Normal Tissue Consequences Flashcards
osteonecrosis
bone death
- in adults after 60Gy (femoral head)
In children, you have to treat the growth plate ____.
evenly
The pelvis contains about ___% of functioning bone marrow in adults.
25%
Genital Organs:
Permanent Sterility unavoidable at
1500-2000 cGy
What is one way to get ovaries out of the radiation field?
ovaries can be surgically moved
Testes are less often exposed because
- can remove teste
2. treat pelvic lymph node
what percent of the dose reaches the teste?
10% from internal scatter
by how much can you reduce scatter to the testes if a shield is used?
1-3%
what kind of cells do testes house?
leukemic
scar tissue can destroy upper vagina and ___
lose patency
should avoid irradiation _______ weeks after surgery
6-8 weeks
In females, _____ is rare , but can have it from recurrence of tumor
stenosis
normal capacity of bladder
400cc
fistulas form at ____ doses
high
enteritis
inflammation of the intestine
What is one reason to stop treatment of the small intestine
severe acute enteritis
What part of the large intestine should be avoided at all costs?
anus because of the sphincter
in the rectum, stenosis can ____
make you have the feeling to deficate
If 75% or more of the liver receives 3000-3500, there is a great risk of ____
liver failure
Liver doses can cause ___
acute hepatitis
kidney causes ___
high BP
Adrenal glands: TD 5/5?
Don’t know what it would be because it is right on top of the kidney.
pancreas
“silent killer”
spleen
can cause alterations in the blood count and immune system
Thorax
receives more radiation than any other area of the body
How can pneumonitis be treated?
steroids, relieve symptoms
resp system:
can develop radiation fibrosis
increases risk of infection
chemo+radiation =
more sensitive
higher daily doses of radiation=
more severe pain
hypofractionization
higher dose, less fractions
hyperfractionization
lower dose, more fractions
Effects of rad of esophagus
loses elasticity
myocardium
interstitial fibrosis
-reduces cardiac function=myocardial infarction
acute pericarditis
may appear 1 year post treatment
anterior chest pain, sob, low grade fever
chronic pericarditits
can impede filling affect which can reduce cardiac output
2 cardio toxic chemo drugs
doxirubicin
adriamycin
chemo drugs along with rad therapy can cause
CHF
late reaction of rad treatment to ribs
fractures
treating breast before puberty can
hinder development
moderate skin erythema
dry desquamation, mild tenderness
treatment can make the breast ___&_____
smaller and harder
skin changes
brachial plexus:
takes about ____for side effects to show up
1 year or more
brachial plexus
bundle of nerves around the shoulder
pass through supraclavicular region
how long does it take for spinal cord injuries to show up post rad
8-48 months
Lhermittes syndrome
electrical shocks going down legs (weeks after rad treatment)
Head and neck treatments
harder for pt
-swallowing
-nutritional intake
lifestyle changes: smoking and drinking
mouth:
rad causes ___
dental decay
may prescribe for mouth
fluoride treatments
anti fungal cream
lead shield over teeth causes
more dose to area
more scatter
for shield, need to use something with lower z number
like wax
higher rad doses in ear
late symptoms
eyes: over time with low doses
glaucoma - anterior chamber of the eye
fibrosis in eye
causes obstruction
causes watery eyes
*can dilate duct
pterygoid muscle
opens and closes mouth
thyroid gland
fatigue, weakness, hair loss, memory loss,
hypothyroidism
Pituitary glad
normal function decrease around 55-60
impair gonads, thyroid, adrenal function
tumoritis
borders of tumor can be more defined- may have to change the treatment plan
CNS
Very sensitive
brain tumors in 2 years of life
rare
moderate or severe handicaps will follow in about __%
33%
how to receive brain symptoms
higher dose/ fx
When you lose hair it usually comes in much
finer
when do they lose hair
around fx 10 or 12
(2 weeks)
skull radionecrosis
extremities
lymph edema
don’t want to treat entire ext
could get subcutaneous fibrosis
lower extremities avoided in elderly
diabetic?
avoid in children- lower extremity
growth plate (epiphysis) could stunt growth
upper extremity
lymph edema
Total Body irradiation
TBI
whole body at once
Low Dose
CLL
(Chronic lymphocytic leukemia)
sytemic, don’t see much anymore
*not curative
High Dose
*can be lethal
bidaily (6 hours inbetween)
less toxicity to pt
AP/PA blocks on lungs
