Radiotherapy and Chemotherapy of Gynaecological Cancers Flashcards Preview

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Flashcards in Radiotherapy and Chemotherapy of Gynaecological Cancers Deck (27):
1

What is the BEAT acronym?

B-bloating that is persistent and doesn't come and go
E- eating less and feeling fuller
A- abdominal pain
T- tell your GP

2

What should all women with non-mucinous ovarian or fallopian tube cancer be offered?

BRCA1 and BRCA2 mutation testing

3

What should women with ovarian cancer who have FHx of breast, ovarian or colon cancer have?

Genetic risk assessment

4

What should women with genetic mutations of BRCA1 and 2 genes be offered?

Prophylactic oophorectomy and removal of fallopian tubes at a relevant time of their life

5

In the RMI score, what US features constitute a score?

Multilocular cyst
Solid areas
Bilateral lesions
Ascites
Intra-abdominal mets

6

In the RMI score, how is the US section scored?

0=No abnormalities
1= One abnormality
2= Two or more abnormalities

7

In the menopausal section of the RMI, how is it scored?

Premenopausal=1
Postmenopausal=3

8

What RMI score constitutes referral?

>200

9

What are the patterns of ovarian cancer spread?

Transcoelomic spread/peritoneal seeding within pelvis-> abdo cavity
Haematogenous spread- late and rare
Brain mets <2%

10

What may be appropriate in selected patients with relapsed epithelial ovarian cancer which is platinum sensitive?

2' cytoreductive surgery- aim to completely resect all macroscopic disease

11

What response rate does ovarian cancer have to chemo?

60-70%
Carboplatin/paclitaxel
Relapse rates high

12

What chemo is used at initial presentation?

Platinum/paclitaxel

13

What chemo is used in the relapse stage?

Caelyx
Plat/pac
Topotecan

14

What chemo is used palliatively?

Carboplatin
Paclitaxel
Etoposide
Caelyx
Topotecan
Gemcitabine
Chlorambucil

15

What should all women with high grade early stage ovarian cancer be considered for?

Adjuvant chemo

16

Patients who are unfit for combination (chemo)therapy should be offered what?

Single agent carboplatin

17

Can a third cytotoxic agent be added to carboplatin and paclitaxel?

No

18

What should women with platinum-sensitive relapsed ovarian cancer be treated with?

Platinum based combination with paclitaxel, PLDH or gemcitabine

19

What can hormonal therapy with tamoxifen or an aromatase inhibitor be used for?

Women with recurrent, platinum-resistant, ovarian cancer or in those wishing to avoid or delay further chemotherapy, particularly where their original tumour is expressing the oestrogen receptor

20

What should patients with low-grade serous, clear cell and mucinous histological subtypes be considered for?

Chemotherapy clinical trials

21

What are some factors in the aetiology of cervical cancer?

HPV
Smoking
Age of onset of intercourse
'High risk' male
OCP
Multiple partners

22

How is cervical cancer staged?

Stage 1a – microscopic
Stage 1b visible lesion
Stage 2 a – vaginal involvement
2b parametrial involvement
Stage 3 lower vagina or pelvic sidewall
Stage 4 bladder/rectum or metastases

23

What are some treatments for cervical cancer?

Surgery-LLETZ, Fertility Sparing, Wertheim
Radiotherapy
Chemotherapy

24

Describe radiotherapy in cervical cancer

High energy x-rays
Targeted to include tumour +-nodes
External bream
Brachytherapy

25

What chemo drugs can be used in cervical cancer treatment?

Cisplatin- 40mg/m2 weekly
Carboplatin/paclitaxol

26

What is brachytherapy?

Radioactive seeds or sources are placed in or near the tumor itself, giving a high radiation dose to the tumor while reducing the radiation exposure in the surrounding healthy tissues.

27

How is endometrial cancer treated?

TAH BSO Washings
Debate over lymphadenectomy
Adjuvant radiotherapy- vault brachytherapy, external bream
Adjuvant chemo- depending on grade