Radiation Therapy (XRT) Flashcards
CNS tumors that are very radiosensitive includes all of the following except?
● A. Gliosarcoma
● B. Germinoma
● C. Metastatic lung cancer
● D. Lymphoma
● E. Choriocarcinoma
A. Gliosarcoma
For most metastatic spine tumors treated with conventional radiation therapy (i.e., not stereotactic radiosurgery), what is the usual fractionation?
● A. 20 Gy administered over 10 fractions
● B. 30 Gy administered over 10 fractions
● C. 60 Gy administered over 10 fractions
● D. 30 Gy administered over 5 fractions
● E. 30 Gy administered over 20 fractions
B. 30 Gy administered over 10 fractions
For acute spinal cord paralysis from lymphoma, if emergency surgery is not a consideration, what is the emergency radiation that can be given in the 1st fraction?
● A. 2 Gy
● B. 3 Gy
● C. 4 Gy
● D. 6 Gy
● E. 8 Gy
E. 8 Gy
In chronic, progressive myelopathy, what is the commonly reported radiation myelopathy type?
● A. I
● B. II
● C. III
● D. IV
● E. V
D. IV
What is the source of particle generation PET scan?
● A. Cyclotron
● B. Tungsten
● C. Cobalt 60
● D. Cobalt 62
● E. Chromium
A. Cyclotron
A patient presented with sudden-onset loss of consciousness. According to Virginia Radiosurgery AVM Scale, a 3 cm3 thalamic AVM presenting with hemorrhage will be awarded how many points?
● A. 1
● B. 2
● C. 3
● D. 4
● E. 5
C. 3
An old female patient with breast cancer presents with first-time seizures. What is the recommended dose of SRS for a 25-mm metastatic brain lesion?
● A. 10 Gy
● B. 18 Gy
● C. 24 Gy
● D. 28 Gy
● E. 30 Gy
B. 18 Gy
A patient presented with unilateral hearing loss, tinnitus, and disequilibrium. What is the recommended single dose SRS for hearing preservation and to minimize new onset or worsening of cranial nerve deficits?
● A. 12 Gy
● B. 16 Gy
● C. 18 Gy
● D. 20 Gy
● E. 25 Gy
A. 12 Gy
A young female presented with galactorrhea amenorrhea and visual field defects. What is the usual SRS dose for secretory pituitary tumors?
● A. 10 Gy
● B. 12 Gy
● C. 20 Gy
● D. 25 Gy
● E. 30 Gy
D. 25 Gy
What is the rate of clinical improvement after interstitial brachytherapy?
● A. 100%
● B. 90%
● C. 75%
● D. 50%
● E. Rare chances
E. Rare chances
What are the four Rs of radiobiology that are referred by radiation oncologists?
● A. Repair of sublethal damage
● B. Reoxygenation of tumor cells that were hypoxic before radiotherapy
● C. Repopulation of tumor cells
● D. Redistribution of cell within the cell cycle
● E. All of the above
E. All of the above
All of the following are the CNS tumors that are very radiosensitive except?
● A. Lymphoma
● B. Thyroid adenocarcinoma
● C. Germ cell tumors
● D. Metastatic small cell cancer
B. Thyroid adenocarcinoma
Radiation therapy is the main treatment modality for radiosensitive spinal metastasis. Even tumors that are considered radioresistant can respond to radiotherapy. What is the usual fractionated therapy for spinal tumors?
● A. 20 Gy administrated over 10 fractions
● B. 30 Gy administrated over 10 fractions
● C. 40 Gy administrated over 10 fractions
● D. 50 Gy administrated over 10 fractions
● E. 60 Gy administrated over 10 fractions
B. 30 Gy administrated over 10 fractions
Following are the side effects of spinal radiation except?
● A. Radiation myelopathy
● B. Due to overlap, radiation injury to GI tract
● C. Bone marrow hyperactivity
● D. Growth retardation in children
● E. Risk of development of cavernous malformation of spinal cord
C. Bone marrow hyperactivity
Small artery injury because of radiation therapy causes which phase of radiation injury?
● A. Acute phase
● B. Early delayed which starts from few weeks to 2 to 3 months following completion of radiation therapy
● C. Late delayed phase which remains from 3 months to 12 years
● D. None of the above
C. Late delayed phase which remains from 3 months to 12 years
Manifestation of radiation effects includes all of the following except?
● A. Decreased cognition
● B. Radiation necrosis
● C. Injury to optic pathways or injury to hypothalamic pituitary axis
● D. Primary hyperthyroidism
● E. May induce formation of new tumor or malignant transformation or leukoencephalopathy
D. Primary hyperthyroidism
Which of the following tests can be done to differentiate radiation necrosis from recurrent tumor?
● A. MRI spectroscopy
● B. DWI
● C. Nuclear brain scan
● D. Computerized radionuclide studies including SPECT or PET
● E. All of the above
E. All of the above
Which of the following are included in the treatment of radiation necrosis which may cause mass effect or otherwise toxicity?
● A. Steroids
● B. Bevacizumab
● C. Reoperation or excision
● D. Hyperbaric oxygen and anticoagulation
● E. All of the above
E. All of the above
Types of radiation myelopathy include which of the following?
● A. Type 1 is mild form with mild sensory symptoms which commonly resolves within several months
● B. Type 2 is injury to anterior horn cells with lower motor neuron signs in arms or legs
● C. Type 3 is described only in experimental animals after doses larger than normal radiation. Complete cord lesion within hours occurs due to injury to blood vessels
● D. Type 4 is chronic progressive myelopathy which is commonly reported
● E. All of the above
E. All of the above
Following are indications of stereotactic radiosurgery except?
● A. Vascular lesions including AVMs or cavernous malformaions
● B. Tumors which include lesions less than 3 cm which can be metastasis, vestibular schwannomas, meningiomas, pituitary adenomas, or gliomas
● C. Compressive tumors of the spinal cord, brain stem, or optic structures
● D. Functional disorders like trigeminal neuralgia or intractable chronic pain, movement disorders of psychiatric disease
C. Compressive tumors of the spinal cord, brain stem, or optic structures
