Radiotherapy

Question 1

What is the difference between adjuvant and neoadjuvant treatment?

Answer 1

Adjuvant is the additional therapy given with/after main treatment

Neoadjuvant is given prior to main treatment to reduce tumour size

Question 2

What are the advantages and disadvantages of neoadjuvant therapy?

Answer 2

• Can do more conservative surgery
• Chemo response can predict outcome
• May overtreat
• Disease may progress

Question 3

What are the advantages and disadvantages of Adjuvant therapy?

Answer 3

• Immediate surgical removal
• Bigger surgery may be needed
• Can’t measure efficacy of chemo/radio before

Question 4

What different methods of radiotherapy can be given?

Answer 4

External beam (EBRT)

Brachytherapy

Systemic (Injected/swallowed)

Question 5

How is radiotherapy dose defined?

Answer 5

Irradiation absorbed by 1kg of tissue. Expressed in Grays (Gy)

Question 6

Why are radiotherapy doses given in fractions?

Answer 6

Highest total dose delivered to tumour but normal tissue preferentially spared

Question 7

What are some acute toxicities of radiotherapy?

Answer 7

Fatigue 
Moist desquamation of the skin
Oral mucositis 
Pneumonitis 
N&V
Cytopenia can occur in whole body radiation

Question 8

What are some long term effects of radiotherapy?

Answer 8

Secondary cancer!!

Others tend to relate to area be radiated: 
Fibrosis leading to reduced ROM
Lymphedema 
Infertility
Hypothyroidism 
Dry eyes and cataract