Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RAD 370 - Techniques and Applications > Test 3 > Flashcards

Test 3 Flashcards

1
Q

Heterogenous group of diseases in blood

A

Leukemia

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

4 subtypes of leukemia

A

Acute lymphoblastic leukemia (ALL)
Acute myeloid leukemia (AML)
Chronic lymphocytic leukemia (CLL)
Chronic myeloid leukemia (CML)

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

Most common leukemia in kids; radiation therapy (RT), chemo, and bone marrow transplant (BMT)
Treatment of choice: BMT

A

Acute lymphoblastic leukemia (ALL)

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

4 RT treatment techniques for ALL

A

Total body irradiation (TBI) used in combination with BMT to prevent rejection
CNS technique
Helmet field/whole brain prophylactic treatment to cover meninges
Testicular field: leukemia cells track to testicles (“sanctuary”)

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

Testicular field dose

A

400 cGy in 1 fraction and TBI

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

Cranial-spinal irradiation (CSI) helmet field (right and left laterals) and spinal fields treat CSF

A

CNS technique

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

Most common leukemia per ACS; same in all ages, slight increase over 50
RT, chemo, and BMT (TBI)
Treatment of choice: BMT

A

Acute myeloid leukemia (AML)

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

Was the most common leukemia in US for years, usually elderly patients that can live awhile with disease
Optimal treatment unknown; palliative RT for local masses and involved lymph node (LN) and/or spleen

A

Chronic lymphocytic leukemia (CLL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Associated with Philadelphia chromosome, middle age around 55
RT for spleen or TBI, chemo, and transplant
Treatment of choice: BMT

A

Chronic myeloid leukemia (CML)

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

2 types of TBI’s

A

High dose

Low dose

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

High dose TBI dose for transplant

A

1000 cGy in 1 treatment

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

2 types of high dose TBI’s

A

Single

Fractionated

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

Single and fractionated high dose TBI dose

A

Single: 550 cGy at 275 cGy a side and 400 cGy/min
Fractionated: 1225 cGy in 7 fractions, about 175 cGy per treatment

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

Low dose TBI dose

A

5-15 cGy 2-5 times a week to 50-150 cGy, 10 cGy/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

TBI lung dose less than _______ cGy; pneumonitis at _______ cGy

A

800 cGy

1400 cGy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Chemo drug that gives same results as TBI

A

Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Half body treatment

A

Hemibody irradiation (HBI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Upper and lower doses for HBI and time between upper and lower treatment

A

Upper: 600 cGy (lower because of lungs)
Lower: 800 cGy
Time: 2-4 weeks between treatments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Produces hormones under complex feedback-control mechanisms that affect various functions to meet ongoing metabolic needs and stresses of the organism; rare diseases

A

Endocrine system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Master regulatory gland of the endocrine system

A

Pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Gland that regulates metabolism
Treatment: surgery, RT (EBRT and brachytherapy with iodine-131), and hormonal therapy; responsiveness dependent on histology

A

Thyroid cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Thyroid dose

A

50-60 Gy in 7 weeks, 180-200 cGy per fraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Iodine-131 for anaplastic thyroid disease dose (radioresistant), activity, and 2 forms

A

Dose: high dose at 60 Gy
Activity: 50-100 mCi (don’t stay in hospital with less than 100 mCi)
2 forms: liquid and pill (traces to thyroid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Primary treatment goal: normalize pituitary hormonal function or relieve local compressive or destructive effects of the tumor; accomplished surgically, RT, medically, or in combination
Post-op RT controversial but can stop recurrence; RT for patients who don’t fit surgery medically or refuse
Protons (rapid fall-off), SRS, IMRT
Use 6-10 or more to get good dose coverage
SRS margin: 0.5-1 cm

A

Pituitary tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

IMRT for pituitary tumors 2 patient positions, fields, field size (FS), and margins

