Chap 3- part 4- Oncology treatments-Laura

______is a systemic treatment, meaning it is used to treat the Whole body

Chemotherapy

Chemotherapy drugs are ____and can kill the primary tumor cell and other tumor cells that have spread through the body

cytotoxic

Chemo Can be given

orally, intravenously, intra-arterially, intraperitoneally, intrathecally, or topically

____is a radiosensitizer and increases the effect of radiation

Doxorubicin

____is a radioprotector and decreases the effect of radiation on healthy cells

Amifostine

____ stops cell division by damaging DNA. The cell cycle is not specific, can work in any cell cycle phase. Similar to mustard gas

alkylating agents

Side effects from alkylating agents include

bone marrow depression, amenorrhea (women), azoospermia (men), carcinogenesis

Alkylating agents are typically used to treat

leukemia, lymphoma, Hodgkin disease, multiple myeloma, sarcoma, brain, lung, breast, and ovarian cancer

What are some examples of alkylating agents

cisplatin (platinol aq)

cyclophosphamide (cytoxan)

_____ hinder DNA synthesis and cross the blood brain barrier since they are lipid soluble. The cell cycle is not specific. Used to treat brain tumors.

Nitrosoureas

What are the side effects of Nitrosoureas chemo

delayed myelosuppression, Gl toxicity, delayed nephrotoxicity

Nitrosoureas chemo examples are

carmustine, lomustine, streptozocin

____ disturb formation of nucleic acids and cell reproduction, Happens in S-phase

Antimetabolites

Antimetabolites chemo side effects

Gl toxicity, acute bone marrow suppression

Antimetabolites typically treat

leukemia, and breast, ovarian, and intestinal tract cancers

Examples of antimetabolites

methotrexate,

5-fluorouracil, Xeloda, hydroxurea, gemcitabine, etc.

______ stops DNA/ RNA transcription. does not treat infections, Cell cycle is not specific but most effective is S and G2.

antitumor antibiotics

examples of antitumor antibiotics include

doxorubicin (Adriamycin), bleomycin, mitomycin C, actinomycin D

_____ removes/replace hormones

hormonal agents

Hormonal agent examples are

tamoxifen and leuprolide

_____ interfers with enzymes and DNA replication

Toisomerase inhibitors

Toisomerase inhibitors examples

Topotecan and etoposide

_______are from periwinkle plans and stop cell replication are most effective in Metaphase phase

Vina Alkaloids

Vina Alkaloids Examples

vincrinstine, Vinblastine, paclitaxel

_______are natural hormones and hormone like drugs

Corticosteroids

Corticosteroids examples

prednisone and dexamethasone

Typical chemos used to treat anal cancer

5-FU, Mitomycin, Capecitabine

Typical chemos used to treat bladder cancer

5-FU, Cisplatin, Gemcitabine

Typical chemos used to treat Esophageal cancer

5-FU, Mitomycin, Cisplatin, Carboplatin, Taxol

Typical chemos used to treat Hodgkins lymphoma

ABVD

(Adriamycin, Bleomycin, Vinblastine,

Dacarbazine),

MOPP (Nitrogen Mustard,

Oncovin, Prednisone, Procarbazine), and

BEACOPP (Bleomycin, Etoposide, Doxorubicin,

Cyclophosphamide, Vincristine, Prednisone, Procarbazine)

Typical chemos used to treat Breast cancer

Taxel, Carboplatin,

CMF (Cyclophosphamide, Methotrexate, 5-FU)

Typical chemos used to treat brain cancer

temozolomide

Surgery is used to treat tumors

locally

____is optimal for solid tumors contained to one area

Surgery

____is recommended when removing the entire tumor might cause damage to the

Debulking

Risks of surgery include

pain after surgery, infection, bleeding, damage to or loss of function of local tissues, and reactions to anesthesia used during surgery

Surgeries can be performed as

open surgery or minimally invasive

____surgery is when the surgeon cuts into the body to remove the tumor, some healthy tissue, and possibly some lymph nodes

Open

_______invasive surgery is when the surgeon creates a few smaller cuts to be able to insert a laparoscope (tiny tube with a camera) and other smaller tubes to remove the tumor

Minimally

Surgical biopsies are used for

diagnosis and stage tumors

some methods for biopsies are

fine-needle aspiration, core needle, endoscopic, incisional, and excisional

_____ treatments stop the tumors growth and prevent it from coming back

Curative

____treatments ease the symptoms the patient is having from cancer

Palliative

Radiation treatments can preserve the function of organs and lead to better cosmetic outcomes as compared with

surgery

______ is a high dose of radiation that comes out of a machine called the linear accelerator and is aimed at the cancer within the body

External beam radiation therapy (EBRT)

