Liver

Question 1

Child Pugh score components

Answer 1

Albumin, Bilirubin, Coagulation, Distention, Encephalopathy
A: 5-6
B: 7-9
C: >10

Question 2

(5 fx SBRT) Liver constraint for healthy liver

Answer 2

Mean 1500-1800 cGy
>700 cc <2100 cGy

Question 3

RILD classical

Answer 3

hepatomegaly, ascites and elevated alk phos
2-3 months after RT

Question 4

RILD non classical

Answer 4

elevated LFTs or jaundice
occurs later
CPS + 2 points

Question 5

Liver constraint for cirrhotic liver 5 fx sbrt

Answer 5

CPA:
Mean 1300-1500 cGy
>700 cc <1500 cGy

CPB:
Mean 800-1000 cGy
>500 cc <1000 cGy

Question 6

SBRT liver prescription

Answer 6

Noncirrhotic (primarily IHC) - 4000-6000 cGy in 3-5 fractions
CPA - 4000-5000 cGy in 3-5 fractions
CPB - 3000-4000 cGy in 5 fractions

Question 7

Conventional fractionation liver constraint

Answer 7

Healthy - mean <3200 cGy
CPA - mean <3000 cGy
CPB - mean <2400 cGy

Question 8

Stomach/duodenum constraints

Answer 8

5-fraction - Dmax <3200
20-fraction - Dmax <5400 cGy, V45 <33.3%, V40<66.7%

Question 9

Liver Large bowel constraints

Answer 9

5-fraction - Dmax <3400 cGy
20-fraction - Dmax <6000 cGy, V55 <5 cc, V45 <60 cc, V35 <150 cc, V30 <200 cc