Treatment Options: Radiation Therapy

Question 1

for EBRT radiation is delivered from a ____inside/outside_____ source

Answer 1

outside

Question 2

LINACs deliver ___ MV or higher

Answer 2

1 MV

Question 3

cobalt-60, protons, orthovoltage are all types of ____ radiation

Answer 3

external
other types of EBRT –> photons/xrays, electrons, protons, gamma rays

Question 4

overall radiation kills or damages _____ of cancer/tumor cells

Answer 4

DNA

Question 5

overall radiation kills or damages DNA of cancer/tumor cells, which does what?

Answer 5

slows or stops their growth and ultimately stops the cell(s) from dividing

Question 6

T/F: radiation therapy has BETTER cosmetic outcomes than other modalities, like surgery

Answer 6

TRUE

Question 7

T/F: radiation therapy preserves the organ better than other modalities, like surgery

Answer 7

TRUE

Question 8

define Therapeutic Ratio

Answer 8

it is the ratio between normal tissue tolerance over tumor lethal dose

Question 9

Brachytherapy = ___short/long___ distance therapy

Answer 9

short

Question 10

what is the modality called when the source is placed in or near tumor

Answer 10

brachytherapy

Question 11

Brachytherapy can be in form of _____, _____, _____, or ____ to insert into patient

Answer 11

wires, seeds, molds, or rods

Question 12

________ sustains surrounding normal healthy tissue because low energies are used w/ their rapid fall off

Answer 12

brachytherapy

Question 13

T/F: Brachytherapy can be used with EBRT to provide better control

Answer 13

TRUE

Question 14

if Brachytherapy is used with EBRT, what is considered the boost?

Answer 14

Brachytherapy

Question 15

_____ = a way to deliver a higher dose of radiation to a more concentrated area

Answer 15

boost

Question 16

the following are examples of _______:
– Cesium 137
– Iridium 192
– Palladium 103
– Iodine 125

Answer 16

brachytherapy

Question 17

the following are methods of ______ application:
– external applicators
– intracavitary
– interstitial implants

Answer 17

brachytherapy

Question 18

T/F: patients receiving brachy must be in a fully shielded room, w/ similar requirements as a trt room would have, including door interlocks, emergency buttons, and audio visual monitors

Answer 18

TRUE

Question 19

for HDR or LDR, the patient is treated as an outpatient and can go home once the source is removed

Answer 19

HDR

Question 20

for LDR or HDR, the source stays in the patient for longer periods

Answer 20

LDR

Question 21

for LDR or HDR, the source stays in patient for shorter periods of time

Answer 21

HDR

Question 22

for LDR or HDR, source stays in patient for 1-6 days (24-144 hrs)

Answer 22

LDR

Question 23

for LDR or HDR, source stays in patient for 10-20 minutes TOTAL and removed immediately after

Answer 23

HDR

Question 24

for __LDR/HDR__ the patient remains in hospital w/ proper shielding

Answer 24

LDR

Question 25

for __LDR/HDR__ it is delivered in fractionated schedules and can vary from twice a day for several days, to, once a week for several weeks

Answer 25

HDR

Question 26

with what implants do the sources remain in patient for life?

Answer 26

permanent implants

Question 27

T/F: the strength of permanent implants lessens daily

Answer 27

TRUE

Question 28

T/F: eventually it will be safe for permanent implant patients to be around people, however they should limit their time around kids and pregnant people

Answer 28

TRUE

Question 29

what allows for remote handling of radioactive sources, reduces dose to personnel, used for LDR and HDR treatments

Answer 29

a Remote Afterloader

Question 30

describe the sequence of events for using a Brachytherapy Afterloader -

Answer 30

1. applicators w/o any radioactive sources are placed w/i patient 2. position of applicators are tested w/ CT imaging everyday prior to treatment using dummy seeds or wires 3. once position is confirmed, patient is then connected to the afterloader 4. once safe, and all personnel has left the room the radioactive source will come out of the afterloader using a remote system and will enter into patient through seeds or wires

Question 31

T/F: the afterloader itself is shielded

Answer 31

TRUE

Question 32

the ___ is used in cases of HDR emergencies, if the source gets stuck in the patient

Answer 32

pig

Question 33

most common source used with Afterloaders is what?

Answer 33

Ir-192 (Iridium-192)

Question 34

helpful hint - you'll know it's a brachytherapy when the isodose lines are __around/far away___ from source

Answer 34

around - close to source.. since brachytherapy is very short distance therapy

Question 35

the following is describing Curative, Palliative, Prophylactic, or Emergency Radiation Therapy -- *controls symptoms associated with cancer; typically delivered at 300 cGy x 10 fx

Answer 35

palliative

Question 36

the following is describing Curative, Palliative, Prophylactic, or Emergency Radiation Therapy -- *prevents spread of cancer for known patterns/high risk

Answer 36

prophylactic

Question 37

the following is describing Curative, Palliative, Prophylactic, or Emergency Radiation Therapy -- *shrinks tumor to reduce pain, bleeding, obstruction, or compression

Answer 37

emergency

Question 38

the following is describing Curative, Palliative, Prophylactic, or Emergency Radiation Therapy -- *tumor can be destroyed w/o harming healthy tissue

Answer 38

curative

Question 39

what is our perfect scenario for radiation therapy? "___radioresistant/radiosensitive___ tumor surrounded by ___radioresistant/radiosensitive___ tissue"

Answer 39

Radiosensitive tumor surrounded by Radioresistant tissues

Question 40

what cancer typically spreads/metastasizes to the brain? And how do we treat it?

Answer 40

small cell lung cancer - PCI radiation to the brain to prevent or delay spread

Question 41

what does PCI stand for?

Answer 41

Prophylactic Brain Irradiation

Question 42

SVC stands for what?

Answer 42

Superior Vena Cava

Question 43

the following are examples of Curative, Palliative, Prophylactic, or Emergency Radiation Therapy? -SVC, emergent GYN, spinal cord compressions

Answer 43

emergency radiation therapy

Question 44

the following describes what type of treatment - Definitive, Concurrent, Sequential, Neo-Adjuvant, Adjuvant, or Salvage *2 trt modalities occur at SAME time; ex. chemo & RT

Answer 44

concurrent

Question 45

the following describes what type of treatment - Definitive, Concurrent, Sequential, Neo-Adjuvant, Adjuvant, or Salvage *1 trt modality follows another

Answer 45

sequential

Question 46

the following describes what type of treatment - Definitive, Concurrent, Sequential, Neo-Adjuvant, Adjuvant, or Salvage *radiation is primary trt modality

Answer 46

definitive

Question 47

the following describes what type of treatment - Definitive, Concurrent, Sequential, Neo-Adjuvant, Adjuvant, or Salvage *radiation is delivered BEFORE another modality like surgery, typically to shrink tumor

Answer 47

neo-adjuvant (neo = 1st in matrix)

Question 48

the following describes what type of treatment - Definitive, Concurrent, Sequential, Neo-Adjuvant, Adjuvant, or Salvage *radiation delivered AFTER primary treatment modality; to treat microscopic diseases

Answer 48

adjuvant (add in RT)

Question 49

the following describes what type of treatment - Definitive, Concurrent, Sequential, Neo-Adjuvant, Adjuvant, or Salvage *radiation is delivered after primary treatment techniques have failed

Answer 49

salvage (salvage what you can)