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causes and consequences > Radiotherapy > Flashcards

Radiotherapy Flashcards

1
Q

how is radiotherapy more commonly given

A

in multi-modality treatment

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2
Q

what is radiotherapy

A

the use of ionising radiation to treat cancer

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3
Q

what type of cancers are treated with radiotherapy

A

most solid malignancies and some liquid

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4
Q

how many cancer patients get R/T

A

50-60%

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5
Q

how many patients are cured by R/T

A

40%

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6
Q

what types of ionising radiation afterused

A

X-rays, gamma rays, beta particles, alpha particles, neutrons and protons

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7
Q

what radiation is used in conventional external beam R/T

A

X rays

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8
Q

how was radiation originally deliviered

A

one big dose, had lots of severe side effects

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9
Q

what is fractionated radiotherapy

A

many smaller doses of radiation for many weeks (up to 7 for more resistant cancers like head and neck)

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10
Q

what equipment delivers R/T

A

linear accelerators (LINACS)

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11
Q

what happens in the treatment planning

A

immobilisation, MRI and CT, image fusion, volume delineation, Treatment planning, plan verification, pre-treatment imaging, treatment (30secs)

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12
Q

what is image fusion good for

A

finding tumour and any other damaged tissue

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13
Q

what is the conventional fraction for breast cancer treatment

A

50Gy (2 Gy x 25) +/- lumpectomy cavity boost

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14
Q

what is the hypofractionation for breast cancer treatment

A

42.5 Gy (2.66 Gy x 16 fractions), 40Gy (2.66 x 15 fractions)

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15
Q

what is accelerated radiotherapy

A

schedule in which the rate of dose -accumulation exceeds 10Gy/week

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16
Q

what is Hyperfractionation

A

ant schedule employing a dose per fraction of less than 1.8Gy

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17
Q

why is radiotherapy given (5)

A
  1. curative intent
  2. shrink cancer before surgery
  3. to reduce risk of recurrence post surgery
  4. to complement chemo
  5. to control symptoms and increase QoL (palliative)
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18
Q

what does neoadjuvant mean

A

given before surgery

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19
Q

what does adjuvant mean

A

given after surgery

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20
Q

Brachytherapy

A

rods inserted into the tumour

21
Q

what is brachytherapy commonly used for

A

prostate cancer and uterine and cervical cancer

22
Q

Brachytherapy for prostate cancer

A

plastic catheters inserted through the perineum and into the prostate under anaesthesia

23
Q

Brachytherapy: what is the dwell time

A

when the radioactive rods are in the tumour

24
Q

advantage of brachytherapy

A

treatment is done in 2-5 days not 6 weeks

25
Q

disadvantages of brachytherapy

A

strict bed rest while catheters are inside so movement is restricted

26
Q

how do LINACS work - EBRT

A

uses microwaves to accelerate electrons that collide with a heavy metal target to produce X-rays which are focused down onto the patient

27
Q

what is the therapeutic ratio in EBRT (external beam radiotherapy)

A

maximising the therapeutic effect and minimising toxic effect on normal tissue

28
Q

How does Intensity-modulated radiation therapy (IMRT) work

A

uses computer-controlled LINACS to deliver precise radiation doses to the tumour, or specific areas within the tumour

29
Q

what does IMRT allow for

A

higher radiation doses to be focused to regions in the tumour while minimising the dose to surrounding structures

30
Q

what is IMRT currently being used to treat mostly

A

prostate, head and neck and CNS cancers

31
Q

How does radiation therapy kill cancer cells

A

stops them dividing and growing

32
Q

early (acute) side effects of radiation treatment

A

tiredness and skin problems such as sensitivity, redness and swelling

33
Q

less common acute side effects of radiation therapy

A

hair loss in area, eating issues, nausea and vomiting, soreness and swelling, mouth issues, diarrhoea, headaches, urinary/bladder changes

34
Q

late (chronic and progressive) side effects of radiation therapy

A

brain, kidney, colon, spinal cord, mouth, rectal, lung and joint changes, secondary cancers, lymphedema, infertility

35
Q

what does alpha radiation consist of

A

2 neutrons and 2 protons bound together so tightly that it acts like a fundamental particle

36
Q

what does beta radiation consist of

A

high speed e- that originate in the nucleus. electrons of low energy should be referred to as delta rays

37
Q

what does gamma radiation consist of

A

its an electromagnetic radiation that consists of photons. They consist of quanta (packets) of energy that are transferred in wave motion

38
Q

difference in X-rays and gamma rays

A

their origin - gamma rays result from nuclear changes and X-rays are emitted when atomic e- undergo a change in orbit

39
Q

which cells are more resistant to radiation

A

hypoxic cells

40
Q

methods of selectively attacking hypoxic cells

A
  1. Hyperbaric oxygen (HBO)
  2. high-LET radiation, hypoxic cells sensitisers
  3. increase Hb levels
41
Q

what causes 1 M-phase cell to become 2 G1 cells

A

non-uniform distribution

42
Q

in which phase of the cell cycle are cells particularly resistant to radiation

A

S phase

43
Q

when is cancer less effective at repairing DNA damage

A

at small doses of RT

44
Q

what are the 4 R’s of radiotherapy?

A

Reoxygenation
Redistribution
Repair
Repopulation

45
Q

which cancers are highly sensitive to radiotherapy

A

lymphoma, leukaemia, seminoma, dysgerminoma

46
Q

which cancers are fairly highly sensitive to radiotherapy

A

squamous cell cancers of the glottis, oropharyngeal, bladder and cervical epithelia

47
Q

which cancers not very sensitive to radiotherapy

A

breast, salivary gland, hepatomas, renal, pancreatic

48
Q

which cancers have low sensitivity to radiotherapy

A

rhabdomyosarcoma

49
Q

what regimens are currently recommended for RT for breast cancer

A

50Gy in 25 daily fractions over 5 weeks or 40Gy in 15 daily fractions over 3 weeks

causes and consequences (15 decks)

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