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RT 411 Final Flashcards

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1
Q

Over the past 50 years, the incidence of lung cancer in women has:

A

Increased

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2
Q

What is the estimated number of lung cancer cases diagnosed each year?

A

224,000

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3
Q

Aside from smoking, what are risk factors associated with lung cancer?

A

Chemical exposure (Radon), work environment, secondary smoke exposure

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4
Q

What is the histology of lung cancer linked to smoking?

A

Squamous Cell

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5
Q

List 4 tests that would beneficial for lung cancer staging

A

Chest x Ray, brain MRI, pleural tap, core biopsy

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6
Q

what are common signs and symptoms of lung cancer?

A

Dyspnea, hemoptysis, chest pain

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7
Q

Why might lung cancer cause hoarseness?

A

Tumor pressing on the left recurrent laryngeal nerve

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8
Q

what are the subtypes of NSCLC

A

Squamous cell, adenocarcinoma, and large cell

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9
Q

What are rumors located in the apex of the lung called?

A

Pancoast tumor or a superior sulcus

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10
Q

What is true about small cell lung cancer?

A

Likely to spread to the brain and commonly found in the central lung region

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11
Q

Common sites for lung Mets

A

Brain, adrenal and liver

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12
Q

When local extension occurs, lung cancer tumors can be seen in:

A

Parts of the lungs and ribs

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13
Q

Surgical resection is likely to be the treatment of choice for which operable lung tumor?

A

Squamous cell carcinoma

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14
Q

Why is it important to evaluate the dvh for lung cancer?

A

Help minimize normal tissue complications, see the percentage of dose the volume of OAR receives, the data can suggest when to spare normal tissue so it doesn’t exceed dose limit and will allow the doctor to predict the endpoint to surrounding organs

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15
Q

What tumor marker is used to aid in the diagnosis of testicular cancer?

A

AFP

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16
Q

For carcinomas if the bladder, how is the initial tissue diagnosis made made

A

Cystoscopy

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17
Q

Most common histology for testicular cancer

A

Germ cell

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18
Q

Most common histology of bladder cancer

A

Transitional cell

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19
Q

Bladder cancer spread via direct extension into the

A

Bladder wall

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20
Q

What lymph nodes are most likely to be treated for testicular cancer?

A

Para aortic

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21
Q

What are the common sites for spread of bladder cancer?

A

Lung and bone

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22
Q

Which lymph node chains are most common for drainage of bladder cancer?

A

External and internal iliac, pre sacral

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23
Q

What is the primary treatment modality for bladder cancer?