______is also called internal radiation therapy and uses a source of radiation that is placed inside the patient's body

Brachytherapy

______treatments combine more than one type of treatment

Multimodality

______ treatment is when two different kinds of treatments occur at the same time

Concomitant or concurrent

___treatment is when one treatment option follows another treatment (one after the other)

Sequential

_____treatment is a treatment given in addition to the primary treatment

Adjuvant

_____ is A cancer treatment that uses the body's defense system to fight cancerous tumors

immunotherapy

The _____is a point that the gantry, couch, and collimator rotate around

isocenter

____can be performed by using table parameters and a coordinate system

Shifts

Remember when performing shifts, they are in reference to

isocenter

3 multiple choice options

____ isocenter shifts would require a positive table shift. or a addition to current table position.

Anterior, inferior, and right

** remember AIR

The isocenter shifts ______would require a negative shift. OR a subtraction form the current table position

posterior, superior and left

if the lateral position of the couch is currently at the coordinate location of 1.5 and there is a right isocenter shift of 10.0, the new shifted couch coordinate should be

11.5cm

(10 + 1.5)

if the longitudinal position of the couch is currently at the coordinate location of 150.0 and there is a superior isocenter shift of 5.0, the new shifted couch coordinate should be

145.0

(150.0-5.0)

f the patient is head-first supine and the gantry is at an oblique angle of 45-degrees, the gantry angle would likely be called

LAO

if the patient is head-first prone, and the gantry angle is 90-degrees, the gantry angle may be named

right lateral

if the patient is feet-first supine, and the gantry angle is 270-degrees, the gantry angle may be named

left lateral

As the distance decreases (or gets closer to the source), the field size will measure

smaller than at isocenter

As the distance increases (or gets further from the source), the field size will measure

larger than at isocenter

______ treatment

- based on conventional treatment planning

- Uses a conventional simulator with x-ray equipment (fluoro simulation)

- Provides a radiographic image with an outline of the tumor and a small margin

- Dose distributions are limited to single fields or a few fields

2D

______ Treatments based on three-dimensional imaging to create a treatment plan

- Most common imaging system is a CT simulator

- Anatomy and critical structures are more accurately defined in three dimensions

3D

3D treatments use ___planning

forward

_____ is a Treatment that includes rotation of gantry with stationary MLCs (not modulated)

Non-volumetric ARC therapy

Four-dimensional treatment plan based on

4-D imaging

For _____ The radiation beam is on when the tumor is within a specific treatment position (based on a specific breathing cycle); the beam is turned off when the tumor moves out of the treatment position

4D

_____ Creates a non-uniform radiation beam in order to optimize the dose to the tumor while minimizing the dose to organs at risk near the tumor

» MLC movement creates modulated beam

» Highly conformal beams

IMRT

IMRT uses ___ planning

Inverse

For ______ Rotational fields are also known as arc therapy, where the radiation is delivered while the gantry is moving in an arc from one set point to another

VMAT

____ has better dose distribution than fixed-field IMRT

VMAT

_____radiosurgery is a single-fraction, high-dose radiation therapy

Stereotactic

For steroitatic radiosurgery Dosimetric accuracy required is

± 5 percent

_____ uses an onboard kV source and imager to image the patient prior to treatment when the patient is in their treatment position

kV imaging

The kV imager is a flat-panel detector located ____degrees from the kV source

180

KV images are

2D

kV images are more detailed and have better contrast than

MV images

CBCT images are

3-D or volumetric images

___ for CBCT is in shape of a cone to cover larger volumes as opposed to fan-beam CTS used in diagnostic or simulation CT scanners

Acquired beam

For CBCT, Multiple images are taken at different angles as the gantry rotates, which are then reconstructed to create a

3-D image

After reconstruction of CBCT , these images can be viewed in three planes »

Axial, sagittal, and coronal

_____ is taken in the beam's-eye view (BEV), or from the angle and setting the

Portal imaging

_____is done before treatments start to verify the treatment plan and then at certain increments throughout treatment as specified on the prescription

Portal imaging

» Wing boards, breast boards, head and neck boards, u-frame head holders, etc. can lock into the

index bar or directly into the table

head holders, sponge pillows, foam cushions, and neck rolls

are examples of

postioning aids

The sagittal laser is located on the wall ____the gantry

opposite

Lasers are checked daily and have a tolerance of

2 mm

_______: Technology that uses an optical surface scanning system to track a patient's 3-D surface in real-time

Surface guided radiation therapy (SGRT)

______: A breathing technique that is used during radiation treatments

» Uses a device to monitor breathing cycle in real-time

Respiratory gating

______ A specific belt or device used around the area of the diaphragm to limit the movement of the chest and abdomen during treatment

Abdominal compression

Abdominal compression: force the patient to

take shallow breaths

The secondary collimators are moveable and can create

asymmetric rectangular fields

Collimators are typically made of

tungsten

Less than _____ Of the beam is allowed to be transmitted through the collimator jaws

0.5 percent

Collimator and MLCs ____the treatment field

delineate

____ is also known as the "range finder". it Displays a light with a scale in centimeters on the patient's surface to specify the SSD Located on or near the collimator

Optical distance indicator (ODI)

The ODI has a ____ tolerance and is checked daily before treatments

± 2 mm

The term "____" is used when the gantry is parallel to the patient's skin or contour

en face