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OCN ONS Bundle > Cancer Treatment Modalities: Radiation > Flashcards

Cancer Treatment Modalities: Radiation Flashcards

1
Q

Radiation therapy =

A

The medical use of ionizing radiation (IR) as part of cancer treatment to control malignant cells

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2
Q

How does RT kill cancer cells?

A

By damaging their DNA directly or create charged particles (free radicals) within the cells that can also damage -> stops cancer division, causing cell death

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3
Q

Classes of RT (3)

A 
External beam RT 
Internal RT (brachytherapy) 
Systemic RT (radioactive iodine travels in blood to kill cancer cells)
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4
Q

Goals of RT can be (3)

A

1) Curative

2) Control
(even when CT/MRI show no tumors, used prophylactically for some types of cancer ex) brain radiation fro lung CA)

3) Palliative
(to relieve sx of pain, mobility, ability to eat/drink such as brain mets, spine mets, tumor near esophagus)

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5
Q

External beam RT is most _____, generated by a ____ _____ (a machine that accelerates electrons to produce x-rays or gamma rays)

A

Common

Linear accelerator

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6
Q

A form of EBRT that uses cyclotrons or synchrotrons to produce charged atoms that destroy tumors

A

Proton therapy

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7
Q

A type or radiation therapy common for tx or prostate, uterus, cervical, breast CA

A

Brachytherapy

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8
Q

Type of radiation that is put inside the pt, sealed in needles, seeds, wires, catheters, or implanted directly into or near a tumor

A

Brachytherapy

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9
Q

Cancers only treated with radiation and not chemo (2)

A

Prostate

Larynx

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10
Q

Radiation used after surgery =

A

Adjuvant RT

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11
Q

Radiation used before surgery

A

Neoadjuvant or induction RT

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12
Q

Combined modality therapy

A

Chemo and RT used simultaneously without surgery

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13
Q

An advanced form of three dimensional (3D) conformal radiation that precisely conforms the dose to tumors, allows safer delivery of higher than conventional doses

A

Intensity modulated RT (IMRT)

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14
Q

Intensity modulated RT commonly combined with what type of RT?

A

Image guided RT (IGRT)

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15
Q

RT that used 3D imaging to determine exact coordinates of tumor

A

Stereotactic radiosurgery

Ex) Gamma knife (uses radioactive cobalt sources to focus multiple beams of RT on a small area)

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16
Q

Radiation used to cut off blood flow to a tumor in vascular organs -> starvation

A

Radioembolization

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17
Q

The basic unit of light and other forms of electromagnetic radiation

A

Photon

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18
Q

EBRT is often delivered in _____

A

Photons

1) X rays
2) Gamma rays

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19
Q

Which type of photon has higher energy? Gamma rays or x rays

A

Gamma rays have the highest energy, followed by photons in x rays

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20
Q

Commonly used machine that delivers EBRT

A

Linear Accelerator (LINAC)

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21
Q

One of the most common types of EBRT that uses very sophisticated computer software and advanced treatment machines to deliver radiation to very precisely shaped targets

A

3D conformal RT (3D-CRT)

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22
Q

A type of 3D RT that reduces damage to healthy tissues

A

IMRT (intensity modulated RT)

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23
Q

Tomotherapy

A type of IMRT
(Helical tomotherapy)

A

RT aimed at tumor from many diff directions (pt put through a donut shaped machine)

24
Q

Type of external RT that uses special equipment to position pt and precisely give a single large dose of radiation to a tumor (often used to treat brain tumors)

A

Stereotactic radiosurgery

25
Q

Type of external RT that uses special equipment to position a pt and precisely deliver radiation to tumors in the body (except in brain)

A

Stereotactic body radiation therapy (SBRT)

26
Q

Type of RT that uses streams of protons to kill tumor cells

Diff than X-ray radiation

Reduces amount of radiation damage to health tissue near tumor

Tx for head and neck, brain, eye, lung, spine, prostate

A

Proton therapy

27
Q

Type of beams used to irradiate superficial tumors, such as skin cancer or tumors near surface of body - cannot travel far in tissue

A

Electron beams

28
Q

Radioactive iodine (oral cocktail) classifies as what type of radiation?

Tx of what type of CA?

A

Systemic RT

Thyroid - thyroid cells naturally take up radioactive iodine

29
Q

Ibritumomab tiuxetan (Zevalin) is a monoclonal antibody that classifies as what type of RT?

How does it work?

Tx for what type of CA?

A

Systemic RT

The antibody joined to the radioactive substance travels through blood, locating and killin tumor cells

B cell non-Hodgkin Lymphoma (NHL) - the antibody binds to protein found on surface of B lymphocytes

30
Q

Samarium 153 Lexidronam (Quadramet)
And Strontium-89 chloride (Metastron) are examples of what type of radiation?

Used to treat what?

A

Radiopharmaceuticals (Systemic radiation)

Pain from bone Mets

31
Q

Acute SE of Radiation

Think of damage to rapidly dividing normal cells

A

Skin irritation
Damage to salivary glands
Hair loss
Urinary or bowel problems

32
Q

Only FDA approved drug that helps protect salivary glands from radiation damage =

A

Amifostine (Ethyol)

33
Q

Systemic SE of Radiation

A

Fatigue

N/V

34
Q

Ibritumomab tiuxetan (Zevalin) is a monoclonal antibody that classifies as what type of RT?

