Lab # 4 Lung Flashcards
Lung cancer is the ________ cause of cancer related deaths in both men and women in the U.S., surpassing breast cancer in women
leading
The most significant etiology is related to
tobacco and the number of cigarettes smoked.
Lung cancer lends itself to ___________ techniques due to tumor location, tumor burden, reduction of tumor, and location of critical structures.
shrinking field (i.e. boost; cone down; off-cord)
how many lobes are in the right lung?
three
how many lobes are in the left lung?
two
what is the major airway into the thoracic cavity?
trachea
where does the trachea begin and end?
inferior border of the larynx and ends at the level of T5
what is the area of bifurication?
where the trachea divides into the left and right bronchi
what is the bifurication of the trachea refered to?
carina
the area where the blood, lymphatics, and nerves enter and exit each lung
hilum
is the anatomical area separating the lungs; it includes the heart, thymus, great vessels, and other structures that help position the lungs on either side of midline.
mediastinum
where do tumor cells gain access to the circulatory system
hilium and carina
what is included in the mediastinum
he heart, thymus, great vessels, and other structures that help position the lungs on either side of midline
Lung cancer is most frequently divided into
Small Cell Lung Cancer (SCLC) and Non–Small Cell Lung Cancer (NSCLC)
what histologies are included in NSCLC
adenocarcinoma, large cell carcinoma, and epidermoid (squamous cell) carcinoma
Squamous Cell lung cancer arises most commonly in the
lining and central portion of the lung
Adenocarcinoma arises more often in the
periphery of the lung
_________ is now the most common form of lung cancer in North America.
adenocarcinoma
is it becoming more and more common for nonsmokers and never smokers to present with which histology?
adenocarcinoma
what is another name for small cell lung cancer
oat cell lung cancer
where does SCLC arise?
in the central region
Due to its rapid growth, SCLC has an early _____ and _____ involvement
lymphatic spread
Superior vena cava
what are some signs of superior vena cava syndrome
swollen face, telangiectasia, and shortness of breath due to tumor obstruction
is superior vena cava syndrome an oncologic emergency?
yes
what are the primary routes of spread for lung cancer?
blood, lymphatics, and intrathroacic direct extension
what is the order of lymphatic involvement
intrapulmonary nodes hilar nodes mediastinal nodes supraclavicular (S/C) nodes.
Involvement of the S/C nodes increases disease incidence in the ________ or __________
superior mediastinal nodes or upper lobe of the lung.
which type of lung cancer is usually treated with PCI as well
SCLC
when is PCI performed?
after a patient’s lung radiation therapy
where does lung mets occur most often in the
cervical lymph nodes, liver, brain, bones, adrenal glands, kidneys, and the contralateral lung
what is virchow’s node?
name given to the nodes in the left S/C fossa.
another mets site is……
the lymph nodes of the S/C fossa (i.e. scalene nodes).
Small Cell Lung Cancer (SCLC) treated with
multiagent chemotherapy and localized radiation therapy offers the best chance for a positive response to treatment
Surgery is the treatment of choice for Non-Small Cell Lung Cancer (NSCLC) when the tumor is ______ and ______
small and localized
If the tumor is inoperable due to its size, location, or regional lymph node involvement what is the best treatment?
high dose radiation therapy
The signs and symptoms of lung cancer are often subtle and especially difficult to differentiate from the symptoms of ________
COPD
Treatment borders for upper lobe tumors include the
primary tumor with a 2 cm margin, both hilar areas, the superior mediastinum, and both supraclavicular areas.
what is prescription for lung cancer?
Primary tumor – 180cGy / fraction x 25 fx. = 4500 cGy
what is the energy used when treating lung cancer?
6MV
what is boost prescription for lung cancer?
200cGy / fraction x 10 fx. = 2000 cGy
what are other names for boost?
shrinking field, cone down, off-cord
during the boost, _____________ can be used to avoid the tolerance dose to critical structures
oblique fields
what is the total dose for lung cancer?
6500 (to 7000) cGy
what are the critical structures when treating the lungs?
spinal cord
heart
esophagus
normal lung
what is the TD 5/5 for the spinal cord?
4700 cGy
what is the TD 5/5 for the heart?
4000 cGy
what is the TD 5/5 for the esophagus?
5500 cGy
what is the TD 5/5 for the normal lung?
1750 cGy
