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External Beam Therapy

Last updated Jan. 22, 2019

Approved by: Maulik P. Purohit MD MPH

Dina-Roberts Wakulczyk

External Beam Therapy (EBT) or External Beam Radiation Therapy (EBRT) is used in the treatment of cancer, to kill cancer cells without destroying normal tissues around it.


Background Information:

What are the other Names for the Procedure?

  • EBRT (External Beam Radiation Therapy)
  • EBT (External Beam Therapy)
  • External Beam Radiotherapy

What is External Beam Therapy radiology procedure? (General Explanation)

  • External Beam Therapy (EBT) or External Beam Radiation Therapy (EBRT) is used in the treatment of cancer, to kill cancer cells without destroying normal tissues around it
  • Linear accelerators are used in this procedure to deliver high energy x-rays, which deposit in tumor cells and eventually destroy them
  • There is no radiation source being placed in the patient’s body in this procedure
  • External Beam Therapy is used in various types of cancers including breast cancer, brain tumors, lung cancers, prostate cancers, head and neck cancers, and bowel cancers

What part of the Body does the Procedure involve?

The External Beam Radiation Therapy can be applied to different parts of the body, depending on the tumor site location.

Why is the External Beam Therapy radiology procedure Performed?

External Beam Therapy has various uses in the treatment of patients:

  • It can be used to destroy tumor cells
  • EBT can also be used before or after the surgery, to shrink the size of tumor, or stop the tumor from returning
  • EBT is also used in palliative care to control patient’s symptoms, where diagnosis is poor

What is the Equipment used? (Description of Equipment)

  • External Beam Therapy uses various kinds of instruments depending upon the requirement
  • The most commonly used instrument is a linear accelerator

What are the Recent Advances in the Procedure?

There are no recent advances in the field of External Beam Radiation Therapy. 

What is the Cost of performing the External Beam Therapy radiology procedure?

The cost of an External Beam Radiation Therapy depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the External Beam Radiation Therapy procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.ncbi.nlm.nih.gov/pubmed/25271934 (accessed on 10/15/2014)

http://www.ncbi.nlm.nih.gov/pubmed/25266654 (accessed on 10/15/2014)

http://www.ncbi.nlm.nih.gov/pubmed/25261675 (accessed on 10/15/2014)

Prior to External Beam Therapy radiology procedure:

How does the External Beam Therapy radiology procedure work?

  • During an External Beam Therapy, linear accelerators are often used to create radiation beams
  • The radiation beams are targeted at specific tumor sites, where they get deposited and damage the DNA of cancer cells, eventually killing these cells

How is the External Beam Therapy radiology procedure Performed?

An External Beam Therapy is usually performed at an outpatient procedure center.

  • Patients are asked to change into a hospital gown and then are taken to the treatment room
  • With the use of imaging tools (such as an x-ray or CT scan), markers are placed during the stimulation phase, and the patient is placed in a specific position
  • Specific masks and pads are placed around the patient, to keep them in that position
  • After the patient is placed in position, the therapist leaves the room and radiation beams are delivered to the target site
  • The total procedure takes about an hour, with most of the time being spent for positioning the patient in the exact manner required
  • The application of radiation beams actually take only a few minutes

Where is the Procedure Performed?

External Beam Radiation Therapy is an outpatient procedure that is usually performed at a procedure center of the hospital.

Who Performs the Procedure?

  • A radiation oncologist evaluates the cancer patient and determines the need of External Beam Therapy, as well as the method of delivery
  • A physicist and dosimetrist work together with the radiation oncologists, to make detailed calculations on radiation delivery
  • The required radiation is calculated by a physicist and radiation therapists deliver the radiation therapy needed

How long will the Procedure take?

  • External Beam Therapy is given once a day, 5-days a week, for a total of 2-9 weeks, as determined previously by the healthcare provider
  • The total procedure takes about an hour, with most of the time being spent for positioning the patient in the exact manner required
  • The application of radiation beams actually take only a few minutes

Who interprets the Result?

A radiation oncologist and the oncologist physician treating the patient, interprets the results of the External Beam Radiation Therapy and plans future treatments, based on the result/report.

