Radiation overview

Question 1

What are the three most common cancers in men?

Answer 1

prostate
lung and bronchus
colon/bladder

Question 2

What are the three most common cancers in women?

Answer 2

breast
lung
colorectal

Question 3

What are the four most common causes of death d/t CA in men?

Answer 3

Lung
prostate
Colorectal
Pancreas

Question 4

What are the four most common causes of death d/t CA in women?

Answer 4

lung
breast
colorectal
pancreas
ovary

Question 5

What are the four basic patterns of spread?

Answer 5

Local growth
local extension
lymph node mets
Hematogenous mets

Question 6

Anyone who has M stage (__) or higher has what***

Question 7

What are the four modalities of medical therapy treatment for CA?

Answer 7

chemo
hormone
biological
vaccine

Question 8

What is the role of radiation?

Answer 8

Replace or complement surgery

Question 9

What CAs are exclusively treated with radiation?

Answer 9

anal cancer
small cell lung (mostly)
Stage IIIB NSCLC

Question 10

small cell lung cancers are found exclusively in whom?

Answer 10

those who smoke

Question 11

What is the role of radiation in esophageal CA?

Answer 11

ok to treat without surgery

Question 12

What is the role of radiation in breast cancer?

Answer 12

removes margins after surgery

Question 13

What is the role of radiation in skin cancer?

Answer 13

After surgery adjuvant

Question 14

What is the role of radiation in prostate cancer?

Answer 14

adjuvant to surgery

Question 15

What is the role of radiation in uterine/endometrial cancer?

Answer 15

adjuvant

Question 16

Dose of radiation is measured in what?

Answer 16

gray

Question 17

What is the most common timing of radiation dosing?

Answer 17

Daily over multiple weeks

Question 18

Why are small doses over a long period of time needed to treat CA?

Answer 18

Kill tumors, and not normal cells

Question 19

What is radiosensitive?

Answer 19

Tumor “melts” with radiation

Question 20

What is radio responsive?

Answer 20

melts quickly

Question 21

What is brachytherapy?

Answer 21

beads that radiate small halos of radiation

Question 22

What is the linear accelerator used in radiation therapy?

Answer 22

machine that emits photons and particles

Question 23

Why is linear accelerators used for kids?

Answer 23

no leftover radiation

Question 24

What is the MOA of radiation in treating tumors?

Answer 24

double stranded breaks in the tumors

Question 25

What is the wanted relationships between tumor control probability and normal tissue complication probability?

Answer 25

very wide difference

Question 26

What is the relationship between radiation dose and cell kill?

Answer 26

Non-linear, but negative trend

Question 27

What is the relationship between oxygen and radiation effectiveness?

Answer 27

More oxygen = more kill | thus need multiple doses to get to hypoxic center

Question 28

What is hyperfractionation?

Answer 28

very small doses of radiation x2/day

Question 29

What is the dosage for standard fractionation?

Answer 29

180-200 cGy /day

Question 30

What is hypofractionation?

Answer 30

Massive dose of radiation to tumors (melanoma)

Question 31

What is the "long shoulder" of CA?

Answer 31

Little effect until high doses of radiation

Question 32

What cancer is cured with radiation?

Answer 32

prostate CA

Question 33

What cancer have a neoadjuvant therapy with radiation?

Answer 33

esophageal CA

Question 34

What cancer has radiation as an adjuvant therapy?

Answer 34

breast CA

Question 35

Palliative treatment with radiation is used with what CAs?

Answer 35

brain mets causing neurological symptoms

Question 36

What is the simulation part of the TP process?

Answer 36

see if pt will tolerate the restraints needed to treat CA

Question 37

What is the treatment planning part of TP process?

Answer 37

angle beam correctly

Question 38

What are the 5 levels of radiation treatments?

Answer 38

1. non planned 2. 2d 3. 3d 4. IMRT 5. SRS/SBRT

Question 39

What is 3D-CRT?

Answer 39

Designs the treatment fields so that the angle of the treatment treats the tumor and avoids normal structures as much as possible

Question 40

What is IMRT?

Answer 40

like 3D-CRT but different portions of the treatment get different doses of the radiation via very small radiation "shots"

Question 41

What is cranial stereotactic radiosurgery?

Answer 41

Using super small doses in the brain

Question 42

What is gross tumor volume?

Answer 42

Gross demonstrable extent of the tumor

Question 43

What is the CTV?

Answer 43

Margi on GTV that accounts for disease spread

Question 44

What is ITV?

Answer 44

CTV + internal margin for physiological movements

Question 45

What is PTV?

Answer 45

CTV or ITV + setup margin for pt movement

Question 46

What is OAR?

Answer 46

organ at risk/critical structure

Question 47

What is the fusion bit for planning?

Answer 47

Taking different imaging modalities to label out the tumor

Question 48

True or false: photons are "skin sparing"

Answer 48

True

Question 49

Which are most effective at deep tissue tumors: photons or electrons

Answer 49

Photons

Question 50

What is a multileaf collimator?

Answer 50

lead block to focus radiation

Question 51

What is image guided radiation therapy?

Answer 51

Using imaging with implanted markers to target tumors that move physiologically to align tumors

Question 52

What is cone beam IGRT?

Answer 52

CT scan on each visit, to allow for comparison of soft tissue anatomy