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1295 Cards in this Set

  • Front
  • Back

Soft tissue, ewing's sarcoma & giant cell carcinoma are located

in the lower and upper extremities

isodose shiFt method is used to

correct for contour irregularities

splenic flexure is located

at the junction of the transverse & descending colon

1 mev photon is equal to

1/10 the wave length of a 100 kev photon

What does amu stand for?

atomic unit of mass (amu)

1 amu of energy is equal to

3.391 mev

electronmagnetic radiation are examples of

xrays, radiowaves and visible light

a photon is a type of energy that has

zero mass, electomagnetic radiaiton and it travels through space at the speed of light

1 curie of 226 Ra is equal to

1G Radium
1.02 mev relates to the

air production threshold
The creation of a positron results from
pair production

photon and an outer shell electron interaction relates to
compton scattering interaction

photoelectric effect results in the maximum energy transfer between a photon and _____

atomic electron

backscatter factors are ratios of
depth at (CAX) and air (free space)

tar is the ratios of absorbed dose at a given

phantom depth and same point in free space

TPR IS THE RATIOS OF DOSE AT A

REFERENCE POINT IN TISSUE, TO THE SAME POINT OF DMAX

MAYNEORDS F FACTOR IS An ___________
INVERSE SQUARE CORRECTION OF THE %DD

THE F FACTOR OR Mayneords IS A

ROENTGEN TO CGY (OR RAD) CONVERSION FACTOR
WEDGE TRASMISSION FACTOR EXPRESSES THE RATIO OF

DOSE RATES ON THE CAX WITH AND WITHOUT THE WEDGE

WHEN SMALL FIELDS ARE USED

THE OVERALL THICKNESS OF THE WEDGE IS NEEDED TO TILT THE CURVE
ESOPHAGUS, PHARYNX AND THE MOUTH ARE LINED WITH

SQUAMOUS EPITHELIUM OF THE MUCOSA
SPLEEN IS LOCATED
9TH-11TH RIB, 5 CM FROM MIDLINE IN THE LT HYPOCHONDRIUM REGION
TUMOR AND LYMPH NODE REMOVAL IS THE

PRINCIPLE DIFFERENCE BETWEEN MODIFIED AND RADICAL MASTECTOMY

PHOTOELECTRIC EFFECT WILL BE ACCOMPANIED BY A___

CHARACTERISTIC XRAY EMISSION
PHOTOELECTRIC EFFECT IS AN INTERACTION BETWEEN A
PHOTON AND PRIMARILY AN INNER SHELL ELECTRON
PHOTOELECTIC EFFECT IS CAUSED BY THE INTERACTION OF INCREASED ENERGY NEAR THE

BINDING ENERGY OF TEINNER ATOMIC SHELLS

THE 2ND HALF-VALUE LAYER OF AN XRAY BEAMS IS
HIGHER THAN THE 1ST HVL
THE COLLIMATOR
DEFINES THE BEAM
ISOCENTER IS
THE POINT AROUND WHICH THE SOURCE OF THE BEAM ROTATES
THE OPTIMAL TREATMENT PLAN IS

ONE THAT RESULTS IN A UNIFORM DOSE TO THE TUMOR AND LOWER DOSE IN ADJACENT TISSUE
TLD RELEASE STORED ENERGY AS

LIGHT WHEN HEATED
%DD IS DEPENDENT UPON
FIELD SIZE, DISTANCE AND BEAM ENERGY

TMR, TPR, BSF AND TAR ARE DEPENDENT OF
SAD
%DD IS A PLOT WHICH SHOWS
TISSUE DEPTH AT CAX OF THE XRAY FIELD

TMR IS THE RATIO OF DOSE AT A SPECIFIED POINT IN TISSUE OR IN A PHANTOM TO
THE DOSE AT THE DEPTH OF MAX DOSE (DMAX)

THE MOST USED ISOCENTRIC CALC METHOD IS
TMR

ABSOLUTE DOSE RATE CALC DECREASED WHEN

DIST INCREASES

WEDGE ANGLE IS THE ANGLE WHICH AN

ISODOSE CURVE IS TILTED AT THE CAX
WEDGE FILTER IS THE
MOST COMMON USED BEAM MODIFYING DEVICE USED
WEDGE FILTER

ALTERS BEAM QUALITY CAUSING BEAM HARDING BY COMPTON SCATTERING
WEDGE INSERTED IN THE BEAMS PATH WILL
ONLY RESHAPE THE EXISTIN ISODOSE CURVE
PLATTENING FILTERS
FLATTEN THE ISODOSE CURVES AT A SPECIFIED DEPTH
THE QUANTITY CALLED RADIATION EXPOSURE IS ONLY USED FOR WHICH TYPE OF BEAMS
PHOTON BEAMS WITH ENERGY LESS THAN 3 MEV

WHAT TYPE OF TX UNIT ACCELERATES E- BY THE PROCESS OF MAGNETIC INDUCTION
BETATRON

WHAT TYPE OF TX UNIT IS MOUNTED FOR ISOCENTRIC TX
RADIATION THERAPY

ISODOSE CURVES ARE
LINES OF EQUAL ABSORBED DOSE
PNUMBRA REFLECTS

SOURCE SIZE AND BEAM SCATTER

DOSE PROFILES ARE MEASURED BY A
IONIZATION CHAMBER OR DIODE
BOLUS

EVENS OUT IRREGULAR CONTOURS AND FLATTENS THE BEAM

TISSUE COMPENSATORS ARE MAINLY USE FOR

OPPOSED FIELDS
WEDGES ARE USED TO COMPANSATE FOR
SLOPING SKIN SURFACES

UNDER THE THIN SECTION OF THE WEDGE THE

DOSE WILL FURTHER INCREASE

THE BEST WAY TO CALCULATE THE OAR(ORGANS AT RISK) IS TO FIND THE

PDD/%DD ALONG THE CAX

WHAT TYPE OF THE TX UNIT PRODUCES AN XRAY BEAM THAT HAS A HVL OF 3MM AL

SUPERFICIAL TX UNIT

WHAT TYPE OF TX UNIT HAS A SOURCE OF HIGH-ENERGY GAMMA XRAYS

RADIATION THERAPY

WHAT TYPE OF TX UNIT HAS AN XRAY BEAM WITH A HVL OF 1.5 CU

ORTHOVOLOTAGE TX UNIT

WHAT TYPE OF TX UNIT WILL PRODUCE NEUTRONS AS A RADIATION HAZARD

MEGAVOLTAGE TX UNIT

WHAT IS THE CORRECTION FACTOR FOR THE STANDARD TEMP AND PRESSURE

1.016

WHICH TYPE OF BEAM PRODUCES MAX DOSE AT THE SKIN SURFACE

100 KEV XRAY BEAM

A 4 MEV XRAY PHOTON BEAM WILL PRODUCE DOSE AT

1CM OF DEPTH

THE ENERGY OF THE BEAM DETERMINES _____

THE DEPTH WHICH EACH PERCENTAGE ISODOSE IS LOCATED

THE E- ISOCURVE SHAPE

BALLOON TO THE SIDES FOR E- BEAMS
PENUMBRA IS
THE AREA OF TRANSITION AT THE BEAMS EDGE

ISODOSE CURVES ARE
DEPTH DOSE
DOSE DISTRIBUTION DEPENDS ON
ENERGY, SOURCE SIZE, SSD AND BEAM ATTENUATION

READING ----90 SSD ON AN AP PORTAL.


