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Breast cancer > Radiotherapy > Flashcards

Radiotherapy Flashcards

1
Q

AZ? What is the rest and what does each thing stand for?

A

Az sy, Atomic number, sy= element,z=proton number

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2
Q

What are isobars? And give examples?

A

Isobars are atoms of different elements that have the same mass number eg,6c14,7n14,8o14)

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3
Q

What are isotanes and give examples?

A

Atoms of different elements that have the same neutron number – 14Si30,15P31)

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4
Q

What is radioactive deacy and radiation?

A

Nuclear instability caused by the size imbalance of proton:neutron ratio.Two different isotopes of the same element will have different tendancies to undergo nuclear decay;carbon-14(6 protons and 8 neutrons)is more likely to decay than carbon -12(6 protons and 6 neutrons)

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5
Q

What is A decay and give 4 pointers.(fusion)

A

A nucleus breaks down and a helium atom is released.
Eg. Ra->Rn + He2+ (helium atom – 2 p and 2 n)
1 alpha gives 10,000 atomic ionistations
Most damaging to tissue but least penetrating (um)- dangerous inside the body.

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6
Q

What is beta decay and give the 4 types.

A

Beta particle – electron – beta decay
- A neutron suddently changes into a proton causing the release of an electron
and neutrino
- Eg.K->ca+e+v
- 1 beta =100 atomic ionisations
- Damaging to tissues and penetrating – dangerous outside the body

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7
Q

What is gaba decay and give the three points.

A
  • The nucleus rearranges to a lower energy state, a photon gamma ray is released - 1 gama gives 1 atomic ionisations
  • Very high energy amd highly penetrating, causing dna danage
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8
Q

Who discovered radioactive elements?

A

Marie curie

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9
Q

What is radium?

A

Radium 223 is a radiopharmaceutical producer of decay of Uranium
235

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10
Q

What is uranium?

A

Uranium 238,92 -the most abundant isotope 99.2% and is a
natural alpha emitter.

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11
Q

What is polonium?

A

Polonium 210 is a powerful alpha emitter, 1 million times more
toxic than cynide.

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12
Q

What elements are used for imaging and what is their half- lives?

A

Gallium(68
mins),Rubidium(4.7h)

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13
Q

What is moly- cow

A

used to exctract TC 99M

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14
Q

What elements are sued for moly – cow and what are their half lives

A

Molybdeuem
Mo99(66h),polonium 210(180 days),Germanium(280 days)

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15
Q

What is RTX?

A

Radiotherapy – given by external beam radiation therapy EBRT –
Tumours with diameter of greater than 2 can be treated using this.

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16
Q

Which elements are used for sterilisation?

A

Cobalt (5 years)

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17
Q

What is EBRT?

A

External beam radiation therapy

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18
Q

What percentage of patients diagnosed with BRCA used radiotherapy?

A

63% as part of
their primary care,its recommended after a lumpectomy.Survival rate is increased by 32-67%

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19
Q

What are the regimen details for radiotherapy?

A

Daily treatments for 6/7 days over 6 weeks- dosing regimen – LDR- Low dose rate less than 2,Moderate dose rate mdr 2- 12,high dose rate hdr- greater than 12

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20
Q

What is APBI

A

Accelerated partial breast irradiation and interstitial RTX

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21
Q

What are the subtypes?

A

IMRT,IBRT,IORT

22
Q

What is IMRT?

A

Intensity modulated radiotherapy

23
Q

What is IBRT?

A

internal beam radiotherapy – internal mammory radiotherapy – the
insertion of radioactive implants (platinum,iridium,iridium and palladium)directly
into tissue

24
Q

What is IORT?

A

intraoperative radiotherapy

25
Q

What is the impacts of water radiolysis?

A

Radiolysis of water produces hydrogen and
hydroxy ions and hydrogen and hydroxy free radicals :H+ +HO- + h. + oh., additional contact with nearby oxygen creates super oxides which cause damage to the cell(indirect DNA Damage.These destroy the DNA by breaking double strands and leading to cell death.If a tumour Is anorexic it is deprived of oxygen due to the rapid outgrowth of blood supply,therefore fewer superoxides are produces.Tumours are very radio resistant and anorexic above 0.5cm3.

26
Q

What is Fractionation?

A

Total dose of radiation is divided into sveral,smaller doses over a period of days.This reduces the toxic effect on healthy cells.

27
Q

What are the 4 main goals of RTX?

A

Repair- Although non canerous cells may be affected -their ability to heal double stranded breaks is better than cancer cells. Fractionation allows normal cells to repair. Repopulation – Tumour cells can repopulate when in completely damaged, each fraction(dose of radiation) must cause more damage than the cells ability to repopulate,fractionation allows normal cells to repopulate.Re-assortment – each fraction allows reassortment of tumour cells to be in M-phase.More considerable DNA damage is caused.Reoxygenation – Most dna damage is indirect – caused by superoxides due to free radical contact with oxygen.Fractionation allows oxygen rich tumours to die first and previously hypotoxic tumour cells to be oxygenated.Cells are more susceptible to radiation in next fraction.

