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CFT I > Exam 1 - Radiation Oncology > Flashcards

Exam 1 - Radiation Oncology Flashcards

1
Q

what is radiation?

A

electromagnetic energy

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2
Q

what is ionizing radiation?

A

radiation with sufficient energy to detach electrons from atoms - ionizing atoms

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3
Q

T/F: gamma=xray=photon

A

true

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4
Q

what is the ionization ability & penetration of alpha-rays?

A

can ionize the atom very readily but penetrability is limited because it isn’t high energy

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5
Q

what is the ionization ability & penetration of beta-rays?

A

greater penetration than alpha-rays but less ionizing than alpha-rays

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6
Q

what is the ionization ability & penetration of gamma-rays?

A

least ionizing but most penetration

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7
Q

what diagnostics use gamma rays (electromagnetic radiation)?

A

radiographs, CT, PET-CT, & radiation therapy

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8
Q

what is teletherapy/tomotherapy (external beam)?

A

showers the patient with photons

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9
Q

what is brachytherapy?

A

radioactive isotype is placed within the patient

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10
Q

what is plesiotherapy?

A

put the probe on top of the area of interest

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11
Q

why can’t you be with the patients receiving radiation therapy?

A

megavoltage photons are used - way too dangerous

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12
Q

what are the diagnostic levels of energy typically used?

A

20-120 kVp

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13
Q

what is mAs?

A

of electrons

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14
Q

what is kVp?

A

energy of xray

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15
Q

what happens when you increase mAs?

A

increase the dose to the patient

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16
Q

what happens to your image if you increase kVp?

A

decrease the diagnostic quality

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17
Q

how many volts are in tomotherapy?

A

6 million volts

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18
Q

what are the 3 parts to integrated oncology?

A

medical, surgical, & radiation oncology

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19
Q

in radiation planning, what is contouring?

A

determining normal structure vs the target for therapy

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20
Q

what are the 3 components of radiation protocol?

A
  1. client goals
  2. dose required for adequate control for tumor type or palliation
  3. limited by dose tolerances of surrounding normal tissues
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21
Q

what tumor types are less responsive to radiation?

A

carcinomas & sarcomas

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22
Q

what tumor types are most sensitive to radiation?

A

round cell tumors

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23
Q

what are the rules of thumb for definitive radiation treatment goals as far as dosing?

A

10-20 fractions - low dose per fraction

high total prescription dose

typically used alone or after surgery

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24
Q

what are the rules of thumb for palliative radiation treatment goals as far as dosing?

A

2-5 fractions - higher dose per fraction

low to moderate total dose

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25
Q

what are the goals of definitive radiation treatment?

A

improve survival in OS, MST, & PFS

achieve local tumor control or locoregional control

26
Q

what are the goals of palliative radiation treatment? what about secondary goals?

A

pain relief, improve quality of life, & improve clinical signs

secondary - slow down the progression of the tumor

27
Q

what are the planning techniques for stereotactic radiation therapy?

A

definitive or palliative setting

28
Q

when would you use stereotactic radiation therapy?

A

well-defined tumors

29
Q

how is stereotactic radiation therapy defined?

A

highly conformational, heterogenous dose

high ablative dose

30
Q

how many doses are needed in stereotactic radiation therapy?

A

1-5

31
Q

what is the primary goal for pre-op radiation therapy? what is the secondary goal?

A

sterilize surgical margins

cytoreduction

32
Q

in preoperative radiation therapy, cytoreduction depends on what?

A

tumor histopathology

33
Q

for short course preop radiation therapy, how many fractions is the rule of thumb?

A

5 fractions

34
Q

for short course preop radiation therapy, how many fractions is the rule of thumb?

A

20 fractions

35
Q

T/F: in preop radiation therapy, lower doses are given compared to post-op radiation therapy

A

true

36
Q

what are the possible risks for pre-op radiation therapy?

A

increased risk of surgical complications (dehiscence) & more challenging surgery

37
Q

what are the benefits or pre-op radiation therapy?

A

well-defined tumor for radiation planning

less irradiated tissue in the patient

associated with improved osteosarcomas in human treatments

more treatment options (short course vs. long course)

38
Q

why is CT used for RT planning?

A

electron density of tissues = HU of CT

39
Q

what is the most common mode of cell death with radiation?

A

mitotic cell death

40
Q

what is the cellular response to radiation for epithelial, mesenchymal, & round cells?

A

epithelial - mitotic cell death

mesenchymal - mitotic cell death

round cell - apoptosis

41
Q

T/F: in radiation therapy, there are not clinically significant side effects

A

true

42
Q

what is the exception to side effects with radiation therapy?

A

acute radiation sickness associated with irradiation of large volumes of the body

43
Q

what is the response of sarcomas to radiation?

A

they are resistant

44
Q

what is the response of round cells to radiation?

A

they are sensitive to radiation

45
Q

what is the response of carcinomas to radiation?

A

radiation responsive

46
Q

T/F: side effects from radiation only occur in the radiation field

A

true

47
Q

what is the most common side effect of radiation?

A

inflammatory - transient in nature

48
Q

with what kind of radiation therapy are you expecting transient side effects?

A

definitive radiation therapy

49
Q

what is the best management of radiation therapy side effects?

A

anti-inflammatories - NSAIDs & steroids

prevention of self trauma!!!!

50
Q

what are the chronic side effects of radiation therapy?

A

fibrosis

51
Q

what radiation therapy type may have an increased risk for chronic side effects?

A

stereotactic

52
Q

what happens in direct cell target in radiation therapy?

A

30%

single strand or double strand breaks

53
Q

what happens in indirect cell target in radiation therapy?

A

70%

oxygen radical formation from water causes damage & damage is ‘fixed’ with oxygen

54
Q

what is the compton effect?

A
55
Q

why are photons related to the ‘skin spare’ effect?

A

they are indirectly ionizing

56
Q

what is a gray?

A

1 gy = 1 j/kg

unit of absorbed dose

57
Q

what is the formula for radiation protocol?

A

___ fractions of ___dose/fraction = total prescribed dose

fraction = treatment

58
Q

what is included in the initial consult of radiation therapy?

A

diagnosis, staging, & treatment plan

59
Q

what is included in the radiation planning of radiation therapy?

A

contouring & computerized planning

60
Q

what is this?

A

multi-leaf collimator - step & shoot modulation

61
Q

T/F: IMRT & IGRT are the most current historical advances seen in radiation therapy

A

true - tomotherapy uses IMRT & IGRT

CFT I (30 decks)

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