iF YOU MOVE ANTERIORLY WILL THE SSD BECOME GREATER OR LESS

LESS, BECAUSE YOU ARE MOVING AWAY FOR ISOCENTER (100)

COMPENSATING FILTERS SHOULD BE
20 CM AWAY FROM THE PT SKIN

BOLUS BRINGS
DMAX TO THE PT SKIN SURFACE
WEDGE FILTERS DISTORT THE ISODOSE DISTRIBUTION BY
TILTING THE ISODOSE LINES THROUGH A SPECIFIC ANGLE

THE ANGLE WHICH THE ISODOSE LINE IS TILTED AT THE CAX OF THE BEAM AND THE 50% ISODOSE CURVE IS CALLED THE

WEDGE ANGLE

THE HINGE ANGLE IS
THE ANGLE BETWEEN TWO FIELDS

1921R ARE TYPES OF BRACHYTHERAPY

TEMP SEEDS

PROSTATE SEED IMPLANTS ARE
125 IODINE AND 198 GOLD
MOST RADIOSENTSITIVE PHASE IN CELL BIOLOGY
M AND LATE G2 PHASE
MITOSIS CELL CYCLE IN ORDER (PMAT)
PROPHASE, METAPHASE, ANAPHASE AND TELAPHASE

INDIRECT ACTION
PRODUCES DAMAGE BY CHEMICAL REACTION (WATER)

INTERPHASE IS THE PERIOD BEFORE GROWTH BEFORE MITOSIS
3 PHASES: G1,S,G2
CELL MEMBRANE
BARRICADE
OXYGEN
TRUE RADIOSENSITIZER

LET IS THE
RATE WHICH ENERGY IS DEPOSITED AS A CHARGED PARTICLE TRAVELS THOUGH MATTER
ALPHA, NEUTRONS, AND PROTONS
HIGH LET, HIGHLY IONIZING
LET RADIATIONS
INCREASE WITH RBE INCREASES
SUBLETHAL DAMAGE REPAIR
SLDR
EARLY RESPONSE
MANIFEXT INJURY WITHIN A FEW MONTHS
EARLY RESPONSE
BONE MARROW, SKIN INTESTINAL LINING AND TESTES
GOAL OF RADIATION THERAPY
MAX THE DOSE TO THE TUMOR WHILE MINIMIZING THE DOSE TO SURROUNDING NORMAL TISSUE
TIME-DOSE FRACTIONATION IS DETERMINED BY
TYPE OF TUMOR AND TOLERANCE OF SURROUNDING TISSUE
CERROBEND ATTENUATE
5% OF THE PRIMARY BEAM OF UNBLOCKED INTENSITY
DENSITY RATIO OF CERROBEND TO LEAD
1.21, WHICH ATTENUATE 5% OF THE PRIMARY BEAM
HVL IS DEFINED AS
THE THICKNESS OF MATERIAL NEEDED TO REDUCE THE INTENSITY TO 1/2 OF ITS ORIGINAL VALUE
POLYENERGETIC OR HETEROENOUS "MIXED BEAMS"
CAUSES BEAM HARDENING
GEOMETRIC FIELD SIZE IS

THE ACTURAL FIELD SIZE AT THE SPECIFIC DIST FROM THE SOURCE LIGHTS FIELD

MONITOR UNIT IS

BASIC UNIT OF MACHINE OUTPUT LOCATED IN THE COLLIMATORS HEAD

WHEN TWO 45 DEGREE WEDGES ARE USED "WEDGES HEELS"
THE DOSE UNIFORMITY IS IMPROVED

1251 AND 103PD ARE TYPES OF BRACHYTHERAPY

PERMANENT SEEDS
MITOCHONDRIA

POWERHOUSE
MOST RADIOSENSITIVE PHASE IN CELL BIOLOGY IS
S PHASE

DIRECT BILOGICAL ACTION
PRODUCES DAMAGE BY DIRCT IONIZATION
DIRECT BIOLOGICAL ACTION
HIGH LET RADIAITON LIKE PARTICLES OR NEUTRONS
MESSENGER RIBONUCLEIC ACID MRNA
FORM OF RNA THAT MEDIATES THE TRANSFER OF GENETIC INFO
GOLGI APPARATUS
TRANSPORTS ENZYMES
OXYGEN ENHANCED RATIO OER
RADIATION DOSE THAT PRODUCES A BIOLOGICAL RESPONSE IN THE ABSENCE OF OXYGEN
M AN GAMMA RAYS
LOW LET SPARSELY IONIZING

REB

DOSE OF RADIAITON COMPARED TO 250 KEV XRAYS

HIGH LET RADIATIONS DO NOT SHOW ANY DOSE RATE EFFECT

BECAUSE THEIR DENSE AND HAVE A LOT OF MASS
POTENTIALLY LETHAL DAMAGE
PLD
LATE RESPONSE
MANIFEST INJURY FOR AT LEAST 3 MONTHS OR LONGER
LATE RESPNSE
LUNG, CNS, KIDNEY, AND LIVER
THERAPUETIC RATIO
NTTD/TLD
THE 4 R'S
REDISTRIBUTION, REPOPULATION, REPAIR, REOXYGENATION
MOST COMMON MEGAVOLTAGE CERROBEND THICKNESS IS
7.5 CM
DIVERGING BLOCK ARE MADE WITH ALLOW TO
COMPENSATE FOR GEOMETRIC DIVERGENCE OF THE BEAM
TVL "TENTH VALUE LAYER" IS
THE THICKNESS OF MATERIAL NEEDED TO REDUCE THE INTENSITY TO 1/10 OF ITS ORIGINAL VALUE

HETEROGENEOUS IS THE
MOST GENERATED XRAY BEAM

RADIATION FIELD SIZE IS DEFINED AT THE
50% ISODOSE DECREMENT LINE
MOST COMMON CHARTING ERRORS ARE
ADDITION OR TRANSPOSITION

DNA DAMAGE CHAIN BREAKS
LOW LET
CROSS-LINKING BETWEEN STRANDS
CAUSED BY UV, XRAYS AND CHEMICALS
PHYSICAL FIELD SIZE
IS THE 50% ISODOSE LINE
CTV

THE AMOUNT TO BE TREATED
PTV
THE RECOGNITION OF TX UNCERTANTIES
VISUALIZATION IS THE
DETERMINATION OF THE LOCATION EXTENT OF THE TUMOR
BREAST LOCATION
2ND TO 6TH RIB FROM THE STERNUM TO ANTERIOR AXILLARY LINE
BRST LYMPHATICS TRANSPECTORAL DRAINS TO THE
SUPRACLAVICULAR LYMPH NODE
BRST LYMPHATICS AXILLARY LYMPH I LOCATION
UNDER THE LOWER PORTION AND LATERAL TO THE PECTORALIS MINOR MUSCLE
BREAST LYMPHATICS AXILLARY LYMPH III LOCATION
SUPERIOR TO THE PECTORALIS MINOR MUSCLE
BREAST HISTOPATHOLOGY MOST COMMON LOCATION
UPPER OUTER QUADRANT OF THE LEFT BREAST
BREAST CA MOST IMPORTANT VARIABLE IS THE
HORMONE RECEPTOR STATUS FOR ESTROGEN "ER" OR PROGESTERONE RECEPTOR "PR"
DUCTAL CARCINOMA IN SITU (DCIS) DOES NOT
MET
BREAST TX PORTALS FOR THE INFERIOR BORDER ARE
1.5 CM BELOW INFRAMAMMARY FOLD

