Treatment of neoplasm

Question 1

independent radiotherapy

Answer 1

H&N, cervical, esophagus, prostate, urinary bladder, skin

Question 2

radiotherapy as a part of combined therapy

Answer 2

Breast, rectum, anus, lung, brain, endometrium, thyroid.

Question 3

palliative vs radical radiotherapy

Answer 3

palliative: shorter treatment time 1-2 d, high fractional dose but lower total dose compared with radical (treatment time: 4-7 w.

Question 4

targeted therapy

Answer 4

monocolonal AB, cytokines (IL2 and IFN a) growth factors, vaccines, gene therapy.

Question 5

in what cancer can you do cytoreductve surgeries (debulking):

Answer 5

ovarian, rectal, parotid, soft tissue sarcoma.

Question 6

advantages of megavolt radiotherapy

Answer 6

higher dose in body depth, skin saving, reduction of the radiation beam, limited number of entry fields.

Question 7

type of chemotherapies

Answer 7

Alkylating: cyclophsphamid, cisplatin, carboplatin
antimetabolic: act as false substate incorporated into DNA –> stop DNA elongation. metotrexate and 5FU (capecitabine)
antineoplastic AB
antracyclines: topoisomerase inhibitors
mitotic poisons.: vincristine

Question 8

toxicity of chemo

Answer 8

Mucositis

pancytpoenia: anemia (100 d) neutropenia (7-10 d) thrombocytopenia (2-3 w)

Question 9

tissue dependent sensitvity to radiotherapy

Answer 9

high: testes, ovary, eye, lung kidney, thyroid, : due to high rate of cell division
low: muscle, bone + cartilage, brain and SC: low rate of division.

Question 10

what happens if you exceed the tolerance dose for radiation?

Answer 10

Necrosis and loss of function

Question 11

beam energy in radiotherapy. which reaches deepest?

Answer 11

Deppest: protons > x-photones > electrons

Question 12

systemic SE of radiotherapy

Answer 12

Fatigue, cytopenia

Question 13

chemo used in chemoradiaton

Answer 13

5.FU, capacytabine, cisplatin/carboplatin, temozolamide, gemzytabine

Question 14

SE of radiation in lung tissue

Answer 14

inflammatory reaction:radiation pneumonitis: dyspnea, non-productive cough, chest-thightness. may occur 6 w after therapy. Tx: Steroid + AB. CXR: hazy in treated areas.
chronic: pulm fibrosis

Question 15

SE of radiation in heart tissue

Answer 15

loss of systolic and diastolic function. probable after lung cancer radical, breast cancer adjuvant, esophageal (radical). Lymphoma (consolidating)

Question 16

SE of radiation in upper GI mucosa:

Answer 16

submucosal inflm: swelling, pain, infection, dryness, dysphagia.