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Skin Radiation therapy > brachy > Flashcards

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
Q

____this catheter allows RO to make adjustments on the fly when doing LDR PROS brachy

A

mICK APPLICATOR

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26
Q

What imaging is considered best in confirming HDR brachy in prostate cancer

A

MRI is best if available at the clinic as it has btterb soft tisue delineation

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27
Q

what gyne applicators come in different shapes and sizes to accomodate different patient anatomies

A

tandem and ovoids come in different shapes and sizes to accomodate pt anatomy

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28
Q

qwhat is point a

A

point a is 2cm sup to the top of ovoids along the tandem and 2cm lat to tandem in plane of applicator

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29
Q

what is point b

A

2 cm sup to top of ovoids and 5 cm lat to patient Ml

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30
Q

what does point b represent in pt anatomy

A

the parametrial LN

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31
Q

what does point a represent in pt anatomy

A

the part where uterine arteries and uterus intersect

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32
Q

where is dose prescribed in vaginal cylinder applicators

A

5mm from pt surface

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33
Q

what stage are brachy treatments typically used for

A

stage 1-2 small lesions (ex <4cm) or for palliation not for large tumours

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34
Q

what is the purpose of packing with gauze after a gyne implant placement

A

moves the rectum out of the field

makes the implant more stable

35
Q

spacing of sources for small tx volumes

A

8mm

36
Q

spacing of sources for lg tx volumes

A

2cmq

37
Q

1/2 life in general for permanent implants

A

should have 1/2 life of a few days

38
Q

1/2 life in general for temporary implants

A

should have 1/2 life of few weeks for temporary impants

39
Q

manual afterloading applications

A

I needles placed in eye and prostate needles/ seeds

40
Q

rules for volume implants for a cylinder

A

mid part of the rind: 4 pts
core: 2 parts
each end 1 part

41
Q

rules for volume implants for a sphere

A

shell: 6 parts
core: 2 parts

42
Q

rules for volume implants for cuboid

A

each side: 1 part
core: 2 parts
each end: 1 part

43
Q

when is brachy given after surgery for cervical cancer

A

> 1LN+
LVSI
close or + margins after Sx

44
Q

when is brachy given after surgery for endometrial cancer

A

grade 3
stage 1b
stage 2

45
Q

what prep is required for HDR gyne brachy

A

nothing treatment is completed in few mins

46
Q

what is prep required for LDR gyne brachy

A

codeine for constipation

47
Q

tx length for vaginal cylinder

A

typically 5 cm

48
Q

where is dose delivered in ovoids and rings

A

dose is delivered to upper 1-2cm of vagina

49
Q

what applicator is done when a deep and high vaginal vault dose is required

A

tandem and ovoids

50
Q

what is the best applicator used for endometrial brachy after hysterectomy

A

vaginal cylinder

51
Q

is gyne brachy treated will full or empty bladder

A

100 ml is in the bladder (full bladder) to move small bowel out of field

52
Q

gyne dose post hysterectomy LDR when in combination with EBRT

A

45-50/25 EBRT then LDR of 15Gy at .5gy/hr

53
Q

gyne dose post hysterectomy HDR when in combination with EBRT

A

11Gy/2fx

54
Q

brachy alone post hysterctomy LDR/PDR dose

A

45-50Gy

55
Q

brachy alone post hysterctomy HDR dose

A

22/4 or 21/3

56
Q

dose tolerance for rectum ingyne brahcy

A

70-75gy

57
Q

dose tolerance for bladder in gyne brachy

A

90gy

58
Q

dose tolerance for sigmoid bowel for gyne brachy

A

70-75gy

59
Q

dose tolerance for small bowel for gyne brachy

A

66Gy

60
Q

indications for brachy with intact endometrium

A

localized tumours when pt is unfit for surgery

inoperable tumours extending past the uterus in combo with EBRT

61
Q

applicators for bulky ndometrial tu,ours

A

rotte y and heymens capsules

62
Q

when is brachy alone done for endometrial cancer

A

stage 1 medically unfit pts

63
Q

dose for XRT alone endometrium ldr and HDR

A

LDR- 75-80Gy to pt A

HDR- 36-42/6 to pt A

64
Q

Indications of LDR brahcy in prostate patients

A

alone in mid risk pts w t1-2 disease

in combo with EBRT for mid and high risk pts

65
Q

indications of HDR brachy in prostate pts

A

used in combo with EBRT for mid and high risk pts

66
Q

contraindications to prostate brachy

A 
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
Q

typical margins for brachy

A

2-3mm

68
Q

what is the most common side effect from prosate brachy

A

urethritis which lasts 2-3wks

69
Q

40-60% of implanted prostate volume will get what dose

A

an extra 50% of the Rx dose therefore around 220gy

70
Q

20% ofimplanted prostate volum will get wht dose

A

will receive 200% of dose therefore 290Gy

71
Q

for larger prostate volume will HDR r LDR be used

A

HDR can cover larger volume than LDR

72
Q

HDR use in porstate brachy

A

used as boost after 45/25

73
Q

dose for prostate brachy

A

6Gy x3
8.5Gy x 2
11 gy x 2
15Gy x 2

74
Q

LDR vagina dose

A

60gy at .5 Gy/ hr

75
Q

LDR vagins dose for boost

A

20-25Gy at .5gy/hr

76
Q

HDR brachy dose aas sole tx for vagina

A

30-36Gy/ 5-6 fx

77
Q

HDR brachy dose as boost for vagina

A

16.5Gy/3

78
Q

indications brachy vagina

A

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
Q

indiations brachy vulva

A

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
Q

what applicators done for barrel shaped cervix

A

tandem and ovoids

81
Q

tandem and cylinder is better for

A

superficial disease involving lower vagina <5mm thick

82
Q

what applicator is use for larg bulky tumours of cervix

A

tandem and ring ovoids with short interstitial needles

83
Q

what is used for lg lesions suboptimally fitting applicator or gross disease inv sidewall or lower vag inv z>5mm thick

A

interstitial brachy

Skin Radiation therapy (40 decks)

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