HEAD AND NECK HISTOPATHOLOGY ARE MOSTLY
80% ARE SQUAMOUS CELL CARCINOMAS "SCC"

ADENOCARCINOMA ARISE FROM THE MINOR SALIVARY GLAND
TO THE MUOSAL LINING OF THE AERODIESTIVE TRACT FROM THE MAJOR SALIVARY GLAND
LYMPHOEPITHELIOMA OCCURS IN THE
TONSIL AND BASE OF TONGUE AND ITS OF SSC TYPE

HEAD AND NECK HISTOPATHOLOGY FRO LARYNX CA
MOST SCCS ARE OF TRUE VOCAL CORD
HEAD AND NECK LOCATION FOR ORAL CAVITY
ANT 2/3 OF THE TONGUE

HEAD AND NECK LYMPHATICS DRAINAGE FOR LARYNX
JUGULODIGASTRIC, MIDJUGULAR AND LOWER JUGULAR NODES
HEAD AND NECK LYMPHATICS DRAINAGE FOR LARYNX
GLOTTIS, SUPRAGLOTTIS AND SUBLOTTIS
GLOTTIS CONSITS OF THE
RIGHT AND LEFT TRUE VOCAL CORDS
DNA DAMAGE DOUBLE CHAIN BREAKS
HIGH LET
CROSS-LINKING BETWEEN TWO IRRADIATED MOLECULES
BASE DAMAGE CAUSED BY UV LIGHT

CAX DOSE VALUES ARE NORMALIZED OR DIVIDED BY
THE MAX VALUE TO CALC DEPTH DOSE
GTV
EXTENT ADN LOCATION OF MALIGNANT GROWTH

PTV INCLUDES THE

CTV PLUS MARGIN
LOCALIZATION OR SIMULATION IS THE
DETERMINATION RADIOGRAPHICALLY OF THE FIELD BORDERS
BREAST LYMPHATICS MAJOR ROUTE OF NODA DRAINAGE
AXILLARY
BREAST LYMPHATICS
AXILLARY, INTERNAL MAMMARY AND TRANSPECTORAL
BREAST LYMPHATICS THE 2 TYPES
DEEP AND SUPERFICIAL
BREAST LYMPHATICS AXILLARY LYMPH II LOCATION
DIRECTLY UNDER THE PECTORALIS MINOR MUSCLE
BREAST HISTOPATHOLOGY MOST COMMON MALIGNANT TYPE
INFILTRATING DUCTAL
BREAST HISTOPATHOLOGY MOST COMMON NON-INVASIVE TYPE
NONIVASSIVE DUCTAL CARCINOMA "DCIS"
BRST CA: SYSTEMIC CHEMO IS USED FOR PT WITH
METS WHOSE TUMOR HORMONE RECEPTORS ARE NEGATIVE
DCIS IS
RADIOSENSITIVE
A 10% TO 15% ANGLE FOR A SUPRACLAV PORTAL PREVENTS

EXPOSURE TO THE SPINAL CORD AND ESOPHAGUS
HEAD AND NECK HISTOPATHOLOGY ARISE FROM THE

EPITHELIAL LINING OF THE AERODIGESTIVE TRACT
SQUAMOUS CELL CA (SCC) ACCOUNT FOR

90% OF ORAL CAVITY CA
H&N HISTOPATH FOR LARYNX CA
95% ARE SCC
H&N LYMPH DRAINAGE FOR OROPHARANX
SUPERIOR JUGULAR, JUGULODIGASTRIC, MIDJUGULAR AND LOWER JUGULAR NODES
H&N LYMPH DRAINAGE FOR ORAL CAVITY
JUGULODIGASTRIC, MIDJUGULAR, LOWER JUGULAR AND SUBMANDIBULAR NODES
H&N LYMPH DRAINAGE FOR HYPOPHARYNX

JUGULODIGASTRIC, MIDJUGULAR AND LOWER JUGULAR NODES
H&N LARYNX TX PORTS
OPPOSED LATS AND WEDGES ANT
FLETCHER SUIT IS MOSTLY USED FOR
BRACYTHERAPY IMPLANTS FOR A CARCINOMA OF THE CERVIX
MEDULLOBLASTOMAS ARE THE
MOST COMMON PRIMARY INTRACRANIAL TUMOR OF THE POSTERIOR FOSSA IN CHILDREEN
RHABDOMYOSARCOMA IS THE MOST COMMON
SOFT TISSUE SARCOMA (STS) IN CHILDREN
OPTIC NERVE
__COND CRANIAL NERVE
THE COLLIMATOR OF A RADIOTHERAPY SIMULATOR
SIMULATES PLANNED FIELD, SHOW LIGHT TO FIELD CONGRUENCE AND MEASURES TX FIELD
MEIOSIS
REDUCES THE NUMBER OF CHROMOSOMES BY HALF
ELECTRON GUN IS THE
SOURCE OF E- IN A LINAC
EDR (EXCESSIVE DOSE RATE) IS THE
__ULT LIGHT INDICATORS FOR A (LINAC) THAT INDICATES TOO MANY MONITOR UNITS COUNTED DURING A 0.01 MINUTE INTERVAL
KLYSTRON IS THE
SOURCE OF MICROWAVE POWER TO ACCERLERATE E- IN A LINAC
STRUCTURE WITH THE HIGHEST RADIOSENSITIVITY IS THE
LENS OF THE EYE
MYCOSIS FUNGOIDES BY E- BEAM THERAPY INVOLVES
ENTIRE SKIN SURFACE

NORMAL TX FOR CA OF THE BREAST PORTALS ARE
TANGENTIAL OPPOSED FIELDS
IRRADIAITON OF THE PARA-AORTIC AREA
MOST COMMONLY A SEMINOMA
LYMPHOCYTIC DEPLETED IS AN INDICATOR FOR A
HODGKINS DISEASE HAS THE POOREST LONG TERM PROGNOSIS
OLIGODENDROGLIOMA IS A
RARE SLOW GROWING TUMOR OF THE BRAIN
MOST COMMON COMPLAINT PRIOR TO DIAGNOSIS OF A SOFT TISSUE SARCOMA
A PAINLESS LUMP
LYMPHATIC SPREAD OF AN ANAL LESION
OBTURATOR NODES, ILIAC NODES AND INGUINAL NODES
THE AGE AT WHICH WHILM'S TUMOR OCCURS
1-10 YRS OF AGE
MALIGNANT TESTICULAR TUMORS ORIGINATE
GERM CELLS
TRANSITIONAL CELL CARCINOMAS ARE
____ SYSTEM TUMORS FROM THE MUCOUS MEMBRANE LINING
SEMINOMA IS A TYPE OF TUMOR OF THE
TESTIS
MOST COMMON TYPE OF LUNG CA
___SQUAMOUS CELL CA ???
60% OF MET BRAIN LESIONS ARISE FROM
PRIMARY LUNG LESION
___ ORIGIN OF CA OF THE PANCREAS
___ THE PANCREAS???
SARCOMAS TEND TO METASTASIZE
THE BLOOD STREAM
TUMORS OF THE MUSCLES ARE NOT
RADIOSENSITIVE
TUMORS ARISING FROM BLOOD ELEMENTS, TUMORS OF THE EMBRYONAL CELL ORIGIN AND NORMAL BONE MARROW ARE
RADIOSENSITIVE
WILM'S TUMOR IS A
NEPHROPLASTOMA
MOST RADIOSENTIVE LYMPHOMA IS
HODGKINS DISEASE
TX VOLUME FOR MEDULLOBLASTOMAS
___ SPINAL CORD???
BRAIN???
A BEAM SPLITTER IS USED TO
TRIM THE SUPERIOR EDGE OF THE TANGENTAL TX PORTAL
1 GY
100 CGY
MULTIPLE MYELOMA IS A NONOSSEOUS
MALIGNANT MARROW TUMOR
SUPRAGLOTTIS CONSIST OF THE FALSE VOCAL CORDS AND THE
EPIGLOTTIS, RIGHT AND LEFT ARYEEPIGLOTTIC FOLD, ARYTENOIDS