A

2 positions: tuck chin to avoid eyes; if patient can’t tuck chin, do vertex, kick couch 90 degrees, and turn collimator
Fields: 2 laterals and AP (dose pushes up towards an unopposed field; use wedge with heel to AP)
FS: 5x5 or 6x6 cm
Margins: 1.5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pituitary dose and dose for tumors 2 or more cm

A

Dose: 180-200 cGy per treatment, 4500-5400 cGy total dose range
2 cm or larger tumor: up to 5400 cGy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

7 hormones secreted by the pituitary

A 
Growth
Prolactin
Thyroid-stimulating
Follicle-stimulating
Luteinizing
Melanocyte-stimulating
Adrenocorticotropic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Hormone that controls body growth

A

Growth hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Hormone that initiates milk production

A

Prolactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hormone that controls thyroid gland

A

Thyroid-stimulating hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Hormone that stimulates egg and sperm production

A

Follicle-stimulating hormone

32
Q

Hormone that stimulates other sexual and reproductive activity

A

Luteinizing hormone

33
Q

Hormone that relates to skin pigmentation

A

Melanocyte-stimulating hormone

34
Q

Hormone that influences the action of the adrenal cortex, stress response

A

Adrenocorticotropic hormone

35
Q

2 cells of the pituitary gland

A

Acidophil

Basophils

36
Q

Cell that secretes growth hormone and prolactin

A

Acidophil

37
Q

Cells that secretes everything else

A

Basophils

38
Q

Located anterior, superior and medial to kidneys; on superior pole of kidneys, surround outer part
Surgery is treatment of choice; RT increases local control a little but is usually used as adjuvant to surgery or for palliation
More common in left than right

A

Adrenal cortex tumors

39
Q

Adrenal cortex tumor dose for inoperable patients and for adrenal mets

A

Inoperable: 50-60 Gy in 5-7 weeks; 1 large field at 40 Gy and smaller boost
Mets: palliative 30-40 Gy in 2-3 weeks

40
Q

Malignancies in thorax; most common in lung, pankos tumor in apex/high in lung
Esophageal thymomas, germ cell tumors, mets, etc.
All modalities together or alone; RT for LN’s (PET)
High doses, very good immobilization devices from head to mid-thigh with arms above head
AP/PA fields and laterals if needed
Patients with lung cancer require treatment of primary tumor, and hilar, mediastinal and supraclavicular LN’s
Treat AP/PA until cord tolerance reached then obliques and laterals; boost fields smaller
Multiple field design variations due to volume (limit volume of structure receiving dose) and dose limitations to certain structures
Shielding, MLC’s, IMRT, VMAT, etc.
Can monitor spinal cord dose; CT to define depth

A

Respiratory system disease

41
Q

Tumor originating from epithelial cells of the thymus which plays an important role in kids’ immunity
Occurs in younger patients, surgery is treatment of choice
RT when tumor unresectable; IMRT, VMAT, and tomotherapy offer conformal isodoses

A

Thymoma

42
Q

3 routes of spread of respiratory system diseases

A

Direct
Lymphatic
Hematogenic through blood

43
Q

Tumor reproduces and grows in size and mass, altered surface enzymes grow into surrounding structures; direct or local extension

A

Direct spread

44
Q

Cancer cells enter LN system

A

Lymphatic spread

45
Q

2 ways of lymphatic spread

A 
LN chain (LN to LN)
Enters LN and gains access to blood/circulatory system
46
Q

7 common mets side of respiratory system disease

A 
Liver
Adrenals
Bone
Brain
Cervical LN's
Kidneys
Contralateral lung
47
Q

Downfall to volumetric arc therapy (VMAT) versus IMRT for lung treatment

A

More lung treated with VMAT

48
Q

When is lung disease treatment definitive or curative versus palliative?

A

Definitive or curative without extrathoracic spread, with = palliative

49
Q

Why may cord dose be higher towards cephalic margin?

A

Thinner part

50
Q

How did PET/4DCT change the treatment of lung cancer?

