pelvic (non prostate)

Question 1

what is additional imaging modality required for cervical cancer?

Answer 1

MRI

Question 2

how are gyne patients simmed?

Answer 2

empty rectum (rectum should not be more than 3 cm in ant/post)
with full bladder and also with empty bladder. TP is done on full bladder. empty/full bladder is used to assess ITV
-empty is more reproduceable but full pushes OARs out of way

Question 3

what is proctitis

Answer 3

inflammation of rectum lining

Question 4

what is cystitis non infective

Answer 4

pain urinating

Question 5

what is hematuria

Answer 5

blood in urine

Question 6

what is dyspareunia

Answer 6

pain during intercourse

Question 7

what is vaginal hemmorhage

Answer 7

bleeding

Question 8

typical dose for cervical, endometrial, and vaginal treatment

Answer 8

45/25

-sometimes a dost above 45 Gy is used

Question 9

review vaginal anatomy in eclipse

Answer 9

order from ant to post is uterus, bladder, cervix, rectum

Question 10

Some OAR constraints for 45 Gy/25 gyne

Answer 10

Rectum < 50 % 45 Gy
Spinal cord max 45 Gy
Kidneys < 55 % 12 Gy
Bladder < 35 % 45 Gy
Bowel < 200 cc 30 Gy

Question 11

what is typically missing OAR for endometrial cancer?

Answer 11

-uterus is missing due to hysorectomy

Question 12

is BID allowed in anal canal or rectal cancer treatment?

Answer 12

no

Question 13

how is anal canal and rectal cancer simmed?

Answer 13

bladder full and have to expel gas (<5 cm in AP direction)

Question 14

fractionations for anal canal

Answer 14

54/30
50.4/28
45/30

Question 15

PTV margin for anal canal

Answer 15

8 mm

Question 16

OAR dose constraints for anal canal 45/30

Answer 16

bladder < 50 % 35 Gy
bowel bag < 180 cc 35 Gy
bone marrow and femoral heads < 50 % 30 Gy

Question 17

do you treat bladder cancer on empty or full bladder?

Answer 17

empty

Question 18

common bladder cancer fractionation

Answer 18

46/23 (phase 1)
14/7 (phase 2)
20/10 (phase 2)
55/20

Question 19

PTV margin for bladder cancer

Answer 19

7 mm to 1 cm

Question 20

rectum constraints for bladder cancer 2 phase plan

Answer 20

V30 Gy < 50 % (phase 1), < 80 % (sum)

Question 21

rectum and bowel bag constraints for > 2 Gy/fx in bladder

Answer 21

rectum < 80 % 24.6 Gy

bowel is STILL < 195 cc 45 Gy

Question 22

rectal cancer fractionations

Answer 22

25/5

45-50 in 25

Question 23

PTV margin for rectal cancer

Answer 23

7 mm

Question 24

bowel and bladder OAR constraints for rectal cancer 25/5

Answer 24

bowel < 180 cc 10 Gy

bladder < 15 % 21 Gy

Question 25

bowel and bladder OAR constraints for rectal cancer 45-50/25

Answer 25

bowel <180 cc 35 Gy

bladder < 55 % 40 Gy

Question 26

why are some anal canals treated prone?

Answer 26

pressure on full bladder pushes bowel out of way, but patient position less stable