Chapter 27 WS Flashcards
What is the most common primary bone tumor in children?
osteosarcoma
What is the most common primary bone tumor in adults?
chondrosarcoma
What is the 2nd most common primary bone tumor in adults?
osteosarcoma
what is multiple myeloma
A malignant disease of the plasma cells which causes as abnormal absorption of bone resulting in painful osseous lesions
In general, do most primary bone tumors occurs more often in males or females?
males
are giant cell tumors (GCT) most often benign or malignant?
benign
which is more common, primary bone disease or metastatic bone disease?
mets
what is the most common primary cancer to spread to bone?
lung cancer
translocation of what chromosomes are most often associated with Ewing Sarcoma?
11 and 22
define diaphysis
main shaft of the bone
define epiphyses
the knoblike portion at either end of a long bone
define periosteum
the hard dense covering of the bone
where is the most common sites of occurrence of osteosarcomas?
Distal femur followed by the proximal tibia and the proximal humerus.
Where do Ewing sarcomas most often develop?
In the appendicular skeleton (pelvis, femur) seen more often in the diaphysis.
what three primary cancers most often mets to the bone
lung, breast, and prostate
in early stage breast cancer patients, are ER+ or ER- tumors most likely to metastasize to bone.
ER+
what is the most common presenting symptom of a bone tumor
pain
Chronic symptoms from a bone lesion is most likely to indicate a ___________ (benign or malignant) tumor whereas symptoms that rapidly progress over weeks or a few months is most likely ___________ (benign or malignant)
benign; malignant
what is skip metastases
When a second, smaller focus of osteosarcoma in the same bone or a second bone lesion on the opposing side of a joint space appears. This is attributed to the extensive spread by the lesion into the marrow cavity of the bone.
are most bone tumors radiosensitive or radioresistant?
radioresistant
when is radiaiton used for treatment of osteosarcomas and chondrosarcomas?
Osteosarcomas-before surgery, with adjuvant chemotherapy, and when the tumor is unresectable. Radiation is advised for patients with positive surgical margins and partial resections and for nonsurgical candidates.
Chondrosarcomas-When the tumor cannot be completely removed as a result of proximity of critical structures.
are chondrosarcomas chemosensitive?
no
what is the standard treatment for muliple myeloma?
A combination of chemo and radiation. Chemo is given with curative intent, whereas radiation is effective in controlling the pain from a bony lesion (palliation)
What is the purpose of radiation in the treatment of multiple myeloma?
Palliation, used to help manage a symptomatic lesion. The lesion is usually painful and can result in a fracture if not treated
What dose of radiation is typically given to multiple myeloma patients?
30 Gy in 10-15 fractions
What modalities are used in the treatment of Ewing’s sarcoma?
Surgery, chemo and radiation. Surgery is considered the primary treatment option
When treating bone tumors and soft tissue sarcomas, why is it important to leave a strip of unirradiated tissue when planning the treatment portal?
To preserve lymphatic drainage to avoid fluid buildup
List three radiopharmaceutical agents used for palliation of metastatic bone disease
Strontium-89, Samarium-153, and radium-223
What is the most common soft tissue sarcoma that affects children?
rhabdomyosarcoma
What is the common sites of metastasis of soft tissue sarcomas and which is the most common?
Lung, bones, liver, skin. Lung is most common
When treating an upper extremity, how must the arm be positioned in relation to the body?
List two reasons why?
The arm must be extended away from the body.
To minimize scatter radiation to the body and to allow for any possible beam angle.
