Chemotherapy and radiotherapy

Question 1

Descriptive terms used to describe chemotherapy treatment?

Answer 1

Cycle = pattern of treatment and rest days
Course = complete pattern of cycles
Line = order of treatments

Question 2

Descriptive terms used to describe intent of cancer treatment

Answer 2

Radical = curative
Neo-adjuvant = before another therapy
Adjuvant = alongside another therapy
Palliative = symptom control

Question 3

Name of the nail changes seen in chemotherapy

Answer 3

Beau’s lines - white horizontal lines seen due to halted cell division

Question 4

Anti-emetic therapy of choice in chemotherapy + dosages

Answer 4

Pre-med = Ondansetron 8mg IV + Dexamethasone 8mg IV

Post-med = Metoclopramide 10mg, TDS, PO 14 days + Dexamethasone 6mg PO

Question 5

Describe the types of performance status

Answer 5

0 = fit and active
1 = slight physical restriction. Active
2 = ambulatory, capable of self care. awake >50% time
3 = limited self care, in bed/chair >50% time
4 = completely disabled. cannot self-care. confined to bed/chair

Question 6

The types of graphs used to predict chemotherapy survival rates?

Answer 6

Kaplan - Meier graphs

Question 7

Toxicities of common chemotherapy agents?

Answer 7

Cisplatin - deafness, nephrotoxicity

Bleomycin - pulmonary fibrosis

Vincristine - peripheral neuropathy

Question 8

Units in Radiotherapy?

Answer 8

Absorbed dose of radiation = Gray (Gy)

Series of grays = Fraction

e.g. 70 Gy in 35 fractions, over 7 weeks

Question 9

Treatment pathway in radiotherapy

Answer 9

Consenting –> immobilisation –> planning CT + analysis –> tattoo –> treatment delivery –> clinical review –> long term follow-up

Question 10

Common S/Es of radiotherapy to the head and neck

Answer 10

radiation dermatitis
mucositis - dry mouth, loss of taste, can’t swallow –> give feeding support, mouth care (saline wash, mugard)

Opiate analgesia often required
NG tube, PEG, supplements

Question 11

S/Es of radiotherapy to the prostate?

Answer 11

cystitis symptoms - dysuria, frequency, urgency - alpha blocker - Tamsulosin
diarrhoea - fybogel (stool bulker)
prostatitis
haematuria

Question 12

S/E of radiotherapy to the lung?

Answer 12

odynophagia/oesophagitis
cough, SoB, chest pain
pneumonitis - 6-8 weeks post-op, progressive SoB and cough - treat with high dose steroids and oxygen