28
Q

Exposure to radiation Side effects include:

A

Fatigue,nausea,fever,vomiting,white blood cell damage after 7 days,hair loss after 12 days,other effects like abdominal pain,palpitations,promotion of cancer and organ damage.

29
Q

What Radionuclide generator?

A

A source of radionucleotide for radiopharmaceuticals.

30
Q

What is the most commonly used generator?

A

Technetium- 99metastable/molybdeeum-99) generator.It has a high short life – 6hrs and can be easily manufactured. Its used as a medical tracer radioactive tracer and can be detected in the body using medical equipment(gamma cameras).it is well suited to the role because it emits gamma rays.

31
Q

What are xrays?

A

x rays blacken photographic film, more dense structures – bones appear white and less dense structures – soft tissue,fat0 appear black.X rays are used to confirm bone fractures or breaks- non invasive,ionising imagine technique. Hydroxyapatite is what bones are made of – from phosphate salt and calcium.

31
Q

What is MDP?

A

Methylene di orthophosphate.tc99 is incoportaed into broken bones, a radioactive tracer may view this radioactive blood pooling,indicating broken bone. Soft tissue doesn’t take up Tc99m

32
Q

What is computer tomography?

A

Ct scans show a slice or cross section of the body,x- ray images result from attenuation of xrays by material through which they pass. A ttenuation is the removal of x-rays from a beam by absorbibg or scattering them – the greater the density of a material,the greater it absorbs/scatters xrays.The image shows bones, organs and soft tissue more clearly than standard xray. Ct uses massive amounts of ionising radiation – effective dose of head ct is 100 times greater,chest CT 300 times greater and abdominal ct 400 times greater.

33
Q

What are mammograms?-

A

ionising radiation – low energy xrays- used as a complement to ultrasound,ductography,positron emission and mammography(PEM) and magnetic resonance imaging – MRI – to give xray image of breast tissue.Parallell plates are used to compress breast tissue to reduce exposure to x rays.

34
Q

What is an MRI?

A

far more detailed images produced. Detailed brain,blood vessles,nerves,bones and organ.Takes pictures of places of the body that contain water and with other imaging cant see. It works by way the waves interact with electromagnetic waves .Protons are aligned parallel or anti parallel and a very strong constant magnetic field forms that remains in place for the duration of the measurement and this strong field makes all the protons try to line up with the poles of the field.Mri machine interrupts the field – they become miassaligned in order to determine difference in the density and shape of the tissue through the body.

35
Q

What is a PET?

A

A positron – beta decay – travels a short distance before colliding with an electron of nearby atom causing annihilations

36
Q

What is annihilation?

A

In particle physics, annihilation is the process that occurs when a subatomic particle collides with its respective antiparticle to produce other particles, such as an electron colliding with a positron to produce two photons - gamma camera. F-fdg is most commonly used radiopharmaceutical – half life of 110 mins – allowing for it to be transported around the body.FDG used to measure rate of glucose metabolism

37
Q

PET-CT

A

a combination of both PET and CT scans.produces one image

38
Q

What rays are used for sterilisation?

A

Gamma rays – bandages,scalpels,needles and
cannulas

39
Q

What is calcifications in the breast?

A

calcium in diet does not cause calcium deposits.

40
Q

What are the side effects of treatment?

A

Hair loss,fatigue,apetite changes,change to
appearance,menopausal symptoms.

41
Q

What are the changes to the body?

A

hot flushes and mood swings,vaginal dryness –
low oestrogen- sexuality

42
Q

What are the changes to anxiety?

A

depression of over 25% diagnosed,CBT other psych
help may be needed.

43
Q

What are the effects that it can have on the heart?

A

due to chemo,radiotheraoy and
hormone theapy.

44
Q

Weight Gain?

A

Less active and onset meno pause

45
Q

What is replication stress induction?

A

The slowing down or stalling of DNA synthesis and/or replication forks is referred to as replication stress (RS)

46
Q

What is Bevacizumab?

A

Bevacizumab is a monoclonal antibody that binds to VEGF
Prevents VEGF binding to the receptor and triggering angiogenesis Prevents expansion of tumour by restricting oxygen/nutrient supply

47
Q

What is considered as a serm?

A

Tamoxifen

47
Q

What is a serm?

A

Selective Oestrogen receptor agonist

48
Q

Why tamoxifen good?

A

Improves bone mass- good for patients with osteoporosis

49
Q

-

A

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Breast cancer (8 decks)

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