H&N POSTERIOR BORDERS
ANT MARGIN OF THE VERTEBRAL BODIES
SUBGLOTTIS EXTENDS FROM THE
GLOTTIS TO THE LOWER MARGIN OF THE CRICORD CARTILAGE
H&N SUPERIOR BORDERS
TOP OF THE THYROID CARTILAGE
STOMACH LYPHATIC FLOW
DRAINS TO THE CELIAC AXIS NODES
H&N INFERIOR BORDERS
BELOW THE CRICOID CARTILAGE
100KEV XRAYS IS THE BEAM THAT PRODUCES
MAX DOSE AT SKIN SURFACE
BEAM PRODUCES MAX DOSE AT ABOUT 1CM DEPTH
4 MEV XRAY
DEPTH OF MAX IONIZATION IS MOST DEPENDENT UPON
XRAY BEAM ENERGY
SIGNIFICANTLY INFLUENCE %DD
SSD, FIELD SIZE, BEAM ENERGY AND DEPTH
SIGNIFICANTLY INFLUENCE BACKSCATTER FACTORS
FIELD SIZE, ENERGY
SIGNIFICANTLY INFLUENCE TAR
FIELD SIZE, ENERGY, DEPTH
SSD AND DEPTH
DOES NOT SIGNIFICANTLY INFLUENCE BACKSCATTER FACTORS
SSD
DOES NOT SINIFICANTLY INFLUENCE TAR
TRIMMERS
REDUCE RADIATION FIELD PENUMBRA
OPTICAL LOCALIZER LIGHT AND THE RADIATION FIELD
2.0 MM

WHAT IS THE EQUIVILANT AREA OF THIS FIELD 8CM X 15CM
10.4 OR 108.8- (SQ 10.4)
EQUATION FOR COMPUTING ACCUMULATED DOSE FOR RADIAITON WORKERS
5 (N-18)
1/10 IS THE WORKERS
INDIVIDUALS OCCASIONALLY EXPOSED FRACTION
OUTPUT RATE FOR A TX UNIT
R/MIN

FILM BADGE IS BACKED BY WHAT KIND OF FOIL TO ABSORB BACK-SCATTERED RADIATION
LEAD

0.1% OF THE USEFUL BEAM AT 1 METER IS THE
LEAKAGE LIMITS OF A RADIAITON THERAPY SOURCE HOUSING WITH THE BEAM ON
150-500 KV IS THE
OPERATING POTENTIALS FOR ORTHOVOLTAGE THERAPY
10 MR/HR AT 1 METER IS THE
LEAKAGE LIMITS OF RADIATION THERAPY SOURCE HOUSING WITH THE BEAM OFF
THE 2 MAIN RADIAITON PROTECTION LAWS WHEN LOADING OR UNLOADING A PATIENT WITH BRACYTHERAPY SOURCES
TIME AND DISTANCE, PERSONAL SHIELDING IS N/A

ABSORBED DOSE X QUALITY FACTOR EQUALS THE
DOSE EQUIVILENT
ABSORBED DOSE X QUALITY FACTOR EQUALS THE
DOSE EQUIVALENT
30 REM/YR IS THE
MPD LIMITS OF EXPOSURE TO THE FOREARM
QUALITY FACTOR FOR BETA, GAMMA, AND XRAYS
1
THE DEGREE OF USE OF AN X OR GAMMA SOURCE IS
WORKLOAD
5 REM IS THE
MAX PERMISSIBLE PROSPECTIVE DOSE IN 1 YR FOR WHOLE BODY IRRADIATION FROM ALL OCCUPATIONAL SOURCES SHOULD NOT EXCEED
THE LARGEST QF IS
ALPHA PARTICLES
MEASURES CUMULATIVE RADIATION EXPOSURE TO PERSONAL
FILM BADGE, TLD, -POCKET DOSIMETER
LEAST AMOUNT OF SKIN SPARING
SUPERFICIAL TX UNIT
GREATEST AMOUNT OF SKIN SPARING
LINEAR ACCELERATOR
ON A LINEAR ACCELERATOR WHAT MAY BE USED TO TERNIMATE ALL POWER
TX ROOM PANIC BUTTON, EMERGENCY OFF BUTTON ON THE CONTROL CONSOLE
IF THE TX COUCH WITH THE PATIENT ON IT WILL NOT STOP__- WHAT SHOULD YOU DO TO STOP THE COUCH
THE MAIN CIRCUIT BREAKER
A TYPE OF MECHANICAL OR OPTICAL PT ALIGNMENT DEVICE
SPIRIT LEVEL
WHILE TREATING A PT USING A ROTATIONAL TECHNIQUE THE GANTRY ROTATES PAST THE END POINT
LIMIT SWITCH MALFUNCTION
COLLIMATOR ALIGNMENT AND MIRROR ANGULATION ARE
SOURCES OF LIGHT MISALIGNMENT
HEMOPOIETIC SYNDROME 200-800 RADS
ACUTE RADIATION SYNDROME
GREATEST PROBABILITY OF INTERACTING WITH MATTER
ALPHA PARTICLES
10% IS THE
ACCEPTABLE VALUE FOR A HIGH DOSE (HOT SPOT) RE___ WEDGE PAIR TECHIQUES
MOST COMMON PRIMARY SITE FOR BONE SARCOMA
METAPHYSEAL

PROGNOSTIC FACTORS INCLUDE
AGE, GENDER, AND LOCATION
CLL IS A LEUKEMIA THAT HAS NOT
HD PREVIOUS RADIATION EXPOSURE
THE GLOTTIS IS
A TRUE VOCAL CORD
A T1 LARYNGEAL TUMOR IS CONFINED TO THE
TRUE VOCAL CORDS

ISO CURVESRS
DEPTH DOSE
ORTHOVOLTAGE TX UNIT
150-500 KVP AT 50-70 CM SSD
BRACHYTHERAPY
INTERSTITIAL OR INTERCAVITARY
SUPERFICIAL TX UNIT
50-20 AT 15-20 CM SSD

MEGAVOLTAGE TX UNIT
1 MV OR GREATER AT 80-100 CM SSD
ISOCENTER IS THE
POINT AROUND WHICH THE SOURCE OF THE BEAM ROTATES
BACKSCATTER FACTOR IS
LARGER WITH LOWER ENERGY BEAM

A FLATTENING FILTER IN A LINAC
REDUCED THE FORWARD PEAK DOSE IN THE CENTER OF THE UNFILTER BEAM

OPTIMAL TX PLAN IS ONE THAT

RESULTS IN THE UNIFORM DOSE TO THE TUMOR DOSE IN ADJACENT TISSUES
PENUMBRA IS THE
REGION NEAR THE FIELD EDGE WHERE DOSE FALLS RAPIDLY
ION CHAMBER IS USED TO
MEASURE OUTPUT