How does it work?

Tx for what type of CA?

A

Systemic RT

The antibody joined to the radioactive substance travels through blood, locating and killin tumor cells

B Lymphocytes

35
Q

Samarium 153 Lexidronam (Quadramet)
And Strontium-89 chloride (Metastron) are examples of what type of radiation?

Used to treat what?

A

Radiopharmaceuticals (Systemic radiation)

Pain from bone Mets

36
Q

Acute SE of Radiation

Think of damage to rapidly dividing normal cells

A

Skin irritation
Damage to salivary glands
Hair loss
Urinary or bowel problems

37
Q

A radioprotector that is the only FDA approved drug that helps protect salivary glands from radiation damage =

A

Amifostine (Ethyol)

38
Q

Late SE of Radiation

A

Fibrosis (replacement of normal tissue w scar tissue -> restricts movement of affected area)
Damage to bowels -> diarrhea or bleeding
Memory Loss
Infertility
Secondary cancer (rare)

39
Q

Radiation safety Acronym

A

ALARA

40
Q

ALARA means

A

As low as reasonably achievable

41
Q

3 main principles of radiation safety

A

Time
Distance
Shielding

42
Q

Education points for pts receiving Brain radiation

A

Short term SE -> hair loss, n/v, hearing loss, scalp changes, trouble w memory and speech, seizures

Advise pts to only to only use recommended moisturizers and shampoos to decrease irritation

Use sunscreen to protect scalp

43
Q

Pt education points for those receiving breast radiation

A

Avoid bras with underwire, nylon, or lace

Wear breathable cotton bra

Can use deodorant but

Don’t shave armpits to prevent skin irritation

44
Q

Pt education points for those receiving head or neck radiation

A

Dry mouth -> suggest oral mouthwash

Advise pt to see dentist before RT to check for decayed teeth or oral infection

45
Q

Pt education for those receiving pelvic radiation

A

For young male and female pts, provide info about sexuality and possible infertility before RT

Banking sperm, egg harvesting options

46
Q

Symptom management for RT SE

1) Fatigue
2) Anorexia
3) Mucositis
4) Xerostomia (dry mouth)
5) Alopecia
6) N/V
7) Bone marrow suppresssion

A

1) encourage pt to prioritize and delegate responsibilities, gentle exercise
2) eat small, frequent meals, appetite stimulant, eat nutritious high protein snacks, avoid fat and grease, take nutritional supplements
3) Avoid oral irritants -> alcohol, tobacco, spicy, acidic food, hot drinks. Eat soft or liquid diet. Oral care w saline or water frequently
4) Moisten foods, use artificial saliva, avoid dry foods, soak foods in coffee, milk, warm drinks
5) Gently brush, decrease frequency of shampoo, avoid hair dye, chemicals, psych support -> wig?
6) small frequent meals, drinking clear cold drinks, avoid overly sweet, greasy, high fat foods. Elevate HOB, Antiemetics
7) weekly blood count monitoring, educate pt to observe s/s of bleeding and infection, let them know blood transfusions might be necessary

47
Q

Type of radiation that uses a computer to create a picture of a tumor to help guide the radiation beam during RT

Pictures made using CT, US, Xray

Also more accurate and less damage to healthy tissue

A

IGRT (Image guided radiation therapy)

48
Q

Type of radiation where radiation materials are placed inside the body =

A

Brachytherapy

49
Q

Type of brachytherapy where the radiation source is placed within tumor tissue =

A

Interstitial brachytherapy

ex) prostate tumor

50
Q

Type of brachytherapy where source is placed within a surgical cavity, or body cavity =

A

Intracavitary brachytherapy

51
Q

Type of brachytherapy used to treat melanoma inside the eye (attaches to the eye) =

A

Episcleral brachytherapy

52
Q

Brachytherapy uses radioactive _______ that are sealed into tiny pellets or _____.

How do the isotopes work?

How is it inserted into the patient?

A

Isotopes, seeds

Isotopes naturally decay, so give off radiation that damages nearby cancer cells

Catheters, needs, etc

53
Q

What happens if you leave the isotopes in the body?

A

They decay completely and no longer give off radiation -> not harmful if left in body

54
Q

Brachytherapy

1) Low dose rate =
2) High dose rate =

A

1) cancer cells receive continuous low dose radiation from the source over a few days
2) robotic machine attached to delivery tubes placed inside body guides radioactive sources into or near tumor, then removes the sources at end of treatment session

55
Q

Mammosite =

A

Type of intracavity brachytherapy used for Breast CA after lumpectomy, small balloon filled with liquid and left in place, catheter places radioactive seeds into balloon twice a day for 5 days then removed each time (balloon catheter radiation)

56
Q

Type of radiation where pt swallows or receives injection of radioactive substance such as radioactive iodine or radioactive substance bound to monoclonal antibody =

A

Systemic Radiation Therapy

OCN ONS Bundle (11 decks)

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