radiation Flashcards
What is the radiation dose if you have microscopic positive groins?
50Gy or 5000cGy given over 28 fractions at 180 cGy per fraction to cover the inguinal, pelvic LN and vulva.
What is the radiation dose if you have multiple nodes/extracapsular spread
60 Gy
What is the radiation dose if you have gross disease in the nodes?
60-70Gy
What does the anterior and posterior field cover?>
The anterior field: inguinal region, lower pelvic nodes, vulva (6 MV) Posterior field (10 MV) narrower to include lower pelvis and vulva but excludes majority of femoral heads to <35 Gy
What are common radiation toxicities?
skin inflammation, diarrhea, cystitis, moist desquamation. frog leg to spread inguinal tissues out, radiation necrosis to femoral heads
How to minimize radiation to bony structures?
use electrons as supplement to lateral portion of inguinal fields. know depth of inguinal nodes with CT planning (this was major flaw in GOG study- there was high relapse rate in groin due to inappropriate electron beam energy utilization.
Tissue sparing block?
use of midline block for upper half of pelvic field - will reduce the amt of vulva covered in the radiation field.
S/p hysterectomy with 2.5cm vaginal mass with paravaginal extension, how do you treat?stage?
Stage II : Radiation with EBRT 4500. Brachytherapy to 60-70 Gy
For a distal 1/3 stage II vaginal cancer, what is the treatment
Radiation EBRT and treat ing nodes to 45-50GY. Tx with brachytherapy entire vag mucosa to surface dose of 60-70 Gy
Stage III vaginal cancer, treatment?
Consider cisplatin, based on cervical and vulvar data.
EBRT 45– 50 gray. If lower one third involvement, treat inguinal nodes to 45–50 Gy. Brachytherapy to entire surface dose of 60–70 Gray. Parametrial and paravaginal boost to 65–70 Gray. Boost the tumor to 75–85 Gy
