HW 1 Prostate

Question 1

Name three prognostic indicators of prostate cancer

Answer 1

Tumor stage & histologic differentiation; Age; Race; Prostate-specific antigen level (PSA); Lymph Node Status

Question 2

what does the gleason score indicate?

Answer 2

“The Gleason score correlates closely with prognosis, with lower scores representing more slowly growing, nonaggressive tumors and higher scores their more invasive, metastatic counterparts”

Question 3

what is the range of dose necessary to control prostate cancer?

Answer 3

“Conventional doses consist of 76 Gy in 38 fractions with 2.0 Gy per fraction”

Question 4

what are the most common treatment options for prostate cancer?

Answer 4

a) Observation
b) Prostatectomy
c) Hormonal Therapy
d) Chemotherapy
e) External Radiation

Question 5

A Gleason score of 2-6 or PSA of <10ng/ml indicates a patient in what prognostic group?

Answer 5

Early stages (T1 or T2)

Question 6

6. A T3 tumor of the prostate indicates what stage?

Answer 6

Stage III

Question 7

Which zone of the prostate is most prone to the development of prostate cancer?

Answer 7

Peripheral glands

Question 8

What is the significance of a detectable PSA following radical prostatectomy?

Answer 8

Following a radical prostatectomy, the PSA should become and remain undetectable. A detectable PSA following radical prostatectomy indicates that presence of cancerous prostate cells (either local or metastatic).

Question 9

What does the term conformal mean?

Answer 9

“Conformal” refers to 3-D conformal radiation therapy (i.e. 3-D CRT), in which the field shape and beam angle change while the gantry moves around the patient.

Question 10

What is the first group of lymph nodes involved in prostate cancer?

Answer 10

Periprostatic and obturator lymph nodes

Question 11

What advantage(s) does conformal offer the patient over traditional prostate irradiation?

Answer 11

“IMRT, which is a type of 3D-CRT, has provided a significant technologic advance in radiation therapy treatment planning. This method of delivering the prescribed dose of radiation therapy has proved beneficial in escalating the dose to the tumor volume and reducing the dose to normal tissue”

Question 12

what is the most common metastatic site of prostate cancer?

Answer 12

bone

Question 13

Should the bladder be empty or full during treatment?

Answer 13

Full (FYI: empty when treating bladder cancer)

Question 14

Prostate brachytherapy involves what type of placement of seeds?

Answer 14

Interstitial brachytherapy

Question 15

What is/are the most common type(s) of seeds used in prostate (permanent) brachytherapy?

Answer 15

a) I-125
b) Pd-103
c) Au-198

Question 16

Half life: Pd-103

Answer 16

17 days

Question 17

Half life: I-125

Answer 17

59.4 days

Question 18

Half life: Gold-198

Answer 18

2.7 days

Question 19

Half life: Iridium-192

Answer 19

73.83 days

Question 20

Half life: Cesium-137

Answer 20

30 years

Question 21

Half life: cobalt-60

Answer 21

5.27 years

Question 22

Half life: radium-226

Answer 22

1622 years

Question 23

etastatic prostate cancer is usually treated with hormone therapy and what 2 radioisotopes?

Answer 23

a) Strontium-89 (which is known as a “bone-seeker”)

b) Sarmarium-153

Question 24

strontium-89 half-life

Answer 24

50.5 days

Question 25

sarmarium-153 half life

Answer 25

46.3 hours (1.93 days)

Question 26

Does lymph node involvement with prostate cancer decrease long term survival?

Answer 26

yes

Question 27

The most common pathology for prostate cancer is what?

Answer 27

adenocarcinoma

Question 28

In relation to the rectum, where is the prostate gland located?

Answer 28

The rectum is posterior to the prostate

Question 29

List three side effects of External Beam Radiation Therapy for prostate cancer.

Answer 29

• Acute: GI (diarrhea, abdominal cramping, rectal discomfort, & occasionally rectal bleeding)
• Late: persistent proctitis, rectal bleeding, & ulceration.
• Sexual impotence (i.e. erectile dysfunction)
• Also: urinary complications (e.g. urgency or frequency)

Question 30

GTV

Answer 30

palpable or visible extent of tumor

Question 31

CTV

Answer 31

GTV plus margin for subclinical disease extension

Question 32

PTV

Answer 32

CTV plus margin for treatment reproducibility (patient/organ movement, daily setup error)