GAP CALC;


FS1 IS 12 X 12, FS2 8 X8 AT A DEPTH OF 10CM TO BE TX AT 80 SSD
1.25CM
THE BASIC PROCESS RESPONSIBLE FOR RADIATION DETECTION OPERATION IS

IONIZATION

IF YOUR HAVE A TX OF 1.8 GY AND THE TRAY WAS LEFT IN "0.95 T-FACTOR" WHAT IS THE NEW CY
1.71, 1.8X0.95=1.71 "THE ANSWER SHOULD BE LESS"
THE MOST SUITABLE MATERIAL FOR REDUCING ELECTRON CONTAMINATION
LEAD AND TUNGSTEN

TO PRODUCE THE LEAST AMOUNT OF ELECTRON CONTAMINATION THE TRAY OR ANY DEVICE SHOULD

BE 15 CM AWAY FROM THE SKIN SURFACE
TISSUE AIR RATIO VARIES WITH
FIELD SIZE, ENERGY, AND DEPTH
GREATEST BSF IN SOFT TISSUE IS WITH
2MM AT HVL XRAYS
A SINGLE POSTERIOR TX PORTAL IS TREATED AT 130 CM CONPAIRED TO 80CM SSD BECAUSE
EXIT DOSE WILL BE GREATER DUE TO BEAM HARDENING
THE FACTOR USED TO DETERMINE THE AMOUNT OF INCREASED IN %DD AS THE SSD IS
MAYNEORD'S F FACTOR
PDD/%DD INCREASED WITH INCREASING SSD, WHY
%DD IS DIRECTLY PORPORTIONAL WITH SSD
THE SHAPE OF THE ISODOSE CURVE IS DEPENDANT ON
FILD SIZE, FLATTENING FILTER AND SSD
TISSUE INHOMGENEITIES THAT ALTER DOSE DISTRIBUTION
AIR CAVITIES, LUNGS, FAT AND BONE
WEDGE FILTER CORRECT FOR
SKIN SPARRING EFFECT
PARAMETERS NECESSARY TO DETERMINE BLOCK FABRICATION AND TX ACCESSORIES ARE
FIELD SIZE AND SHAPE, TARGET FIM DISTANCE "TFD" SSD AND HALF VALUE THICKNESS OF THE BLOCK
SIZE OF THE LYMPH NODES AND HISTOLOGY ARE
MANAGEMENT FACTORS OF NECK CARCINOOMAS WITH POSITIVE LYMPH NODES
A TX PLAN IS NORMALIZED TO THE 175 CGY ISODOSE LINE WHAT % WILL THE 200 CGY ISODOSE LINE GET
114% BECAUDE175=100% LINE
WE ARE INCREASING 175 TO 200`
SAFITTAL PLAN IS FROM
RIGHT TO LEFT / LEFT TO RIGHT
IF PT HAS TUMOR 10CM FROM THE ANT SURFACE AND IS SET UP USING AN ISOCENTRIC TECHNIQUE 80CM SAD, HOW FAR IS THE SOURCE FROM THE TUMOR
80 CM, BECAUSE IT WAS SET UP AT SAD
CALC THE MU'S REQ TO DELIVER 100 CGY TO A DEPTH OF 6 CM FOR A 6MV BEAM. THE TAR IS 0.888 AND THE CGY/MU IS 1.02
___ MU???
IF A PT HAS A TUMOR 10 CM FROM THE ANT SURFACE AND IS SET UP USING AN ISOCENTRIC TECHDNIQUE 80CM SSD, HOW FAR IS THE SOURCE FROM THE TUMOR
90 CM, BECAUSE IT WAS SET UP AT SSD
A 2/3 SHIFT`
CAN MAKE A FLAT SURFACE ISODOSE DISTRIBUTION APPLY TO ANY ANGLED SURFACE
THE HIGH ENERGY LINACS ELECTRON STREAM IS BENT TO DIRECT THE STREAM TO THE TARGET VIA
BENDING MAGNENT "FOCUSING COILS"
WHAT FININSHING ANGLE RESULTS FROM AN ARC SETUP WITH A STARTING ANGLE OF 270 DEGREES WITH CLOCKWISE ROTATION, THE MU/DEGREE= 1.25 AND THE MU SETTING =208
104 DEGREES
THE SPREADING OF ELECTRON BEAMS FROM A LINAC
SCATTERING FOIL
WHAT IS THE HINGE ANGLE FOR A 30 DEGREE WEDGE
120* DEGREES, FORMULA "180-30-30=120*
SUPERFICIAL HAS THE
LEAST AMOUNT OF SKIN SPARING
TILTING OF AN ISODOSE CURVE IS BEST ACCOMPLISHED BY A
WEDGE FILTER
THE LOWEST MV XRAY ENERGY WILL HAVE THE
LEAST BACKSCATTER
THE CONSTRUCTION OF CERROBEND "SHIELDING BLOCKS"THESE PARAMETERS MUSTE BE CONSIDERED
BEAM QUALITY, SOURCE TO BLOCK DISTANCE AN SOURCE FIELD DISTANDCE "SFD"
THROACIC CAVITY CRITICAL STRUCTURES TO CONSIDER THEIR MAX TOLERABLE DOSE
LUNG, HEART AND SPINAL CORD
ABDOMINAL TX CRITICAL STRUCTURES TO CONSIDER THEIR MAX TOLERABLE DOSE
SML BOWEL, BLADDER, RECTUM & AND KIDNEYS
PELVIX TX CRITICAL STRUCTURES TO CONSIDER THEIR MAX TOLERABLE DOSE
SML BOWEL, BLADDER AND RECTUM
THE DEPTH OF MAX IONIZING RADIATION (DMAX) IS MOST DEPENDANT ON
BEAM ENERGY
TISSUE COMPENSATING FILTERS
HAE ADVANTAGES OVER THE USE OF BOLUS IN HGH ENERGY RADIATION THERAPY
TX OF THE RECTUM REQUIRES THE PT TO BE IN THE
PRONE POSITION, 3 FIELD WEDGES
BONE METS IS NOT
AN INDICATION FOR THE USE OF E-
EARLY STAGE LARYNX CA REQ THE TX
OF PRIMARY TUMOR ONLY
WHEN TREATING THE NASOPHARYNX THE STRUCTURES THAT MUST BE CONSIDERED ARE
OCCIPITAL LOBE OF BRAIN, BRAIN STEM, OPTIC CHIASM, AND PAROTID
A WBC BELOW 2000 WILL
REQ A STOPPAGE OF HODGKINS TX
THE SUPERIOR AND INFERIOR BORDERS OF THE MANTLE PORTAL FIELD
MASTOID TIP AND XIPHOID PROCESS
AML IS A TYPE OF LEUKEMIA SEEN
SAME FREQ IN ALL DECADES OF LIFE
TRUE VOCAL CORDS ARE LOCATED WITHIN A CATILAGINOUS STRUCTURE IS THE
LARYNX
SHADOW TRAY HOLDS
SHIELDING BLOCKS
OUTER PORTION OF THE EYE
CORNEA
DIVERGENT BLOCKS PERMIT THE USE OF THE
LONGEST SOURCE TO SURFACE DISTANCE
COMPENSATING WEDGES PROVIDE
SKIN SPARING EFFECT FOR SLOPING SKIN SURFACES
NORMAL CELL TYPES FOUND IN LYMPHOCYTES
B & T CELLS
IF A PT FALLS
GET A DOCTOR, HELP THE PT UP AND FILL OUT AN INCIDENT REPORT
STRONTIUM-89 IS USED TO
RELIEF OF BONE MET PAIN
BON PAIN RELIEF BY STRONTIUM-89 IS A ACCOMPLISHED TY THE
UPTAKE OF A BETA-EMITTING ISOTOPE
SPLENIC FLEXURE IS THE JUNCTION OF
TRANSVERSE AND DESCENDING COLON
FAILURE OF THE MAGNETRON, BEAM TRANSPORT SYSTEM AND ELECTRON GUN WILL ALTER
ENERGY OUTPUT OF A LINAC
2.5 CM SUP & 2.5 CM ANT TO THE EAM
LOCATION OF THE PITUATTARY FOSSA
MOST COMMON SITE OF MALIGNANCE IN H&N
LARYNX
PRESCRIBED DOSE FOR HISTOLOGIC TUMOR IS BASED ON THE EVALUATION OF
