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Peds Flashcards

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1
Q

What are favorable sites

A

orbit, non-para h&n, non-bladder/prostate GU, billiary (bong)

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2
Q

What are non-parameningeal sites

A

larynx, soft tissues, salivary glands,

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3
Q

Group I rhabdo

A

completely resected

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4
Q

Group IIA rhabdo

A

microscopic positive margin

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5
Q

Group IIB rhabdo,

A

grossly resected LN disease

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6
Q

Group IIC rhabdo

A

IIA + IIB, positive margin and LN

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7
Q

Group III rhabdo

A

Gross residual disease

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8
Q

Group IV rhabdo

A

DM

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9
Q

Stage I rhabdo

A

favorable site

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10
Q

Stage II rhabdo

A

unfav site <=5 cm and LN-

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11
Q

Stage III rhabdo

A

unfav site >5 cm or LN+

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12
Q

Stage IV rhabdo

A

DM

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13
Q

Low risk rhabdo

A

fox-1 negative and Group I-III fav site or Group I-II unfav site

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14
Q

Intermediate risk rhabdo

A

Every Alveolar and Group III of unfav site, and Group IV age<10 embryonal

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15
Q

high risk rhabdo

A

All Group IV except for Age<10 embryonal

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16
Q

Path needed for rhabdo

A

primary site biopsy, BM biopsy, CSF if parameningeal, SLNB if extremity

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17
Q

Management of low risk rhabdo

A

VACx24 w with RT at week 12

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18
Q

Management of intermediate risk rhabdo

A

VAC/VIx42w, RT at week 12

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19
Q

Management of high risk rhabdo

A

VAC/IE x54w, Primary RT at week 20, DM RT after CHT

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20
Q

Dose for primary site RT for rhabdo Group 1

A

Embryonal: 0 Gy, Alveolar: 36 Gy

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21
Q

Dose for primary site RT for rhabdo Group II

A

IIA: 36 Gy, IIB: 41.4 Gy (draining lymphatic chain receives 36 Gy)

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22
Q

Rhabdo Orbit PR dose

A

50.4 Gy

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23
Q

Rhabdo Orbit CR dose

A

45 Gy

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24
Q

Dose for primary site RT for rhabdo Group III

A

<5 cm: 5040, >5 cm: 5940 cGY

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25
GTV1 and GTV2 for rhabdo
GTV1: pre-CHT GTV, GTV2: Post-CHT GTV
26
SIB for Rhabdo
GTV1 to 36 Gy then cone down to the other dose
27
Rhabdo DM dose
CR: 40/2, PR: 50/2
28
Rhabdo whole lung dose
15/1.5 (12/1.5 if < age 6)
29
Whole liver RRT rhabdo
23.4/1.8
30
Whole abdomen Rhabdo dose
24/1.5
31
Management of Ewing's Sarcoma
Induction with VAC-IE q2w x 6, then consolidation with VAC-IE q2wx11, Local therapy at Week 13
32
What is local therapy for ewings
Surgery or RT (surgery if reasonably resectable)
33
GTV1 and GTV2 for Ewings
Prechemo GTV, Postchemo GTV except Prechemo in bone
34
Primary site dose for Ewings
45 to PTV1, 55.8 to PTV2
35
Whole lung dose for Ewings
15/1.5 (12/1.5 for age<6)
36
Whole abdomen for Ewing's
24/1.5
37
Favorable histologies for Wilms
Epithelial, stromal, blastemal
38
Unfav hist for wilms
CCSK, Rhabdoid, anaplasia (focal or diffuse)
39
Imaging findings for wilms
no calcs, pseduocapsule, claw sign, not cross midline
40
lab work for wilms
cbc/cmp, ua, urine vma/hva
41
imaging for wilms
abdom US, MRI abd, CT CAP, MRI brain if CCSK or RTK, bone scan if CCSK
42
how to get path for wilms
radical nephrectomy and ipsi LND NEVER BIOPSY
43
Stage I wilms
I: completely reseted tumor limited to the kidney
44
Stage II wilms
Complete resected extending into renal sinus or blood vessels
45
Stage III wilms
SLURPPP: spillage positive LN, unresectable, residual disease, prior biopsy, peritoneal implants/positive cytology, positive margin
46
Stage IV Wilms
Beyond abdomen DM
47
Stage V wilms
bilateral
48
Management of wilms
Radical neph and LND, adj CHT, Flank RT
49
How soon after surgery do you do flank RT for wilms
10-14 days
50
Standard RT dose for flank RT for wilms
10.8/1.8
51
Who should get dose escalated RT Flank in wilms
DA stage III, RTK, Gross residual
52
Indications for Whole badomen with Wilms
Rupture, spillage, peritoneal implants, positive cytology
53
Dosing for escalated flank RT
19.8/1.8
54
Dose for whole abd RT for wilms
10.5/1.5
55
Dose if gross residual disease whole abd RT for Wilms
21/1.5
56
Whole lung RT dose for wilms
12/1.5 (10.5/1.5 if Age<1)
57
Flank RT volume
preop extent of tumor + kidney + 1cm to CTV + 0.5 cm, lateral flash, medial VB+1cm.
58
Borders of PA LN if radiating during wilms flank RT
T11/T12 to L5/S1
59
Borders of whole abdomen field
1 cm above diaphragm, inferior: bottom of OF, Lateral: body wall, block femoral head and heart.
60
Lab work for Neuroblastoma
cbc/cmp, ua, urine vma/hva
61
Imaging for neuroblastoma
abd US, MRI abd, CT chest, MIBG scan
62
what makes neuroblastoma high risk
MYC amplification in L2/M/MS, Age>1.5 with stage M, Age>1.5 who progresses to M
63
INRT staging for neuroblastoma
L1: localized not involving vital structure, L2: locoregional tumor invading adj structures, M: DM, MS: Age <1.5 with limited DM involving skin/liver/bone or BM<10%
64
Management of high risk Neuroblastoma
induction chemo x 5 cycles then surgery, ASCT x2, then radiation 4-6 weeks later
65
RT dose for neuroblastoma
21.6/1.8, cone down to 36 to residual tumor + 1cm
66
What volume gets RT in neuroblastoma
post-chemo, presurgery + 2 cm
67
cord compression dose for neuroblastoma
9 Gy/1.8, 21.6 Gy/1.8 if Age>3
68
Germinomatous GCT management
24 Gy WVRT then 45 Gy IFRT
69
NGGCT management
carb/etop + I/E then surgery then CSI 36 Gy then IFRT 54
70
Management of Myxo ependymoma
GTR then observe, lRT only for STR
71
management of calssic/anaplastic ependymoma
GTR then 50.4 Gy IFRT.
72
When do you give CSI for ependymoma
if CSF+
73
Which wilms do not need flank rt
Stage I and II favorable histology

Constraints (10 decks)

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