4th Year Radiotherapy Flashcards
4R’s
repair
repopulation
re-assortment
re-oxygenation
early side effects
tiredness skin reaction (erythema/desquamation) mucositis (dental check before therapy) N&V diarrhoea dysphagia cystitis
late side effects
spinal cord myelopathy brachial plexopathy pneumonitis benign strictures fistulae erectile dysfunction panhypopituitarism secondary cancers skin fibrosis infertility
methods of delivery
external beam radiotherapy (EBRT)
stereotactic radiotherapy
brachytherapy
radioisotope therapy
what does brachytherapy procedure need?
GA
invasive
what is radioisotope therapy?
tumour-seeking radionuclides to target specific tissues
what is the unit used to prescribe radiotherapy?
grays
how many grays is a joule?
1Gy = 1joule/kg
how many joules are deposited per kg?
1
what is hypofractionation?
> 2Gy per fraction
what is hyperfractionation?
<1.8Gy per fraction
standard radiotherapy dosing
18Gy x 3 fractions
conservative radiotherapy dosing
12Gy x 5 fractions or 11Gy x 5 fractions
very conservative radiotherapy dosing
5-6Gy x 8-10 fractions
how to assess a patient’s level of fitness?
performance status
performance status 0-1
fit for radical treatment
performance status 0-2
fit for chemotherapy (palliative or radical)
scoring system used for performance status
ECOG/ WHO PS
score of 0
fully active
no restrictions on activities
score of 1
unable to do strenuous activities but able to carry out light housework and sedentary activities
score of 2
able to walk and manage self-care, but unable to work
out of bed >50% waking hours
score of 3
confined to bed or chair >50% waking hours
capable of limited self-cares
score of 4
completely disabled
totally confined to bed or chair
unable to do any self care
score of 5
death
other performance status scales
Karnofsky scale
zubrod scale
