The Radiotherapy Pathway: Pre-Treatment


Before commencing radiotherapy treatment, you may have an appointment with the doctor, and in some case with a specialist nurse, to discuss your treatment options. This is where you will be consented for your Radiotherapy treatment.

CT Planning Scan

All patients having external beam radiotherapy will need to have a CT scan in the position they will be in for their radiotherapy treatment. Our large bore CT scanner is specially designed to allow us to take 3D and 4D scans with our patients in the best position for them to receive their radiotherapy treatment. At this stage, some patients will need to have an immobilisation device made to help ensure patients are in the same position for each treatment.  For treatment of the head and neck, a mask/shell is routinely made.

For sites such as lung and limb, a vacuum-formed bean bag may be used, whilst for other sites, our adjustable site-specific equipment is sufficient. It may be necessary for you to have an injection of contrast material at your CT scan. This will be fully explained at the CT appointment, if applicable to you.

To help reproduce your position for the treatment, we may make one or more permanent ink dots (tattoos) to use as reference points.

The images from the CT scan are then used to plan treatment.


Our dosimetry radiographers use advanced planning systems to accurately plan the radiotherapy treatments. The planning team routinely plan advanced treatments such as Intensity-Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), Stereotactic Radiosurgery (SRS) and Stereotactic Ablative Radiotherapy (SABR).

Once the plan is complete a series of checks are carried out before it is ready to be used for radiotherapy treatment.  This process can take between 1-5 weeks depending on the type of treatment. Once the planning process is complete, you will be notified with an appointment to start your radiotherapy treatment.


Before the first treatment each patient will have a start of treatment review where you will be given your full appointment list and a check in card, which enables you to check in for your treatment each day. We can take a preference for morning or afternoon appointments at your planning scan, however we cannot guarantee this. You may also be treated at different times each day.

A radiographer will discuss your upcoming treatment with you, including the treatment process, side effects and their management, as well as going through any concerns or queries. The side-effects of radiotherapy will vary from person-to-person and will depend on the area of your body that is being treated.

The liaison area is where you will have radiographer, doctor, speech and language and dietician reviews to help you cope with the treatment. These appointments may be routine or they may be arranged as required.

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