CRYOGENIC FACTORS, STAGE OF DISEASE, AND PATHOLOGIC GRADE
RADIOSENSITIVITY IF TISSUE WILL EFFECT
ISODOSE CURVE SHAPE
THE CERVIX IS
A THICK WALLED MUSCULAR ORGAN AT THE LOWER CONSTRICTED PORTION
AT BEAM ENERGIES ABOVE 8 MEV THE BSF BECOMES
NEGLIGIBLE
NEGATIVE SHIELDING BLOCKS
LUNG
POSITIVE SHIELDING BLOCKS
ABDOMEN, H&N, SHOULDERS
HIGHEST % OF ESOPHAGEAL CARCINOMAS ARE IN THE
TERMINAL ESOPHAGUS
MAX ENERGY AT 180* FROM A SCATTERING OBJECT
255 KEV
THROMBOCYTES
HELP DESTROY INVADING ORGANISMS
NORMAL RED BLOOD CELL COUNT FOR AN ADULT
5,000,000 PER CC "5 MILLION"
EQUIVALENT SQUARES
EFFECTS USING SHIELDING BLOCKS
OATS CELL CARCINOMA
LUNG CA THAT IS SYSTEMIC
CACHEXIA IS CHARACTERIZED BY
ANOREXIA, SATIETY, ANEMIA, AND WEIGHT LOSS
SSD, SSD AND SOURCE SIZE EFFECTS THE
SHAPE OF THE ISODOSE CURVE
HODGKINS DISEASE WITH INVOLVEMENT OF THE SPLEEN AND MEDIASTINAL NODES
STAGE 3
STAGE OF CERVIX WITH EXTENSION OF LOWER 1/3 WITH NO INVOLVEMENT OF THE PELVIC WALL
STAGE 3A
HEART CAVITY LOCATION
MEDIASTINUM
LEVEL OF AORTIC BIFURCATION
T4/T5
BEST WAY TO TREAT A BLADDER IS 3 FIELD WHY
MINIMUM DOSE TO THE RECTUM, NODES WILL BE INCLUDED AND URETHRAS WILL GET A HIGH DOSE
LOCATION OF THE KIDNEY
11TH RIB TO L3
WHAT GOES FROM C2 TO THE CARINA
TRACHEA
BASAL AND SQUAMOUS CELL CA ARE
RADIOSENSITIVE TO RADIATION
BLOOD, URINE AND SALIVA ARE ALL RADIOACTIVE AFTER USAGE OF
STRONTIUM-89, A PURE BETA EMITTER AND TRANSPORTED IN A WOODEN BOX
OVOIDS USED TO TREAT
3000 CGY DOSE, AP/PA PROTALS, BLOCK KIDNEYS AND LIVER W__ 1-2 HVLS
ESOPHAGUS TX TO MID 1/3 TO 6500 CGY, WHAT IS THE BEST TECHNIQUE
AP & 2 POSTERIOR OBLIQUES
BASAL AND SQUAMOUS CELL CA ARE
RADIOSENSITIVE TO RADIATION
DIVERGENT BLOCKS REDUCE
COMPENSATE FOR THE GEOMETRIC DIVERGENCE OF THE BEAM
WHAT MOVES DURING A PHOTON TO AN E- TX THAT BLOCKS THE FIELD LIGHT
SCATTERING FOIL
STOMACH LOCATED IN THE LUQ
BEGINS AT THE GE JUNCTION, ENDS AT THE PYLORUS JOINING THE DUODENUM IN THE
IF THE TX TABLE STARTS TO GO UP DURING A TX AND THE EMERGENCY OFF BUTTON DOESNT WORK WHAT DO YOU DO
MAIN CIRCUIT BREAKER
IF THE DOOR INTERLOCK DOSE NOT WORK WHAT DO YOU DO
NOTIFY THE PHYSICIST OR RSO, GET THE PATIENT OUT OF THE ROOM
MELANOMAS ARE
THE MOST RADIORESISTANT
SUB CRANIAL BLOCK IS USED FOR
BRAIN BLOCK USED DTO TREAT THE ENTIRE CRANIAL VAULT
WRONG WEDGE IN DURING TX, WHAT DO YOU DO
STOP TX AND NOTIFY DOSIMETRIST
IF THE MACHINE FAILS DURING TX HOW DO YOU KNOW HOW MUCH THE PT RECEIVED
THE MECHANICAL COUNTER IN THE TX CONSOLE
WHAT IS THE HALF BEAM BLOCK USED FOR
NON DIVERGENT EDGES FOR FIELD ABUTMENT
MOST RADIOSENSITIVE TISSUE GROUP
ALIMENTARY TRACT TISSUE (IE SMALL BOWELL)
VULVA NODES DRAIN TO
INGUINAL NODES, BLOOD SERUM FROM THE VULVA
HYPOXIC MEANS
DECREASE IN OXYGEN
DOMES OF THE DIAPHRAGM ARE TX FOR WHOLE ABD TO ENSURE
THAT THE CORRECT AMOUNT OF TX PORTAL IS INCLUDED
WHEN A PT IS TX FOR SVC, THE EARLIER TX MAY REQUIRE
NEW MEASURMENTS AFTER A FEW DAYS
THE PT SUPINE MEASURES 22 DEPTH AT 100 CM SAD, THE WIDTH SEPARATION IS 36 CM. IF THE ISOCENTER IS SHIFTED 3 CM ANT, WHAT IS THE NEW PA SSD
22/2= 11 WHICH IS 89 SSD
89-3 "ANT SHIFT" = 86 PA SSD
WHICH GI MUCOSA HAS THE GREATEST RADIOSENSITIVITY
RECTUM
IF 1 CM IS ADDED TO THE SUP/TOP OF THE PORTAL, WHAT HAPPENS TO THE ORIGINAL ISOCENTER
NOTHING
WHERE CAN A PERSON FIND INFO ON WHAT TO DO IF THEY THINK THEY EXPOSED TO PROCESSING FILM AGENT CHEMICAL
MATERIAL SAFETY DATA SHEET "MSDS" CHEMICAL LABEL AND BROCHURE
IF THE PT IS PRONE AN A ANTERIORLY ISO SHIFT IS NEEDED, WHAT DO YOU DO
-PT PRONE "AP" FIELD SIZE DECREASES WITH ANT SHIFT
-PT PRONE "AP" FIELD SIZE INCREASES WITH POST SHIFT
WHAT ARE PROBLEMS WITH MAKING BLOCKS
INGESTING ALLOYS, INHALING ALLOYS AND BURNS
WHAT SALIVARY GLAND IS LOCATED ANTERIOR AND INFERIOR TO THE EAR
PAROTIC GLAND, THE LARGEST GLAND
WHERE IS WALDERYERS RING
BRAIN, OPPOSED LAT TX PORTALS
WHEN TREATING A NASOPHARYNX THE LATERAL HAS A 5=10* POST ANGLE TO
AVOID THE EYES
WHEN TREATING THE PROSTATE, WHY IS THE BLADDER FULL
TO MOVE THE SML INTESTINES OUT OF THE WAY
THE CERVICAL OS IS THE
LOWER BORDER OF CERVIX
WHY USE A MIDLINE BLOCK FOR TX OF THE CERVIX
BOOST PARAMETRIAL NODES, BLOCK IMPLANT AREA, BLOCK THE BLADDER AND RECTUM
SYMTOMS OF PANCOAST TUMORS ARE
SHOULDER PAIN, SUPERIOR PULMONARY SULCUS IN THE APEX OF THE LUNG, THE TUMOR HAS A MASS GROWING AT THE THORACIC INLET
MOST MARROW IS IRRADIATED IN AN ADULT
PELVIC GIRDLE AND EXTREMITY
WHAT WOULD DEPRESS HEMOPOIETIC SYSTEM MOST
HOCKEY STICK AND INVERTED Y TX
BSF
TAR @DMAX
MOST COMMON INDIRECT ACTION
FREE RADICALS ARE FORMED
STERILE TECHNIQUE ARE USED WHEN
PLACING INSTRUMENTS IN BODY CAVITIES
ASEPTIC TECHNIQUES IS USED
WHEN SKIN IS PUNCTURED OR PIERCED
IONIZATION OF AIR
EXPOSURE AND TAR
ROENTGEN TO RAD CONVERSION FACTOR
F-FACTOR OR F MED
THE MOST RADIOSENSITIVE MAJOR COMPONENT OF BONE
OSTEOBLASTS
DOSE RATE OUTPUT IS CHECKED
ANNUAL
