part 5

Question 1

Cytostatic drugs: alkylating cytostatics

Answer 1

Fase independant

ex. cyclophosphamide (for leukaemia or mamma)
ex. cisplatin (very high toxicity, for solid tumors

Question 2

cytostatic drugs: antimetabolites

Answer 2

S-fase
inhibit DNA synthesis
ex methotrexate, 5-fluorouracil, cytarabine

Question 3

cytostatic drugs: antimitotics

Answer 3

M-fase
ex. paclitaxel
side effects: alopecia and hypersensitivity

Question 4

cytostatic drugs: topo-isomerase inhibitors

Answer 4

G2-fase
decrease capacity DNA repair and replication
ex. doxorubicin

Question 5

cytostatic drugs

Answer 5

affect cell division

general toxic effect: alopecia, sterility, nausea and vomiting etc

Question 6

resectability margins

Answer 6

R0: radical (no tumor left in margin)
R1: macroscopically radical, microscopically not
R2: residual tumor macroscopically in situ

Question 7

brachytherapy

Answer 7

radioisotope very close to the tumor

Question 8

fractionation

Answer 8

used to reduce side-effects of radiotherapy

Question 9

hormonal treatment

Answer 9

used for ex ER+ BC, testicular cancer etc
tamoxifen (receptor blockers) [can give endometrial cancer]
in post-menopauze: anastrazole (=aromatose inhibitor) [can give osteoporosis]

Question 10

chemotherapy

Answer 10

side effects: alopecia
kills ALL fast dividing cells
combination therapy: usually more effective, less chance of treatment resistance

Question 11

VEGFR targeted therapy

Answer 11

used to treat kidney cancer

Question 12

chemo: enhance tumor sensitivity

Answer 12

combine w/ radiation (chemoradiotherapy)
add biological agents (ex. cetuximab for head and neck cancers)
add oxygen to tumor
hyperthermia (high temp kills cancer cells + blood vessels, ex. cervical or BC)

Question 13

chemoradiation

Answer 13

chemotherapy works as radio sensitiser
is seen as local treatment

synergy: cisplatin adducts to DNA icm radiation induces single strand breaks and inhibits post-radiation repair

Question 14

chemoradiation as primary treatment

Answer 14

organ saving treatment

curative resection impossible

Question 15

chemoradiation as adjuvant treatment

Answer 15

increases local tumor control after resection

Question 16

chemoradiation as neoadjuvant treatment

Answer 16

increases local tumor control after resection

Question 17

chemoradiation side effects: acute

Answer 17

skin, mucosa, pain, infection

Question 18

chemoradiation side effects: late

Answer 18

function loss, fibrosis/stenosis, oedema, infertility

Question 19

stereotactic radiotherapy

Answer 19

much higher doses, but precisely-targeted
saves surrounding tissues from too much radiation
when used for SCLC: high chance of lymphogeneic reoccurrence (but rarely observed)

Question 20

stereotactic radiotherapy: indications

Answer 20

brain metastases
small benign brain tumors
lung cancer stage I
oligometastases

Question 21

proton therapy

Answer 21

form of irradiation but w/ protons
doesn’t permeate deeply
Bragg peak: max reached last few mm
expensive

Question 22

proton therapy: indications

Answer 22

children
chroma/chondrosarcoma (skull base/spine)
only used when >10% decrease in grade 2 toxicity and >5% decrease in grade 3 toxicity when compared to photon treatment

Question 23

BRAF inhibitors

Answer 23

very effective, but resistance prone so comes back w/ a vengeance