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brachy Flashcards

1
Q

activity is measured in

A

Ci

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2
Q

which isotope has the longest hallf life

A

Ra-226 1622 yrs

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3
Q

beta emitting isotopes

A

SR90, y90, p32

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4
Q

photon emitting isotopes

A

ra236, co 60, cs137, ir192, au198, i125,pd103

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5
Q

permanent brachy applications

A

seed prostate brachy

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6
Q

temporary brachy usually uses ____ system

A

afterloading system

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7
Q

permanent brachy usually uses ____ system

A

manual loading system

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8
Q

afterloading vs remote afterloading

A

in remote afterloading the tx plan is already made and the source is housed in tx unit that sends source into applicator based on predetermined tx plan
in afterloading the applicators are first put into the pt and then the tx plan is determined

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9
Q

LDR dose ate

A

<2gy/hr

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10
Q

MDR dose rat

A

2-12gy/hr

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11
Q

HDR dose rate

A

> 12gy/hr

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12
Q

interstitial brachy

A

placement of source directly into the tumour of tumour bed

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13
Q

interstitial brachy is usedc in what sits

A

breast, prostate, sacoma, neck

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14
Q

intracavitiary brachy used for what site

A

mainstay of cervix

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15
Q

intracavitiary brachy definiion

A

implants are placed in th body cavity

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16
Q

intraluminal brachy definition

A

placement of applicator inside a tube (lumen of the body)

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17
Q

what sites usw intraluminal brachy

A

esophagus, trachea, bronchus

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18
Q

uses surface brachy

A

nonmelanoma, hard palate, oral cavity, nasal cavity

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19
Q

exposure is measured in units of …..

A

roegnten

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20
Q

area 17cm what fraction of peripheral activity

A

2/3

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21
Q

area 49cm what is the fraction of peripheral activity

A

1/2

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22
Q

area of 109cm what is the fraction of peripheral activity

A

1/3

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23
Q

manchester system

A

described implant dose distribution rules
area <25 cm 2/3 of peripheral activity
area 25-100cm 1/2 of peripheral activiy
area >100cm 1/3 peripheral activity

