OVERVIEW Flashcards
(78 cards)
1
Q
tx of Ca less commonly (TD, BD, NCG)
A
RADIOTHERAPY
2
Q
radthera uses this ionizing radiation
A
HIGH ENERGY XRS
3
Q
Fx of radiotherapy
A
- disrupt ability CA CELLS to GROW/ DIVIDE
- KILL ca cells
- SLOWing their GROWTH
- SHRINKING TUMORS (for surgery)
4
Q
radt is given as
A
OUTPATIENT (5x a week)
5
Q
Whys is radt given in a short period of time
A
for normal cells to - RECOVER, REPAIR, REPOPULATE
6
Q
has sufficient energy to alter atomic structure
A
IONIZING RADIATION
7
Q
characteristics of ionizing rad
A
- INVISIBLE
- SILENT
- PAIN FREE
8
Q
has suff. energy to cause EXCITATION
A
NON IONIZING RADIATION
9
Q
based on tertiary hospitals
A
RADIOTHERAPY DEPARTMENTS
10
Q
radiotherapy in combi with chemotherapy
A
CHEMORADIATION
11
Q
4 intents
A
- RADICAL/CURATIVE
- ADJUVANT
- PALLIATIVE
- NEO ADJUVANT
12
Q
- way of curing ca
- uses rad to kill ca cells but min. damage to normal tissues
- often combi w/ chemo
A
RADICAL/CURATIVE
13
Q
- addition to curative surgery
- POSTOPERATIVE IRRADIATION / AFTER SURGERY
- reduce risk of local recurrence
fx: avoid/kill/remove microscopic spread
A
ADJUVANT
14
Q
- accepts ca as INCURABLE
- control the symptoms
- All ca sites
e: prostate ca w/ bone metastasis
A
PALLIATIVE
15
Q
- radthera + chemo to shrink ca cell
- prior to surgery = higher success of surgery
A
NEO ADJUVANT
16
Q
- high energy xrs
- penetrate deeper into body tissue but spare over-lying skin
- produce: SECONDARY ELECTRONS w/in tissue
- cause: DNA DAMAGE to both ca + normal cells
A
PHOTONS`
17
Q
- for superficial maligancies
- damage dna directly
- deliver dose superficially
- continue to travel
A
ELECTRONS
18
Q
this generates and delivers the 2 main ways of delivering radt
A
LINAC (linear accelerator)
19
Q
- gen. reserved for v. specific circumstances such as children w brain tumor
- very little dose is delivered to NORML tissues
- deliver to specific areas only, no further penetration
A
PROTONS
20
Q
can often repair damage and survive except when radt is too much or not calibrated which results in being stiill damaged
A
NORMAL TISSUE
21
Q
- once ca cells are irradiated they die
A
APOPTOSIS
22
Q
absorbed dose/ rad
A
GRAY (Gy)
23
Q
series of small doses delivered in radt rather than in single dose
A
FRACTIONS
24
Q
reqs LARGE DOSE of radt divided into multiple small fractions
A
RADICAL
25
deliver in SMALLER no of fractions and Lower total dose
PALLIATIVE
26
____ is dep on which part of the body is receiving tx
caused by: transient damage to normal cells
that given time will repair and result to _____
TOXICITY/SIDE EFFECTS
ACUTE TOXICITY
27
Common toxicities assoc w. most radthera txs
FATIGUE. SKIN REACTION
28
-skin rxn (rad dermatitis)
- muscositis- pain
thick oral secretions
loss of taste
fatgue
dry mouth
MANAGEMENT: oral care
HEAD NECK CA
29
management: analgesic
| need to exclude to cure uti first before radt
PROSTATE CA
30
odynophagia (painful swallowing) / oesophagitis
due to: mucositis in oesophagus
- cough / SOB / chest pain / rarely nausea
LUNG CA
31
occurs 6-8 wks after rad
progressive SOB & cough
tx: high dose of steroids & oxygen generator
pneumonitis
32
for hgiher effectivity of radt
often used in curative / neoadjuvant setting
but w/ increased toxicity (CHEMOTHERAPY TOXICITY)
added in esp INCREASED RISK OF NEUTROPENIA (low type of wbc)
CHEMORADIOTHERAPY
33
total duration of tx
| no of days b/n 1st and last session
PROTRACTION
34
in 4 intents, is it ok for radt-surgery-radt
radthera-adjuvant-neoadjuvant
| radt cant be 2x a day
35
if ever secondary ca caused by radt can radt heal it
| What is its TREATMENT PLAN
true
- HORMONAL THERAPY
- TARGETED THERAPY
- MOLECULAR THERAPY
36
radt as emergency tx
T - PALLIATIVE
37
radt not avail in most hospitals
T
38
delivered accurately in 2mm
T
39
not visible
| causes burns
T
40
radt and chemo given at the same time
T
41
in 4 intents, what is commonly applied in all stages of ca
radical / neoadjuvant / adjuvant
42
important components of radiotherapy
```
CONSENT
IMMOBILIZATION
CT SIMULATOR
VOLUME DEFINITION
RADIOTHERAPY TREATMENT
