Lymphomas

T/F: cancers of the lymphatic and hematopoietic system arise from a particular organ

False

T/F: lymphoma cancer cells are highly radiosensitive

True

T/F: Lymphoms are systemic and need to be controlled systemically

True

T/F: XRT is the first line of defense

False

XRT is a _______ (local/systemic) tx

Local

Which system is a major contributor to the immune system?

Lymphatic system

Lymphatic system transports ______ and removes _______

Nutrients; waste

LN become _____ when bacteria is present

Swollen

Lymphocytes that grow abnormally are the origins of ______

Lymphomas

What is Waldeyer's ring

Ring of tonsillar lymphatic tissue surrounding the naso and oropharynx

Which LN are involved in the Lymphatic system?

• cervical

• Preauricular

• Occipital

• Axillary

• Thorax (Hilar and Mediastinal)

• Abdominal

• Pelvic

• Inguinal/Femoral

What are the non-nodal parts of the lymphatic system

• spleen

• Thymus

• Bone marrotonsils

• Adenoids

All lymphomas not classified as Hodgkin’s lymphoma are considered?

Non-Hodgkins Lymphoma

Hodgkin's is determined by the presence of _____-_______ cells

Reed-Steinberg

Reed-Steinberg cells arelarge lymphoid cells that contain multiple _____

Nuclei

For Hodgkin's, the _______ ___ ______ is predictable, but the ______ _______ _________ is not predictable

Route of spread; rate of progression

Which lymphoma is characterized by bulky and usually painless masses along the Lymph system

Hodgkins

XRT tx fields are usually _______ (larger/smaller) than where the observed active LN afe

Larger

Mantle fields are fields including the ______, _____, and ________

Neck; Chest; Axilla

What type of tx technique for Hodgkins

AP/PA

Borders for Hodgkins XRT

Sup: Lower mandible with extended chin

Inf: T9-T10 space

Lat: Flash beyond axillary nodes

What happens when you set the collimator to 0 when using mantle fields

Block the areas you want to treat

Turning the collimator ____° allows to block lungs without covering the tumor volume

90

The Clarkson Method is used to determine MUs for ________ ______ ______

Irregular field sizes

What does the Clarkson Mrthod involve

Dividing the field into segmans from the central point, then looking up the SAR for each segment

• SARs added together, then divided by # of segments

Clarkson Method correct for lack of _______ due to shielding in a field with an irregular shape

Scatter

How to find the TAR with the Clarkson Method

TAR = TAR0 + (Average of SAR of segments)

Field borders for Abdominal/Para-aortic fields

Sup: Mid T10-T11

Inf: L4-L5

Lat: 9-10cm from midline

T/F: abdominal fields MUST cover the spleen

False; may or may not

Which structures for tolerance do you need to consider for abdominal tx’s

Cord and Kidney

Which organ is more radiosensitive than most surrounding healthy organs

Kidney

Field borders for Pelvis

Sup: L5

Inf: 2 cm below Ischial Tuberosity

Lat: 2 cm past Pelvic Inlet

What is a concern of pelvic XRT

Fertility

Pelvic and Para-aortic fields being treated together are called an _________ ___ ______

Inverted Y Field

______ ______ are used to protect bone marrow, bowel, and bladder during pelvic XRT

Shielding blocks

When mantle fields, abdominal fields, and pelvic fields are all treated together, it is called _______ _______ __________

Total nodal irradiation

Are Reed-Steinberg cells present for Non-Hodgkins

No

Which lymphoma is more likely to spread randomly

Non-Hodgkins

Which lymphoma is more likely to involve ExtraNodal tissue

Non-Hodkins

Which lymphoma is more likely to involve multiple sites

Non-Hodgkins