Quiz 1 - Energy, Techniques and Dose/Fractionation Schedules

ONCOL 309 - Clinical Oncology I. University of Alberta

Dupuytren’s Contracture Orthovoltage Treatment: energy, technique, and Dose/Fractionation

120 kVp

Direct Apposition with custom lead shielding

15 Gy/5 Fractions —> 12 weeks —> 15 Gy/5 fractions

Dupuytren’s Contracture Electron Treatment: energy, technique, and dose/fractionation

6-12 MeV

Direct abutment with custom shielding and bolus

21 Gy / 3 fractions

Graves Ophthalmopathy treatment: energy, technique, and dose fractionation

6 MV Photons

Lateral Opposed Fields, 3DCRT, VMAT/IMRT (better distribution) with 5 degree gantry angle to push field postierioly to avoid lens

2000 cGy / 10 fractions over 2 weeks

AVM treatment: technique and dose/fractionation for lesion < 3 cm

SRS

21-22 Gy to the margin

AVM treatment: technique and dose/fractionation for lesion > 3 cm

SRS

16-18 Gy to the margin

Keloid Treatment: energy, technique, and dose fractionation (2 of them)

orthovoltage kV or electron MeV

Single field with shielding

10-15 Gy / 2-3 fractions

37.5 Gy / 25 fractions

Craniopharyngioma EBRT treatment: energy, technique, and dose / fractionation

MV photon

IMRT

5040-5400 cGy / 28-30 fractions

Craniopharyngioma SRS treatment: energy, technique, and dose / fractionation

MV

SRS gamma knufe

9-20 Gy / 1 fraction to tumor margin (20-50 Gy / 1 fraction for max dose)

Acoustic Neuroma treatment: energy, technique and dose/fractionation

MV photon

SRS gamma knife

11-14 Gy / 1 fraction

Pterygium treatment: technique and dose/fractionation (2 of them)

Strontium-90 beta applicator

1600-1800 cGy / 3 fractions over three weeks

1700 cGy / 1 fraction

Ectopic Bone Formation treatment: energy, technique, and dose / fractionation (2 of them)

Co⁶⁰ or low MV photons

POP

700-800 cGy / 1 fraction

2000 cGy / 10 fractions over two weeks

NMSC orthovoltage treatment: energy, technique, and dose / fractionation

50-300 kV

direct apposition

3000-5500 cGy / 10-25 fractions

NMSC electron treatment: energy, technique, and dose / fractionation (three of them)

6-10 MeV

direct abuttment

4500 cGy / 10 fractions

5000 cGy / 15 fractions

5500 cGy / 20 fractions

NMSC mould (skin) brachytherapy to the lip: dose / fractionation

5500 cGy / 20 fractions to centre of lesion

• 7000 cGy max to mucosa

Merkel Cell Carcinoma treatment: dose / fractionation

60 Gy / 30 fractions

Melanoma treatment: energies used

electrons: 6,9,12,15,18 MeV

orthovoltage: 50-300 kV

MV lymph nodes

Melanoma treatment: dose / fractionation for radiation to larger inner canthus, eyelid, nasal, or pinna lesions (20-30 cm²)

55 Gy / 30 fractions over 6 weeks

melanoma treatment: dose / fractionation for radiation to moderate sized lesion or Post-op treatment of moderate sized cancer on skin with positive argins

45 Gy / 15 fractions over 3 weeks

melanoma treatment: dose / fractionation for treatment to small lesions where cosmesis is not as important (3 of them)

40 Gy / 10 fractions

30 Gy / 5 fractions

20 Gy / 1 fraction

Palliative Melanoma treatment: energy, technique and dose / fractionation (2 of them)

6 or 15 MV

POP

2000 cGy / 5 fractions

3000 cGy / 10 fractions

Palliative Melanoma SRS solitary mets. treatment: dose / fractionation

16-25 Gy / 1 fraction to 80% isodose

Ocular Brachytherapy for Melanoma: dose and time span

tumor + safety margin treated from 70-100 Gy over 4-7 days