ORDER OF OCCURRENCE
1ST- EPILATION
2ND-DRY DESQUAMATION
3RD- MOIST DESQUAMATION
RESCUE BREATHES
2 & 1 MAN= 15;2, 100 COMPRESSION PER 1 MIN
IV IS INFILTRATED HOW DO YOU KNOW
INJECTION SITE BECOMES COOL AND RED
MOST COMMON THYROID DIAGNOSIS
PAPILLARY
KELOIDS
ARE CAUSED BY BURNS FROM 15-18 GY IN 3 FRACTIONS
WHICH IS TRUE OF OSTEOSARCOMAS
TRAUMA IS A PROVEN ETIOLOGY AND HISTOLOGIC GRADE IS USED FOR STAGING
WHEN DO YOU TX A WHOLE BRAIN PROPHALACTICLY
SMALL CELL
FOR THE PROSTATE METS SPREAD TO THE LIVER BY WAY OF THE
PORTAL VEIN
BEST WAY TO KEEP PORTAL MARKINGS IS TO
__ THE MARKER TO THE PT TO TOUCH UP
PDD/%DD DOES NOT DEPEND ON
FILTRATION
THE LARYNX LIES
__ TO C6
THE BREAST BOARD IS USED TO
DECREASE SLOPE OF THE STERNUM AND GET BETTER REPRODUCIBILITY
AP/PA FIELD WEIGHTED 3:1 WITH DOSE OF 200
AP 150 TO PA 50, 200/4 =50 X 3 =150
MOST RADIOSENSITIVE PART OF NORMAL CELL
CHROMOSOME
AFTER A SINGLE INJECTION OF A RADIOACTIVE MATERIAL WHAT DO YOU DO WITH THE SYRINGE
PLACE IN BIOHAZARD CONTAINER, SEND IT TO TE MANUFACTURE FOR DISPOSAL
ISOCENTER IS
ROTATION OF GANTRY AND HORIZONTAL AXIS OF THE TABLE
MOST COMMON SYMPTOM OF A SALIVARY GLAND CA
FACIAL PALSY
MANIFEST PERIOD
THE TIME AFTER AN ACUTE EXPOSURE TO RADIATION
THE MOST SENSITIVE CELL OF THE BODY TO RADIATION
SPERMATAGONIA
PRODROMAL SYNDROME
EARLY RADIATION SICKNESS, NAUSEA AND VOMITING AT DOSES BETWEEN 1 TO 2 GRAY
DURING IRRADIATION OF THE ESOPAGUS THE SENSITIVE INTRATHORACIC STRUCTURES ARE
SPINAL CORD, HEART AND LUNG
BOLUS IS USED IN HIGH ENERGY PHOTON TX MAINLY FOR
INCREASED SKIN DOSE, CORRECT FOR TISSUE INHOMOGENEITY
MOST LIKELY CAUSE OF INTERACTIONS IN BONE @ ORTHOVOLTAGE RANGE
PHOTOELECTRIC OR CHARACTERISTIC
TUMOR CAN BE DESTOYED BUT NORMAL TISSUE SUFFERS SEVERE COMPLICATION
RADIORESISTANT TUMOR
RADIATION DAMAGE TO READIORESISTANT ORGANS
INDIRECTLY VIA VASCULATURE DAMAGE
ADVERSE EFFECT ON WBC PRODUCTION IS MOST LIKELY AFTER EXPOSURE TO THE
SKELETAL SYSTEM
A DECREASE IN LYMPHOCYTE COUNT AFTER
10 CGY "LOW LEVEL"
MOST RADIOSENSITIVE CELL
LYMPHOCYTE
GI TRACK WITH THE LOWEST RADIOSENSITIVITY
COLON
TUMORS THAT HAVE HIGH RADIOSENSITIVITY
LYPHOMA, LUEKEMIA AND SEMINOMA
STAGE 3 CA CERVIX CA
EXTERNAL BEAM AND INTRACAVITARY IMPLANT TX
AS RADIOSENSITIVITY OF A TUMOR INCREASES
NORMAL TISSUE AND TUMOR LETHAL DOSE WILL DECREASE
GREATEST INCREAS IN RADIOSENSITIVITY WHEN OXYGEN IS GIVEN
DURING IRRADIATION TX
DURING ESOPHAGUS TX THE DIAPHRAGM IS NOT
A SENSITIVE INTRATHORACIC STRUCTURE
SKIN CANCERS
-BASAL CELL
-SQUAMOUS CELL
-ACTINIC KERATOSIS
-MELANOMA
-KAPOSIS SARCOMA
-CUTANEOUS T-CELL LYMPHOMA
SIGNS/SYMPTOMS SKIN CA
-CHANGE OF SKIN
-BLEEDING
-PAIN
-PIGMENTATION
RISK FACTORS SKIN CA
-UV RADIATION
-FAIR COMPLEXION
-EXP TO COAL, TAR
-FAMILY HISTORY
-MULTIPLE MOLES
ABCD OF SKIN CA
A- ASYMMETRY
B-BORDER IRRGULARITY
C- COLOR
D- DIAMETER > 6MM
BASAL CELL CA
**MOST COMMON SKIN CA
-SUN EXPOSED AREAS
-RARELY MET
-90% H/N
5YR 95%
BASAL CELL PRESENTS AS
NODULAR FORM- SMOOTH, SHINY, PEARLY GRAY
SUPERFICIAL FOR- ERYTHMATOUS, PLAQUE, CHEST/BACK
SQUAMOUS CELL CA
-ERYTHEMATOUS, FIRM LESIONS, SCALY, CRUSTY
-SUN EXP AREAS
-RARE METS
5 YR/ 90%
ACTINIC KERATOSIS
-PREMALIGNANT STAGE SKIN CA
-RED, SCALEY PLAGUES
-SCC ELSE WHERE
5YR/100%
TX OF SKIN CA
-SURGURY=90%
-ELECTRODESSICATION
-CRYOSURGURY
-LASER THERAPY
SKIN CA AND RADIOTHERAPY
**SITE**
-LESIONS WHERE SURGURY IS DIFFICULT NOSE, EYELID
-OLD PT
MALIGNANT MELANOMA
-ARISES IN MELANOCYTES
-MET TO LUNG, LIVER, BONE, BRAIN
-SURGURY +- INTERFERON
5YR/88%
LUNG CA RISK FACTORS
5YR/14%
-CIGARETTE
-EXP TO INDUSTRIAL CHEM
-ASBESTOS, ARSENIC, RADON
LUNG CA SIGNS SYMPTOMS
-FATIGUE
-COUGH
-CHEST PAIN
-BLOOD IN SPUTUM
-RECURRING PNEUMONIA
-SOB
-WEIGHT LOSS
LUNG CA PATHOLOGY/ INCIDENCES
ADENO- 40%
SQUAMOUS- 30%
SMALL CELL- 15%
LARGE CELL- 15%
LUNG CA METHOD OF SPREAD
LOCAL
LYMPH
DISTANT
LUNG CA METHOD SPREAD
HEMATOGENOUS:
OPP LUNG
ADRENAL GLAND
BONE MARROW
BRAIN AND CORD
NON SMALL CELL/ SMALL CELL PRESENT WITH DISSEMINATED DISEASE
SVC SYNDROME
TUMOR GROWS AND OBSTRUCTS THE SVC, CAUSING SOB, SWELLING OF NECK/FACE/ARMS
DISTENDED VEINS OF THE CHEST/NECK
LUNG CA EVAL
CXR
BLOOD TEST
CT
BRONCHO
CT/NEEDLE BX
BONE SCAN
HEAD CT: SMALL CELL
BONE MARROW BX
LUNG CA STAGING
TNM
NON SMALL CELL PRIMARY TX
SURGURY IF POSSIBLE
SMALL CELL TX
CHEMO-PRIMARY
RAD THERAPY- USED WITH CHEMO TUMORS LIMITED TO THE CHEST
RAD THERAPY SIDE EFFECTS LUNG CA ACUTE
ACUTE:
ESOPHAGITIS
SKIN IRRITATION
FATIGUE
COUGH
RAD THERAPY SIDE EFFECTS LUNG CA LATE
LATE:
PNEMONITIS
PULM FIBROSIS
SPINAL CORD DAMAGE
PERICARDITIS
LUNG CA SURVIVAL %
5 YR/ 14%- ALL STAGES
5 YR/ 49%- LOCALIZED
GI ESOPHAGUS
BLACK > WHITE
ETOH/ SMOKING
PATH: SCC & ADENO
PRESENTS: DYSPHAGIA, WEIGHT LOSS, CHEST PAIN
SPREAD: THRU WALL
LYMPH NODES: MEDIASTINUM, SUPRACLAV, CELIAC
METS: LUNG, LIVER, BONE
GI ESOPHAGUS -WORK UP -TX
WORK UP- BAR SWALLOW, CT CHEST/ABD, ENDOSCOPY BX

