Radiation Therapy

Question 1

Discovery of X-rays

Answer 1

Roentgen 1895

Question 2

Discovery of Radioactivity

Answer 2

Becquerel1896

Question 3

Definition of Radiation

Answer 3

Radiation=Energy

Question 4

Diagnostic vs. Therapeutic Radiation

Answer 4

Therapeutic radiation is of higher energy

Question 5

Radiation Machines

Answer 5

Superficial machines, orthovoltage, Cobalt, Linear Accelerators

Question 6

Radiation Sources

Answer 6

Cobalt, Radium, Iridium, Iodine, Gold,Cesium,Palladium

Question 7

Mechanism of Radiation Cytotoxicity

Answer 7

DNA injury

Question 8

CANCERS COMMONLY TREATED EFFECTIVELY WITH RADIATION THERAPY ALONE

Answer 8

Squamous cell carcinomas of head and neck Squamous and basal cell carcinomas of skin Cervical cancers

Vaginal cancers

Prostate cancers Hodgkin’s Disease NonHodgkin’s lymphoma

Question 9

CANCERS COMMONLY TREATED EFFECTIVELY WITH THE COMBINATION OF SURGERY AND RADIATION THERAPY

Answer 9

Head and neck cancers Brain tumors

Uterine cancer

Colorectal cancer Breast cancer

Soft tissue sarcomas

Question 10

CANCERS COMMONLY TREATED WITH THE COMBINATION OF CHEMOTHERAPY AND RADIATION THERAPY

Answer 10

NonHodgkin’s lymphoma Hodgkin’s Disease

Anal cancer

Esophagus cancer

Head and neck cancers

Inflammatory breast cancer

Question 11

Very Sensitive Tumor to Radiation

Answer 11

Germ cell tumors

Lymphomas

Question 12

Moderately Sensitive

Answer 12

Adenocarcinomas

Squamous cell carcinomas

Question 13

Less Sensitive to Radiation

Answer 13

Osteogenic sarcomas

Renal cell carcinomas

Question 14

RADIATION DOSES REQUIRED FOR 90% liKEliHOOD OF CONTROL OF SQUAMOUS AND ADENOCARCINOMAS

Answer 14

Microscopic disease: 1em of disease :

2 em of disease:

5000 cGy in 25 treatments

6000 cGy in 30 treatments

7000 cGy in 35 treatments

Question 15

INDICATIONS FOR RADIOTHERAPY

Answer 15

Cancers which can’t be resected or resection would cause unacceptable cosmetic or functional deficit

Question 16

TECHNIQUES IN RADIOTHERAPY

Answer 16

Physical Aspects (Exclude as much normal tissue as possible)

Beam Orientations

Beam Shape

Radiation Energy

Source Distance

Number of Fields

Question 17

Fractionation

Answer 17

FractionationDividing total radiation dose into number of small treatments

Question 18

BRACHYTHERAPY INDICATIONS

Answer 18

Definitive Treatment

Boost Treatment

Recurrent Disease

Pediatrics

Question 19

Acute Toxicity

Answer 19

Dependent upon total dose, fraction size, interval between fractions

Question 20

Late Toxicity

Answer 20

Dependent upon total dose and fraction size

Question 21

FUTURE DIRECTIONS IN RADIOTHERAPY

Answer 21

Increasingly localized treatment

Altered fractionation

Concurrent systemic agents

Assays for tumor response

Assays for normal tissue response

Tailoring of treatment based on genetic profile

Question 22

Rationale for Non-Surgical Treatment

Answer 22

Question 23

Rationale for Fractionation

Answer 23

Question 24

Senstitivity of Tumors to Radiation

Answer 24

Question 25

Indirect Action vs. Direct Action of DNA Damage

Answer 25

Question 26

Diagnostic vs. Therapeutic

RAD

Answer 26

Diagnostic vs. Therapeutic Radiation— Low energy photons for diagnostic — High Energy radiation for therapeutic.

RAD — Radiation absorbed Dose

Centigrade and RAD used interchangeably.