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CSB069 > SRS and SRT > Flashcards

SRS and SRT Flashcards

1
Q

What defines sterotactic?

A
  • high precision
  • small targets
  • high dose
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2
Q

What does SRS allow?

A
  • steep dose gradient and thus minial dose to OAR

- increased conforminty

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3
Q

How is conformity achieved?

A
  • use of multiple non-coplanar beams
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4
Q

What is SRS?

A
  • single high dose of radiation
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5
Q

What is SRT?

A
  • treatment is delivered in more than one fraction
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6
Q

What are the indications for SRS/SRT?

A
  • small tumour size
  • tumour location
  • pathology of tumour
  • the patient
  • tumour recurrance
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7
Q

What are the acute side effects of SRS?

A
  • headache
  • nausea/vomitting
  • visual disturbances
  • swelling
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8
Q

What are the late side effects of SRS?

A
  • facial weakness
  • numbness
  • hearing loss
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9
Q

What are the advantages of stereo over VMAT?

A
  • minimal damage to surrounding tissue
  • treat to higher doses
  • treatment can be given mutliple times
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10
Q

What are the most common sites for SRS?

A
  • acoustic neuroma
  • meningioma
  • cranial mets
  • AVM (arteriovenous malformation)
  • GBM (glioblastoma multiforme)
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11
Q

What is acoustic neuroma?

A
  • benign tumour of the 8th cranial nerve
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12
Q

What are the presentation symptoms or acoustic neuromas?

A
  • hearing loss
  • tinnitus
  • balance disturbances
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13
Q

When is SRS used for acoustic neuromas?

A
  • when surgery risks damage to facial nerves and hearing

- 12Gy in 1#

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14
Q

What is meningioma?

A
  • benign tumour arsiing from meningeal tissue
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15
Q

When is SRS used for meningioma?

A
  • inoperable or small tuours
  • SRS: 18-20Gy in 1#
  • SRT: 50-60Gy in 25-30#
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16
Q

When is SRS used for mets?

A
  • can treat up to 5 in one session

- 16-20Gy in 1#

17
Q

What is AVM?

A
  • vascular abnormality
18
Q

What are the presentation of AVM?

A
  • intracranial bleed
  • seizures
  • problems with movement speech or vision
19
Q

When is SRS used for AVM?

A
  • where surgery or embolisation is high risk of failed

- 15-20Gy in 1#

20
Q

What is a GBM?

A
  • highly malignant and fast growing tumour
21
Q

What are the presentations of GBM?

A
  • headache
  • nausea/vomitting
  • seizures
  • memory loss
  • changes in speech or personality
  • walking difficulties
22
Q

When is SRS used for GBM?

A
  • reccurence

- 6-16Gy in 1#

23
Q

Why is MRI used?

A
  • excellent definition of tumour volume

and critical structures

24
Q

What occurs in sim for SRS patients?

A
  • in treatment position lying on brainlab couch overlay

- cranial array positioned over patient to ensure head fits in

25
Q

What are the advantages of brainlab mask?

A
  • suitable for SRS and SRT
  • non-invasive
  • forehead, nose and mouth re-enforcement for extra stability
  • re-usable
26
Q

What are the dosimetric considerations for SRS?

A
  • beam vs arc depends on tumout size and location
  • numer of beams and floor angles dictates length of treatment and need to consider patient tolerance
  • achieve most optimal plan
27
Q

What are stero plans presribed to achieve?

A
  • 80% iso line covering PTV
28
Q

What are the patient pre-treatment preparations?

A
  • obs taken

- nurse administer lorazepam

29
Q

How does exactrac work once the patient is on bed?

A
  • patient moved to iso defined from sim
  • x-rays taken and infr-red detector moves patient bed position adjusted
  • once in tolerance treatment starts
  • imaging is repeated every time floor angle is changed
30
Q

What are the imaging tolerances?

A
  • > 3Gy: 0.5mm
  • <3Gy: 0.9mm
  • VMAT: 3mm
31
Q

What do the patients do after SRS treatment?

A
  • wheeled out in wheelchair
  • obs repeated by nurses and monitored for 30 mins
  • not to drive home

CSB069 (7 decks)

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