```
43
discuss w the pt what youre going to do, why. possible side fx, altnv options
CONSENT
44
1. head neck immobilization
2. whole body ""
3. v rigid / hot water flexible / animated
perplex mask
vacuum bag
thermoplastic shell
45
reason for immobilization
- target right spot
| - keep positioning
46
to locate tumor accurately
CT simulation
47
reference point for laser
| to refrain irradiation to other body areas
TATTOO
48
volume definitions
GTV (gross tumor volume)
CTV (clinical target volume)
PTV (planning target volume)
49
margin of tumor that we can see
GTV
50
not visible possiblt cancerous
| margin of microscopic spread
CTV
51
margin to take account of day to day variability and potential tumor motion
PTV
52
close clinical follow up during radt
radiotherapy treatment
53
began w superficial and orthovoltage therapy w xray tubes and teletherapy w sealed radioactive sources
external beam radiotherapy
54
sealed sources used by brachytherapy
```
Radium-226 (1901),
Radon-222 seeds
Caesium-137
Iridium-192
Cobalt-60
Iodine-125
Gold-198
```
55
Brachytherapy with beta sources
Strontium-90 and Ruthenium-106
56
Various manual loading systems have been superseded by modern high-dose-rate
Iridium 192 and Cobalt-60
57
automated systems for delivery of ___ to the prostate.
Iodine-125
58
three commonly used radiotherapy technologies
1. External beam radiation therapy (EBRT or XRT or teletherapy)
2. Brachytherapy or sealed source radiation therapy
3. Systemic radioisotope therapy or unsealed source radiotherapy
59
Other highly specialized radiotherapy technologies also include:
1. Particle therapy
2. Intraoperative radiation therapy
3. Stereotactic radiation therapy
60
using protons or heavy particles
Particle therapy
61
delivering radiotherapy during the peri-operative
| period at time of the surgical removal of the tumour
Intraoperative radiation therapy
62
delivering very high radiation dose called ablative
| dose to a well-defined small tumour
Stereotactic radiation therapy
63
ultimate foal of all the changes and developmetns and improvemens
- effective destruction of ca tissue while delivering mnimal dose of radiaiton to adjacent healthy tossues
- make tx easier and shorter for pt to sustain and physicians and other healthcare professionals to perform
64
- act of emitting radiation spontaneously
- giving off rays of energy or particles by breaking apart atoms of certain elements
- done by atomic nucleus when unstable
Radioactivity
65
pierre curie suggested to Dr Henri Danlos
| if radioactive source could be near or close proximity / inserted into a tumor (interstitial brachytherapy)
foundation of brachytherapy
66
types of radiotherapy treatments
teletherapy
| brachytherapy
67
delivers radiaiton externallly
aplication of co 60
external beam radiotherapy
teletherapy
68
places radiaiton internally
gk word close
internal beam radiotherapy
brachytherapy
69
uses high energy radiation from xrays to kill or shrink ca cells
roentgen therapy
70
close proximity
earliest form of brachytherapy
using radioactive drugs that gives of energy to kill thru vein the ca cells
Radium therapy
71
different radiotherapy techniques
3DCRT (3D conformal radiotherapy)
IMRT (Intensiy modulated therapy)
IGRT (image guided radiation therapy)
72
started in 1990 wherefields used are designed that the radiaiton is mostly towards the tumor (tumoricidal dose) and the surronding tissues have little to no dose
- has 3d info about patients body supplied by CT simultaneous process
3DCRT
73
advance form of 3DCRT that manipulates photons to be directed to tumor and also shape the beam
uses sophisticated software and hardware
it varies the shape and intensity of radiaiton DELIVERED TO THE DIFF PARTS OF THE TX AREA
IMRT
74
most expensive includes imaging while having tx
| growing popularity primarily due to widespread adoption of new linac
IGRT
75
fundamental principle of matter
| building blocks
atom
76
anything that takes up space and has mass
matter
77
3 parts of an atom
proton neutron electron
78
positive charged particles found inside nucleus
proton