What Preparations are needed, prior to the Procedure?

There are 3 stages to an External Beam Radiation Therapy. These are outlined as below:

Stage 1 - Stimulation:

  • This stage is to determine in what position the patient is required to be placed on the radiation table, to apply radiation
  • Different kinds of masks, pads, and other supporting devices, are made to keep the patient in a specific position, so that the same position can be maintained during every session
  • The physician may even mark the area with colored ink, to guide them during the procedure. Sometimes, markers seeds are also placed at the site of tumor to identify the site
  • Several images are also taken during this stage, to determine the site of tumor and target for radiation

Stage 2 - Treatment planning:

  • A radiation oncologist along with the physicist and dosimetrist are involved in this stage, where they calculate the exact dose needed for the treatment, mode of radiation delivery, and instruments needed for the procedure
  • This planning is done with the help of CT, MRI, and PET scan, to ensure that only a minimum amount of normal tissues are destroyed

Stage 3 - Treatment delivery:

  • This stage is when the actual treatment begins and radiation therapy is applied

What is the Consent Process before the Procedure?

  • A physician will request your consent for an External Beam Therapy procedure using an Informed Consent Form
  • Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent
  • You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the External Beam Therapy procedure:

  • The EBT procedure may completely cure the cancer, shrink the tumor size, or reduce symptoms of the cancer
  • The procedure is completely painless
  • It can be performed as an outpatient procedure

Following are the risks of the External Beam Therapy procedure:

  • There is a minimal chance of developing cancer, due to the exposure of radiation to normal tissues surrounding tumor
  • Normal tissues around the tumor may be destroyed, due to radiation

What are the Limitations of the External Beam Therapy radiology procedure?

The External Beam Therapy cannot be used with certain kinds of tumor, due to their insensitivity to radiation therapy, or due to the location of these tumors.

What are some Questions for your Physician?

  • What is an External Beam Therapy procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • What are the costs involved

During the External Beam Therapy radiology procedure:

What is to be expected during the External Beam Therapy radiology procedure?

  • External Beam Radiation Therapy is a completely painless procedure
  • A buzzing sound or sound of the machine may be heard, during the procedure
  • The patient may smell ozone produced by the linear accelerator
  • They may also see some lights, if radiation is applied to their brain or eyes
  • After the procedure, the physician may recommend certain imaging tests, blood tests, or other tests, to determine the effect of the procedure
  • Patient may be required to see their physicians several times after the procedure, to determine the success of the procedure, as well as to plan future treatment course

What kind of Anesthesia is given, during the Procedure?

An External Beam Therapy is a painless procedure and anesthesia is not required for it.

How much Blood will you lose, during the Procedure?

There is no blood loss involved in an External Beam Therapy procedure.

What are the possible Risks and Complications during the External Beam Therapy radiology procedure?

An External Beam Radiation Therapy procedure may destroy healthy cells that are adjacent to the cancer cells.

What Post-Operative Care is needed at the Healthcare Facility after the External Beam Therapy radiology procedure?

No specific post-operative care is needed at home, after the procedure.

After the External Beam Therapy radiology procedure:

What is to be expected after the External Beam Therapy radiology procedure?

  • After an External Beam Therapy, the physician may recommend certain imaging procedures, blood tests, or other tests, to determine the effect of the procedure
  • Patients may be required to see their physicians several times after the procedure, to determine the success of the procedure as well as to plan the future treatment

When do you need to call your Physician?

The patient should inform their physician, if there is significant nausea and vomiting, and if they are unable to eat or drink.

What Post-Operative Care is needed at Home after the External Beam Therapy radiology procedure?

No specific post-operative care is needed at home after the External Beam Therapy procedure.

How long does it normally take to fully recover, from the Procedure?

Generally, no recovery time is needed after an External Beam Radiation Therapy. The patient may resume their normal activities, immediately after the EBRT procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient during the External Beam Radiation Therapy procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the External Beam Therapy radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the External Beam Therapy procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Oct. 22, 2014
Last updated: Jan. 22, 2019