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OCN ONS Bundle > Cancer Treatment Modalities: Radiation > Flashcards

Cancer Treatment Modalities: Radiation Flashcards

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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)

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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)

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A

Stereotactic radiosurgery

25
Type of external RT that uses special equipment to position a pt and precisely deliver radiation to tumors in the body (except in brain)
Stereotactic body radiation therapy (SBRT)
26
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
Proton therapy
27
Type of beams used to irradiate superficial tumors, such as skin cancer or tumors near surface of body - cannot travel far in tissue
Electron beams
28
Radioactive iodine (oral cocktail) classifies as what type of radiation? Tx of what type of CA?
Systemic RT Thyroid - thyroid cells naturally take up radioactive iodine
29
Ibritumomab tiuxetan (Zevalin) is a monoclonal antibody that classifies as what type of RT? How does it work? Tx for what type of CA?
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
Samarium 153 Lexidronam (Quadramet) And Strontium-89 chloride (Metastron) are examples of what type of radiation? Used to treat what?
Radiopharmaceuticals (Systemic radiation) Pain from bone Mets
31
Acute SE of Radiation | Think of damage to rapidly dividing normal cells
Skin irritation Damage to salivary glands Hair loss Urinary or bowel problems
32
Only FDA approved drug that helps protect salivary glands from radiation damage =
Amifostine (Ethyol)
33
Systemic SE of Radiation
Fatigue | N/V
34
Ibritumomab tiuxetan (Zevalin) is a monoclonal antibody that classifies as what type of RT? How does it work? Tx for what type of CA?
Systemic RT The antibody joined to the radioactive substance travels through blood, locating and killin tumor cells B Lymphocytes
35
Samarium 153 Lexidronam (Quadramet) And Strontium-89 chloride (Metastron) are examples of what type of radiation? Used to treat what?
Radiopharmaceuticals (Systemic radiation) Pain from bone Mets
36
Acute SE of Radiation | Think of damage to rapidly dividing normal cells
Skin irritation Damage to salivary glands Hair loss Urinary or bowel problems
37
A radioprotector that is the only FDA approved drug that helps protect salivary glands from radiation damage =
Amifostine (Ethyol)
38
Late SE of Radiation
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
Radiation safety Acronym
ALARA
40
ALARA means
As low as reasonably achievable
41
3 main principles of radiation safety
Time Distance Shielding
42
Education points for pts receiving Brain radiation
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
Pt education points for those receiving breast radiation
Avoid bras with underwire, nylon, or lace Wear breathable cotton bra Can use deodorant but Don’t shave armpits to prevent skin irritation
44
Pt education points for those receiving head or neck radiation
Dry mouth -> suggest oral mouthwash Advise pt to see dentist before RT to check for decayed teeth or oral infection
45
Pt education for those receiving pelvic radiation
For young male and female pts, provide info about sexuality and possible infertility before RT Banking sperm, egg harvesting options
46
Symptom management for RT SE 1) Fatigue 2) Anorexia 3) Mucositis 4) Xerostomia (dry mouth) 5) Alopecia 6) N/V 7) Bone marrow suppresssion
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
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
IGRT (Image guided radiation therapy)
48
Type of radiation where radiation materials are placed inside the body =
Brachytherapy
49
Type of brachytherapy where the radiation source is placed within tumor tissue =
Interstitial brachytherapy ex) prostate tumor
50
Type of brachytherapy where source is placed within a surgical cavity, or body cavity =
Intracavitary brachytherapy
51
Type of brachytherapy used to treat melanoma inside the eye (attaches to the eye) =
Episcleral brachytherapy
52
Brachytherapy uses radioactive _______ that are sealed into tiny pellets or _____. How do the isotopes work? How is it inserted into the patient?
Isotopes, seeds Isotopes naturally decay, so give off radiation that damages nearby cancer cells Catheters, needs, etc
53
What happens if you leave the isotopes in the body?
They decay completely and no longer give off radiation -> not harmful if left in body
54
Brachytherapy 1) Low dose rate = 2) High dose rate =
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
Mammosite =
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
Type of radiation where pt swallows or receives injection of radioactive substance such as radioactive iodine or radioactive substance bound to monoclonal antibody =
Systemic Radiation Therapy

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