GI technique Flashcards
Immobilisation for Upper GI technique?
Wingboard Knee bolster Footstocks Vacuum bag Compression device
Field arrangement for upper GI?
4-6 fields
45-50Gy in 1.8 fractions
What does CTV include for the upper GI?
primary tumour, adjacent nodal groups -(suprapancreatic, coeliac axis, and -pancreaticodudoenal) and the duodenal wall for head of pancreas lesions
OAR for GI tract?
stomach, duodenum, liver, both kidneys, spinal cord and surrounding small bowel
What interruptions are allowed for treatment?
over grade 3 toxicity may resume treatment once it goes back to grade 2 toxicity
50000 platelets
treatment should be withheld
45-51 treatment duration allowed
over 50 days not allowed
What are treatment reactions?
if grade 3 oesophagitis may be treated during the last week in conjunction with XRT and trastuzumab
What should happen if there is more than a 2 week break?
Consult the radiation oncologist
Adverse effects of radiation therapy?
nausea/vomiting diarrhoea weight loss fatigue myelosuppression skin erythema subcutaneous fibrosis oesophagitis carditis myelitis acute radiation pneumonitis late pulmonary fibrosis oesophageal stricture
Factors that affect nutrition?
dry mouth, mucositis, dysphagia, nausea, vomiting, diarrhoea and tenesmus
Treatment for Diarrhoea?
Loperamide (Imodium)
Codeine phosphate is especially useful if diarrhoea is associated with colicky abdominal pain.
Treatment for nausea and vomiting?
granisetron
Oesophageal treatment for upper and lower?
Lower oesophague-gastric setup
Upper oesophague- Head and neck setup
What is the beam arrangement for proton treatment?
75% for posterior field remaing dose through right lateral beam.
What is the definitive radiochemotherapy oesophagus prescription?
50 Gy in 25 daily fractions with cisplatin-5FU given in 5 weeks reduced to
45 Gy in 25 daily fractions if radiochemotherapy is given preoperatively.
Curative radiotherapy oesophagus prescription?
55 Gy in 20 daily fractions of 2.75 Gy given in 4 weeks