A

4D = time, tracks tumor motion; lead to more arc/IMRT treatments

51
Q

AP/PA might miss part of lung tumor so do _________; _________ increase dose to both already compromised lungs, thicker part

A

Obliques; laterals

52
Q

Difficulty breathing except in upright position, can’t lay flat

A

Orthopnea

53
Q

Dose for SVC syndrome oncologic emergency and time it takes to relieve symptoms

A

Dose: 250-400 cGy in 2-3 fractions (high)
Time: relief from symptoms in 2-3 weeks but no long-term survival

54
Q

2 reasons boost/shrinking fields are done

A

Decrease when tumor decreases in size

Reduce dose to OARs

55
Q

Organ that has lower dose tolerance than what’s needed to treat tumor

A

Critical structure

56
Q

Spinal cord, heart, lung, and esophagus TD’s

A

Spinal cord: 4500-4700 cGy
Heart: 4000 cGy
Lung: 1750 cGy
Esophagus: 5500 cGy

57
Q

When treating near heart, consider when ___% of heart receives ___-___ Gy; can see pericarditis and pancarditis

A

60%

45-55 Gy

58
Q

Inflammation of membrane surrounding heart

A

Pericarditis

59
Q

Inflammation of entire heart

A

Pancarditis

60
Q

Lung = pneumonitis; fibrosis greater than ___% volume exposure

A

40%

61
Q

Volume of lung receiving 2000 cGy, want it at 20-30%

A

V20

62
Q

Need SSD and thickness at point; lateral horns from flattering filter lead to high doses

A

Off-axis points

63
Q

Percent of lung cancer cases that are large cell non-oat/non-small cell lung cancer (NSCLC)

A

88%

64
Q

Palliative dose for NSCLC

A

45 Gy in 18 fractions

65
Q

Right lung has ___ lobes, left has heart so ___ lobes

A

3, 2

66
Q

Fields, dose, and 2 boost doses for NSCLC where surgery is not possible

A

AP/PA obliques up to 5000 cGy and 1 boost of 1000 cGy = 60 Gy in 6-7 weeks to tumor or regional LN’s with positive disease
2nd boost to primary tumor of 500-1500 cGy = 65-7000 cGy total

67
Q

Preoperative dose for NSCLC where surgery is possible (early T’s, no nodes, M1-M2)

A

30 Gy in 10 fractions, no improvement in survival

68
Q

Postoperative dose (initial and boost) for NSCLC where surgery is possible (early T’s, no nodes, M1-M2)

A

60-66 Gy, 200 cGy per fraction

Initial dose of 5000 cGy with boost of 1000-1500 cGy to volume with disease = 60-66 Gy

69
Q

2 sources for brachytherapy for postoperative for NSCLC; permanant interstitial catheter implants

A

HDR iridium

LDR iodine-125

70
Q

20% of lung cancers; poor prognosis, more aggressive
High mets rate, rapid proliferation results in a greater initial response to radiation
Chemo and RT
Prophylactic brain irradiation because it commonly metastasizes to brain

A

Small/oat cell lung cancer

71
Q

Dose to primary tumor, residual tumor, and total dose per fraction for small/oat cell lung cancer

A

4000 cGy in 6 weeks to primary tumor and 1000 cGy to residual tumor = 45-60 Gy in 180-200 cGy per fraction

72
Q

Thymoma dose per fraction and dose for positive margins

A

Dose: 45-50 Gy at 180-200 cGy per fraction

Positive margins: 54-60 Gy

73
Q

Connection between two tubular structures by surgery or pathology, creates weakness

A

Anastomosis

74
Q

Past _____ cGy to trachea, fistula can form

A

4500 cGy

75
Q

Trachea dose, boost, and borders

A

50-60 Gy (over 60 Gy gives best results but can result in complications)
Lower border at carina, initially give 4500 cGy at lower carina and a boost to 50-60 Gy

76
Q

Tumors along chest wall; ex: recurrent breast cancer (tangents), connective tissue, etc.
Size and location affect field arrangement; ex: electrons if superficial

A

Soft tissue tumors

77
Q

Lymphoma dose

A

4500 cGy

RAD 370 - Techniques and Applications (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions