RT treatment details Flashcards

1
Q

Involved Field Borders for Unilateral Cervical/SCL

A

Sup: 1-2 cm above lower tip of mastoid process and midpoint through chin unlesss only SCL is involved in which case superior border is at level of larynx
Inf: 2 cm below clavicle
Lat: include medial 2/3 of clavicle
Medial:
1. Include vertebral body (if medial nodes near vertebrae) to contralateral TP
2. Contralateral transverse process (if SCL nodes involved)
3. Otherwise, limit to ipsilateral transverse process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dose threshold to start for larynx block

A

19.8 Gy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dose threshold to start cord block

A

40 Gy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Involved Field Considerations for Bilateral Cervical/SCL

A
  1. Use posterior mouth block

2. Treat full fields regardless of extent of disease on each side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Involved field Mediastinum or hilar nodes

A

Sup: C5-C6 interspace
Inf: 5 cm below carina or 2 cm below pre-chemo border (whichever is lower)
Lateral: post-chemo volume
Hilum + 1 cm (not involved) or OR + 1.5 cm (if involved)
Include medial SCL nodes even if not clinically involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Involved Field Axilla

A

Sup: C5-C6 interspace
Inf: Tip of scapula or 2 cm below lowest axillary node (whichever is lower)
Lateral: flash axilla
Medial: ipsilateral cervical transverse process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Involved Field Spleen

A

Treat post-chemo volume + 1.5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Involved Field Paraaortic

A
Sup: Top of T11
Inf: Bottom of L4
Lat: Edge of transverse processes
>2 cm on post-chemo volume for lateral 
Consider kidneys when designing blocks
Include porta hepatis if originally involved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Involved Field Femoral/External Iliac

A

Sup: Middle of S-I joint
L4-L5 if common iliacs involved
Inf: 5 cm below lesser trochanter
Lateral: Greater trochanter >2 cm outside involved nodes
Medial: Medial border of obturator foramen
>2 cm outside involved nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

IFRT dose for CR to chemo?

A

30.6 Gy at 1.8 Gy per fraction in 17 fractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

IFRT dose for bulky disease initially?

A

36 at 1.8 Gy per fraction in 20 fractions or

39.6 Gy at 1.8 Gy per fraction in 22 fractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is meant by Subtotal lymphoid irradiation?

A

It includes mantle and inverted Y fields but sans the inguinal/femoral nodal regions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When do you perform CT simulation with arms up?

A

When treating the axilla, so that the nodes are drawn up and less radiation will be provided to the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should be targeted when treating DLBCL involving Waldeyers ring?

A
  1. Bilateral tonsil
  2. Base of tongue
  3. Nasopharynx
  4. Bilateral cervical neck
  5. Bilateral SCL nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What nodal regions does a Mantle Field include?

A
  1. Bilateral cervical
  2. supraclavicular
  3. infraclavicular
  4. mediastinal
  5. axillary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the draw backs to simulating with ams up?

A
  1. SCL skin folds will be present
17
Q

What are the sites that you use the post-chemo volume for?

A
  1. Hilar/Mediastinum
  2. Spleen
  3. Paraaortic nodes