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Small Animal Medicine > Oncology - Radiation > Flashcards

Oncology - Radiation Flashcards

1
Q

*Gastrointestinal (GI) lymphoma diagnosed in cats is most frequently low/high grade and B-cell/T-cell in origin?

A

low, T-cell

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2
Q

*Lymphoma is currently diagnosed most commonly in older, feline leukemia virus (FeLV) positive/negative cats.

A

negatiive

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3
Q

*Most commonly used oral chemotherapeutic to treat low grade GI lymphoma in cats?

A

Prednisone and chlorambucil

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4
Q

*Diagnostic test utilized to determine clonality of lymphocyte population?

A

PCR (PARR)

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5
Q

What are the realistic challenges for radiation therapy in veterinary oncology?

A

Availability, logistics/time, cost, side effects, and perception

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6
Q

When are X-rays produced?

A

when charged particles (such as electrons) strike dense material and suddenly decelerate

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7
Q

When are gamma rays produced?

A

when naturally unstable atomic nuclei decay

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8
Q

What is the direct action on DNA of radiation?

A

It breaks the double strand

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9
Q

What is the indirect action on DNA of radiation?

A

70% of biologic effect of RT comes from free-radical formation

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10
Q

The biologic effects of radiation result from what?

A

damage of DNA

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11
Q

In order of decreasing sensitivity, what is the degree of tissue susceptibility to radiation?

A

Blood-forming organs, reproductive organs, skin, bone and teeth, muscle, and the nervous system

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12
Q

In a general sense, what cells are more susceptible to radiation?

A

rapidly dividing cells because they have less time to repair

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13
Q

In what phase of replication are cells most sensitive to radiation?

A

Cells in the Late S phase, G2, or Active mitosis

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14
Q
  • The most important mechanism by which external beam radiation therapy causes DNA damage and results in cell death is via:
    a. Direct action of ionizing radiation causing double strand breaks in the cellular DNA
    b. Thermal damage to cells caused by ionizing radiation
    c. Indirect action of ionizing radiation via free radical induction and subsequent DNA damage
    d. Inhibition of topoisomerase II
A

c. Indirect action of ionizing radiation via free radical induction and subsequent DNA damage

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15
Q

We see acute/chronic radiation side effects more often.

A

acute

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16
Q

What are some examples of acute radiation side effects?

A

Moist desquamation of skin, mucositis, conjunctivitis, colitis, proctitis, rhinitis, and more

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17
Q

How do you manage acute radiation side effects?

A

Based on the symptoms they are showing

18
Q

Pain medication for acute radiation side effects are central/peripheral.

A

central

19
Q

What tissues are commonly effected by acute radiation side effects?

A

rapidly dividing cells/tissues

20
Q

What tissues are commonly effected by chronic radiation side effects?

A

Late responding tissues - lens, bone, fibrous tissue, and nerves

21
Q

In tissues affected by chronic radiation, DNA damage results in _____ catastrophe months to years after radiation.

A

mitotic

22
Q
  • Which of the following would be a possible early side effect following radiation therapy in a dog with a nasal tumor?
    a. Cataract OS
    b. Oral mucositis
    c. Necrosis of the hard palate
    d. Change in hair color in area treated
A

b. Oral mucositis

23
Q

What tumors can radiation therapy be used for?

A

Nasal, oral/craniofacial, brain, ear canal, thyroid, mediastinal, bone/spinal, mast cell tumors, soft tissue sarcomas, urinary bladder, prostate, and anal sac

24
Q

What is the indication for palliative-intent radiation therapy?

A

Absence of curable disease OR when co-morbidities preclude definitive-intent RT

25
Q

What is the goal of palliative-intent RT?

A

Improve/maintain quality of life

26
Q

What is the goal of definitive-intent RT?

A

Deliver enough dose to achieve durable local tumor control

Maximize quantity and quality of life

27
Q

True or False: Radiation therapy is only used after surgery.

A

False - it can be used before or after surgery

28
Q

What are the pros to palliative-intent RT?

A

Low cost, convenient schedule, and low risk of severe acute toxicity

29
Q

What are the cons to definitive-intent RT?

A

Expensive, inconvenient schedule, and may be associated with bad side effects

30
Q

What are the pros and cons to stereotactic RT?

A

Expensive, convenient schedule, low risk of severe acute toxicity

31
Q

What are some common types of external beam RT?

A

Clinical/manual setup
3-dimensional conformal RT
Intensity-modulated RT
Stereotactic RT

32
Q

What are the advantages to clinical/manual point calculation?

A

Less expensive, treat microscopic disease, and even distribution when treating cuboid structures

33
Q

What are the disadvantages to clinical/manual point calculation?

A

Over/under dosing more common, uneven distribution of dose for complex shapes, and no dose painting/shaping

34
Q

What is the clinical utility of clinical/manual point calculation?

A

Microscopic disease of extremities, rostral maxilla or mandible, and palliative radiation of many sites

35
Q

What are the advantages of intensity-modulated RT (IMRT)?

A

More effectively spare normal tissue, minimize radiation effects, and treats gross or microscopic disease

36
Q

What are the disadvantages to IMRT?

A

requires advanced accelerator/technology

37
Q

What is the clinical utility of IMRT?

A

Nasal/oral, brain, body wall, and urinary tract tumors

38
Q

What are the advantages to sterotactic radiotherapy?

A

Treatment is completed in 1-5 fractions and minimizes acute radiation side effects

39
Q

What are the disadvantages to stereotactic radiotherapy?

A

Requires advanced equipment/technology and cannot treat microscopic disease/requires gross tumor

40
Q

What is the clinical utility of stereotactic radiotherapy?

A

Brain, nasal, bone, thyroid, lung, mediastinal, heart-based tumors
Palliative treatment at almost any site

41
Q

How does stereotactic radiotherapy work?

A

It uses onboard imaging and dynamic collimation to deliver high doses of targeted radiation

Small Animal Medicine (100 decks)

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