A

Surgery

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24
Q

Standard of care for for the first line of treatment for testicular cancer is

A

Orchiectomy

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25
The loader is boosted to what dose in a curative setting?
65 Gy
26
A stage 1 seminoma has a 5 yr survival of
97%
27
What is a common acute toxicity for RT for seminoma?
Kidney failure
28
What disease is renal cancer associated with?
Von hipple-Lindau disease
29
What are the risk factors for breast cancer?
Early menarche, nulliparous, previous radiation to the chest
30
What is the difference between in situ and invasive breast cance?
In situ has not broken through the basement membrane
31
What is the most common breast cancer histology?
Infiltrating ductals carcinoma
32
A mass located in the lower inner quadrant of the breast drains to which lymph nodes?
Internal mammary lymph nodes
33
Describe the location of the level 1-3 axillary lymph nodes
I-III move from the axillary top toward the clavicle with I being in/around the axilla, just inferior to the pectoralis muscle and level III being most superior and on the pectoralis muscle
34
what are the most common metastatic sites for breast cancer?
Bone, lung, brain
35
What is used if Her2Neu is amplified
Herceptin
36
What is the primary treatment for breast cancer?
Mastectomy or lumpectomy+RT
37
What treatment modalities are used for the management of breast cancer?
Hormonal treatment, chemo, surgery
38
What treatment modalities are used for the management of breast cancer?
Hormonal treatment, chemo, surgery
39
At what approx. dose would an electron boost be prescribed for?
10-15 Gy
40
What are the borders for a breast tangent field?
2 cm sup and inf of breast tissue, medially to the sternum and laterally to the axilla line or 2cm past breast tissue
41
What is the total dose delivered to a whole breast without a boost?
45-50 Gy
42
What field is used to increase the dose to the level III axillary nodes?
PAB, posterior axillary boost
43
What is the benefit of using a wedge when treating tangential breast?
avoid hot spots
44
When are electrons used for breast treatments?
Scar boost, IMC fields
45
At what dose is dry desquamation most likely to occur?
30-40 Gy
46
In which ethnicity is there a high prevalence of nasopharyngeal cancer?
Chinese
47
In which ethnicity is there a high prevalence of nasopharyngeal cancer?
Chinese
48
What virus is associated with nasopharynx cancer?
EBV
49
What is used for the detection/diagnosis of H and N cancer?
Laryngoscopy, H&P, swallow study
50
Level I lymphatic chain
Sub mental
51
Level II lymphatic chain
Sub mandibular
52
Level III lymphatic chain
Mid cervical
53
Level V lymphatic chain
Posterior cervical
54
Level VII lymphatic chain
Lymphatic around the SSN
55
Level VII lymphatic chain
Lymphatic around the SSN
56
What is the primary tumor location that would drain to the jugulodigastric node?
Most common lymph node in head and neck cancer
57
What is the primary tumor location that would drain to the retropharyngeal node?
nasopharyngeal
58
What is the primary tumor location that would drain to the submental node?
tip of tongue
59
What is the primary tumor location that would drain to the submental node?
tip of tongue
60
What structures are removed in a radical neck dissection
Salivary glands, lymph nodes, sternocleidomastoid muscle
61
What is a treatment option for advanced head and neck tumors?
Treated with surgery followed by concurrent chemoradiation
62
What is a treatment option for early head and neck tumors?
surgery or radiation alone
63
What is the most important prognostic factor in had and neck cancers?
involvement of nodes
64
Osteoradionecrosis
Treating through the mandible and weakening it so it is more likely to break
65
What dose erythema occur?
20-30 Gy
66
what dose does skin necrosis start?
>60 Gy
67
what dose does temporary alopecia start?
20 Gy
68
what dose does permanent alopecia start?
43 Gy
69
what dose do most mouth changes occur and which one is different
20- 30 Gy except laryngitis which starts at 40 Gy
70
what dose does nausea and vomiting start?
10-20 Gy
71
what dose does diarrhea start?
20-50 Gy
72
what dose does cystitis start?
30-40 Gy
73
Normal WBC
5,000 - 10,000
74
Platelets
200,000 - 500,000
75
Hemoglobin
12-16
76
Hematocrit
36-54%
77
About how many new cases of primary CNS are diagnosed each year?
23,000
78
Most adult brain tumors are located in the
cerebrum
79
Risk factors for brain tumor
p53 mutation, chemical exposure
80
Intracranial pressure (ICP) symptoms of CNS tumors
Headaches, visual changes, nausea
81
Focal symptoms of CNS tumors
Seizures, imbalance, weakness, speech problems
82
What modality is best for brain and spinal tissue?
MRI
83
What is another name for GBM?
High grade astrocytoma
84
Histology for brain tumors
GBM, medulloblastoma, meningioma
85
What are the lymphatics of the brain?
none
86
How do brain tumors typical spread?
Local invasion, CSF
87
Craniospinal fields must include
all tissue bathed in CSF
88
If you need to treat the spine with 2 fields it is preferred to match at or below what vertebral body?
L2
89
Prognostic factors for primary brain tumors
Age and KPS
90
Order GYN malignancies in order from most common to least common
Endometrial, ovarian, cervical, vaginal
91
colposcopy
procedure to closely examine the cervix, vagina and vulva for signs of disease
92
CA 125 is a tumor marker for
Ovarian and endometrial/uterine
93
what is D&C
Dilation and curettage - remove tissue from inside of the uterus for diagnostic purposes
94
what staging is used for GYN cancers?
FIGO
95
Most epithelial cells are of what cell origin?
Epithelial
96
ovarian cancer seeds in the ___ cavity
peritoneal
97
What chemotherapy is used concurrently with cervical cancer treatment?
Platinum based chemo
98
What type of brachytherapy applicator is used for treatment of vaginal cancer?
cylinder

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