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24
Q

what sources are used for permanent implants

A

aU198, Pd103, I125, cs131

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25
____this catheter allows RO to make adjustments on the fly when doing LDR PROS brachy
mICK APPLICATOR
26
What imaging is considered best in confirming HDR brachy in prostate cancer
MRI is best if available at the clinic as it has btterb soft tisue delineation
27
what gyne applicators come in different shapes and sizes to accomodate different patient anatomies
tandem and ovoids come in different shapes and sizes to accomodate pt anatomy
28
qwhat is point a
point a is 2cm sup to the top of ovoids along the tandem and 2cm lat to tandem in plane of applicator
29
what is point b
2 cm sup to top of ovoids and 5 cm lat to patient Ml
30
what does point b represent in pt anatomy
the parametrial LN
31
what does point a represent in pt anatomy
the part where uterine arteries and uterus intersect
32
where is dose prescribed in vaginal cylinder applicators
5mm from pt surface
33
what stage are brachy treatments typically used for
stage 1-2 small lesions (ex <4cm) or for palliation not for large tumours
34
what is the purpose of packing with gauze after a gyne implant placement
moves the rectum out of the field | makes the implant more stable
35
spacing of sources for small tx volumes
8mm
36
spacing of sources for lg tx volumes
2cmq
37
1/2 life in general for permanent implants
should have 1/2 life of a few days
38
1/2 life in general for temporary implants
should have 1/2 life of few weeks for temporary impants
39
manual afterloading applications
I needles placed in eye and prostate needles/ seeds
40
rules for volume implants for a cylinder
mid part of the rind: 4 pts core: 2 parts each end 1 part
41
rules for volume implants for a sphere
shell: 6 parts core: 2 parts
42
rules for volume implants for cuboid
each side: 1 part core: 2 parts each end: 1 part
43
when is brachy given after surgery for cervical cancer
>1LN+ LVSI close or + margins after Sx
44
when is brachy given after surgery for endometrial cancer
grade 3 stage 1b stage 2
45
what prep is required for HDR gyne brachy
nothing treatment is completed in few mins
46
what is prep required for LDR gyne brachy
codeine for constipation
47
tx length for vaginal cylinder
typically 5 cm
48
where is dose delivered in ovoids and rings
dose is delivered to upper 1-2cm of vagina
49
what applicator is done when a deep and high vaginal vault dose is required
tandem and ovoids
50
what is the best applicator used for endometrial brachy after hysterectomy
vaginal cylinder
51
is gyne brachy treated will full or empty bladder
100 ml is in the bladder (full bladder) to move small bowel out of field
52
gyne dose post hysterectomy LDR when in combination with EBRT
45-50/25 EBRT then LDR of 15Gy at .5gy/hr
53
gyne dose post hysterectomy HDR when in combination with EBRT
11Gy/2fx
54
brachy alone post hysterctomy LDR/PDR dose
45-50Gy
55
brachy alone post hysterctomy HDR dose
22/4 or 21/3
56
dose tolerance for rectum ingyne brahcy
70-75gy
57
dose tolerance for bladder in gyne brachy
90gy
58
dose tolerance for sigmoid bowel for gyne brachy
70-75gy
59
dose tolerance for small bowel for gyne brachy
66Gy
60
indications for brachy with intact endometrium
localized tumours when pt is unfit for surgery | inoperable tumours extending past the uterus in combo with EBRT
61
applicators for bulky ndometrial tu,ours
rotte y and heymens capsules
62
when is brachy alone done for endometrial cancer
stage 1 medically unfit pts
63
dose for XRT alone endometrium ldr and HDR
LDR- 75-80Gy to pt A | HDR- 36-42/6 to pt A
64
Indications of LDR brahcy in prostate patients
alone in mid risk pts w t1-2 disease | in combo with EBRT for mid and high risk pts
65
indications of HDR brachy in prostate pts
used in combo with EBRT for mid and high risk pts
66
contraindications to prostate brachy
``` inability to go under anesthesia TURP of the prostate within the last year urinary outflow problems <15ml/s gland size >60ml pubic arch interfernce ```
67
typical margins for brachy
2-3mm
68
what is the most common side effect from prosate brachy
urethritis which lasts 2-3wks
69
40-60% of implanted prostate volume will get what dose
an extra 50% of the Rx dose therefore around 220gy
70
20% ofimplanted prostate volum will get wht dose
will receive 200% of dose therefore 290Gy
71
for larger prostate volume will HDR r LDR be used
HDR can cover larger volume than LDR
72
HDR use in porstate brachy
used as boost after 45/25
73
dose for prostate brachy
6Gy x3 8.5Gy x 2 11 gy x 2 15Gy x 2
74
LDR vagina dose
60gy at .5 Gy/ hr
75
LDR vagins dose for boost
20-25Gy at .5gy/hr
76
HDR brachy dose aas sole tx for vagina
30-36Gy/ 5-6 fx
77
HDR brachy dose as boost for vagina
16.5Gy/3
78
indications brachy vagina
alone or in combination with external beam treatment for stage I tumours; as a boost after external beam treatment for stage II and III tumours; as a palliative local treatment for stage IV and recurrent tumours.
79
indiations brachy vulva
as primary treatment for small T1 tumours; as a boost after external beam treatment for more locally advanced tumours; as a palliative treatment for locally advanced or recurrent tumours.
80
what applicators done for barrel shaped cervix
tandem and ovoids
81
tandem and cylinder is better for
superficial disease involving lower vagina <5mm thick
82
what applicator is use for larg bulky tumours of cervix
tandem and ring ovoids with short interstitial needles
83
what is used for lg lesions suboptimally fitting applicator or gross disease inv sidewall or lower vag inv z>5mm thick
interstitial brachy

Skin Radiation therapy (40 decks)

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