Radiation and chemotherapy Flashcards

1
Q

Therapeutic ratio

A

Therapeutic effect of radiation on tumor vs normal tissue toxicity

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2
Q

Fractionation

A

Use of small doses of ionizing radiation over time (interval between doses allows for normal cell repair of sublethal damage)

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3
Q

Dose-rate

A

Rate at which ionizing radiation is administered in a single fractionation (lower means more capacity for cells to repair sublethal injury)

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4
Q

Compton scatter

A

Primary means of interaction in modern RT; incident photon interacts with outer shell electrons resulting in ejection from the atom and further interaction with other atoms

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5
Q

Logrhythmic cell death

A

Chemo is thought to kill tumor cells by first order kinetics, ie. a fraction rather than a number of tumor cells

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6
Q

How many tumor cells can be detectable if achieving prolonged survival or cure

A

<10,000

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7
Q

Alopecia

A

Alkylating agents, plant alkaloids, most antimetabolites (NOT platinum)

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8
Q

Peripheral neuropathy

A

Taxol, platinum agents, ifosphamide, cyclofosphamide

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9
Q

CNS neuropathy

A

Ifosphamide, cyclofosphamide

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10
Q

Cardiac dysrhythmia

A

Taxol, doxorubicin

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11
Q

Cardiomyopathy

A

Doxorubicin (less likely with doxil)

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12
Q

Hypersensitvity

A

Taxol, platinum (less common)

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13
Q

Pulmonary fibrosis

A

Bleomycin

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14
Q

Renal toxicity

A

Platinum (cisplatin worse)

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15
Q

Hemorrhagic cystitis

A

Ifosphamide, cyclophosphamide

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16
Q

Vessicants

A

Antitumor abx, antimetabolites

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17
Q

Palmar plantar erythrodysthesia (PPE)

A

Doxil

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18
Q

Radiation recall

A

Doxorubicin, actinomycin D

19
Q

Mucositis

A

Anti-tumor abx, antimetabolites

20
Q

Premature ovarian failure

A

Alkylating agents (cyclophosphamide, cisplatin, doxorubicin, bleomycin)

21
Q

Mechanism of paclitaxel (Taxol)

A

Stabilization of microtubule apparatus

22
Q

Mechanism of cisplatin

A

Forms DNA adducts, single and double strand DNA breaks

23
Q

Mechanism of carboplatin

A

Forms DNA adducts, single and double strand DNA breaks

24
Q

Cisplatin vs carboplatin

A

Cisplatin more nephro- and neuro-toxic, emetogenic; carboplatin causes myelosuppression, less other side effects

25
Q

Mechanism of liposomal doxorubicin (doxil) = antitumor antibiotic

A

Intercalation into DNA strand, free radical formation, inhibits topoisomerase I

26
Q

Mechanism of topotecan

A

Inhibits topoisomerase I

27
Q

Mechanism of gemcitabine (Gemzar)

A

Inserts into DNA as fraudulent base pair

28
Q

Mechanism of bevacizumab (Avastin)

A

Recombinant humanized monoclonal antibody that targets VEGF (inhibits angiogenesis)

29
Q

Side effects of bevacizumab

A

Proteinuria, HTN, wound healing problems

30
Q

Mechanism of olaparib (Lynparza)

A

PARP inhibitor (PARP normal involved in DNA repair)

31
Q

Indication for olaparib

A

BRCA 1 or 2 ovarian cancer already treated with 3 courses of chemo

32
Q

Mechanism of doxorubicin (Adriamycin) = antitumor antibiotic

A

Intercalation into DNA strand, free radical formation, inhibits topoisomerase I

33
Q

Side effects of doxorubicin

A

Myelosuppression, cardiotoxicity (cardiomyopathy, pericarditis-myocarditis syndrome)

34
Q

Mechanism of ifosphamide

A

DNA cross-linking, formation of DNA adducts

35
Q

Side effects of ifosphamide

A

Myelosuppression, hemorrhagic cystitis, neurotoxicity, SIADH

36
Q

Most common chemo of chemo RT regimens

A

Cisplatin

37
Q

Side effects of cisplatin

A

Nephrotoxicity, ototoxicity, neurotoxicity, emesis

38
Q

Mechanism of methotrexate

A

Binds dihydrofolate reductase

39
Q

Mechanism of actinomycin D

A

Intercalates into DNA strands

40
Q

Mechanism of cyclophosphamide

A

DNA cross-linking, formation of DNA adducts

41
Q

Mechanism of etoposide

A

Inhibits topoisomerase II causing DNA strand breaks

42
Q

Late effect of etoposide

A

AML and myelodysplasia

43
Q

Mechanism of vincristine

A

Binds tubulin to prevent microtubule assembly

44
Q

Mechanism of bleomycin

A

Produces free radicals