation for therapy is called the "simulation." The simulation will generally take longer than any other appointment, from thirty minutes up to two hours. Because simulation does not involve any highdose radiation, parents are often allowed to remain in the treatment room to help and comfort their child. As discussed previously, some children will need to be sedated for the simulation.

During simulation, the radiation oncologist and technologist use a specialized x-ray machine to outline the treatment area. They will adjust the table that your child lies on, the angle of the machine, and the width of the x-ray beam needed to give the exact dosage in the proper place. In addition, the oncologist or technologist will put small ink marks on the skin to pinpoint the area to be treated. These marks should not be scrubbed in the bath or shower. They do fade with time, so the technologist may need to add more ink at some point in the childs treatment.

Children who wear masks during treatment will have these ink marks put on the mask, not their skin. At some institutions, children who require spinal radiation may have tiny black dots permanently tattooed on their skin. These tattoos are made by putting a drop of India ink on the skin, then pricking with a pin. They look like tiny black freckles.

After the simulation is completed, the child can go home while the radiation oncologist carefully evaluates the developed x-ray film and measurements to design the treatment field.

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