Session 2 Prework _ Radiation and Small Cell Lung Cancer Flashcards
Pre-Work for 3/19/25 session
What is external beam radiation therapy (EBRT)?
Uses a beam of photons or electrons to kill tissues, typically administered over several days.
What is stereotactic radiosurgery (SRS)?
Full calculated dose of radiation delivered in one fraction, typically for small tumors.
Typically to brain, spine
Stereotactic Body Radiation Therapy
SBRT
2-5 fractions of precise radiation, usually extracranial
To lung, liver, pancreas, prostate, bones
What is stereotactic body radiation therapy?
SBRT
2-5 fractions of highly precise radiation usually to spine, lung, prostate, pancreas, liver
What is brachytherapy?
Radiation source placed inside or next to the area. Can be low dose or high dose. Helps to focus radiation around the tumor cells and spare healthy cells because it only travels short distances.
Examples: Prostate, Endometrial, Cervical, Breast Cancers
What is radiation therapy?
Cytotoxic treatment that ionizes atoms to cause double strand breaks in DNA of cells. Tumor cells are more susceptible to damage than healthy tissues, but all get impacted.
What are acute side effects of radiation therapy to the abdomen?
Nausea, Vomiting, Diarrhea
Tissues swell during the treatment, so can have side effects related to edema. These are all temporary, improves once the tissue swelling goes down and healing occurs.
What are acute side effects of radiation therapy to the Thorax?
Esophagitis / Odynophagia / Dysphagia
Tissues swell during the treatment, so can have side effects related to edema. These are all temporary, improves once the tissue swelling goes down and healing occurs.
What are acute side effects of radiation therapy to the Pelvis?
Bowel / Bladder changes
Tissues swell during the treatment, so can have side effects related to edema. These are all temporary, improves once the tissue swelling goes down and healing occurs.
What are the indications for radiation therapy?
Symptom management, Neoadjuvant therapy, Adjuvant Therapy, Definitive (Curative) therapy
What are the different types of radiation therapy?
External Beam Radiation Therapy, Brachytherapy, Intraoperative Radiotherapy, Targeted Radionuclide Therapy
What is fractionation in radiation therapy?
Each dose of radiation delivered, a fraction of the total dose delivered over time.
Example: 5 Fractions (Fx) of 2 Gray (Gy) = 10 total Gy.
What wavelengths are used in radiation therapy?
Xray, Gamma Rays
What are the types of External Beam Radiotherapy (EBRT)?
3D-CRT, 4D-CRT, IMRT, VMAT, SRS, SBRT, WBRT
How long are patient visits for radiation therapy, typically?
15-30 minutes
What is hypofractionation?
Less fractions than standard
What is hyperfractionation?
More fractions than standard
What does Gy stand for?
Gray: unit of radiation delivered
What is the median overall survival for patients with extensive stage small cell lung cancer treated with chemotherapy?
10.5 months
What does it mean to be radiosensitive?
Cancer that is highly susceptible to the radiation therapy (tumor cells can easily be killed by radiotherapy)
What does it mean to be radioresistant?
Cancer that is resistant to radiation therapy (tumor cells not so easily killed by radiotherapy)
What is Extensive Stage Small Cell Lung Cancer?
Advanced SCLC that has spread beyond one lung (hemithorax) and may include distant metastases, malignant pericardial or pleural effusions, and/or contralateral lymph node involvement.
Why does Small Cell Lung Cancer have a poorer prognosis compared to non-small cell lung cancer?
Because, although SCLC is very responsive to chemotherapy and radiation initially, it very commonly recurs and subsequent treatments are not as effective. Essentially, lesser treatment options that prolong life. With the exception of newer data coming out related to BiTE therapy.
What are the 4 most common side effects of platinum based chemotherapy?
Myelosuppression, Nausea, Neuropathy, Nephrotoxicity
What are the 4 most common acute side effects of IMRT to the Head and Neck?
Mucositis, Skin toxicities (localized skin breakdown/burning/itchiness), Dysphagia, Hoarseness
What are common late side effects of IMRT to the Head and Neck?
Xerostomia (dry mouth), Fibrosis, jaw trismus, pharyngeal dysfunction, Thyroid dysfunction
When would you expect acute side effects to H&N radiation to start developing?
2-4 weeks after initiation of radiation
When would you expect acute side effects to H&N radiation to hit its peak?
Right at the completion of Radiation therapy
When would you expect acute side effects to H&N radiation to start getting better?
1-3 weeks after radiation is completed
For radiation to treat bone pain, when would you expect pain to improve?
2 weeks to 2 months later
What is first line therapy for ES-SCLC?
Extensive Stage - Small cell lung cancer
Chemotherapy + Immunotherapy
What is first line therapy for LS-SCLC?
Limited Stage - Small cell lung cancer
Chemotherapy + Radiation Therapy, sometimes including prophylactic cranial irradiation (PCI)
What is Small Cell Lung Cancer?
Neuroendocrine Carcinoma - highly aggressive, can have paraneoplastic syndromes associated. High risk of brain metastases.