TX: SURGURY, RAD DOSE 6000 CGY, CHEMO 5FU
GI STOMACH
RISK: SMOKED/ SALTY FOODS, LOW VIT A+C
PRESENTS: MASS, BLEEDING, PAIN
PATH: ADENO, SCC
SPREAD: LYMPH NODES: INGUINAL OR PELVIS
METS: PERITONEAL SURFACES, LIVER, LUNG
GI STOMACH WORK UP/ TX
WORK UP: UGI SERIES, CT, ENDOSCOPY, BX

TX: SURGURY, RAD DOSE 45-50 GY, CHEMO
GI ANAL CA
RISK: HIV, ANAL INTERCOURSE
PRESENTS: MASS, BLEEDING, PAIN
PATH: ADENO, SCC
SPREAD: LYMPH NODES- INGUINAL OR PELVIS
METS: PERITONEAL SURFACES, LIVER, LUNG
GI PANCREAS
RISK: SMOKE, CHRONIC PANCREATITIS
PRESENTS: ABD PAIN, NAUSEA, ANOREXIA, JAUNDICE
GI PANCREAS WORK UP/ TX
WORK UP: CT, ERCP, LAPAROTOMY
TX: SURGURY- WHIPPLE PANCREATICODUODENECTOMY
RAD DOSE: 50-60 GY
CHEMO
GI COLORECTAL
RISK: FAMILIA POLYPOSIS, INFLAM BOWEL DISEASE
PRESENTS: BLOOD IN STOOL, PAIN, CHANG IN BOWEL, BOWEL OBSTR
PATH: ADENO
SPREAD: LYMPH NODES, LIVER, LUNG
GI COLORECTAL WORK UP/ TX
WORK UP: BE, SCOPYS, BX, CT, CXR
TX COLON: SURGURY, CHEMO
TX RECTUM: RAD DOSE 45-50 GY, CHEMO
GI RADIATION EFFECTS ACUTE
N/V
DIARRHEA
FATIUGE
DYSURIA
GI RADIATION EFFECTS LATE
ENTERITIS
GASTRIC ULCER
PROCTITIS
SML BOWEL OBSTR
GYN: INCIDENCES %
ENDOMETRIUM- 45%
OVARY- 30%
CERVIX- 20%
VULVA- 3-4%
VAGINA- 1-2%
GYN: ENDOMETRIUM
RISK: OBESITY, NULLIPARITY, LATE MENOPAUSE
PRESENTS: PAINLESS, VAG BLEEDING, 80% WITH TUMOR CONFINED TO UTERUS
PATH: ADENO
SPREADS: PELVIC LYMPH NODES, PARAORTIC,
METS: LIVER, LUNG
GYN: CERVIX
RISK: HIGH SEX PARTNERS, SEX EARLY AGE, EXPOSURE TO HERPES, TYPE 2 HPV
PATH: SCC, ADENO
PRESENTS: VAG BLEEDING, PELVIC PAIN
GYN STAGING CERVIX CA
FIGO STAGING SYSTEM
GYN: CERVIX TX
CONIZATION OR SIMPLE HYSTERECTOMY TAH-BSO
RADICAL TAH-BSO +- RT
RT +- CHEMO
GYN: CERVIX RT
EXT BEAM: 45-50 GY
INTRACAVITY T&O W/ CESIUM 137, DOSE TO POINT A 80-90 GY
CHEMO
GYN: OVARY
WOMEN > 55
PRESENTS: ADV
PATH: ADENO
PRESENTS: NAUSEA, LOWER ABD PAIN, BLOATING, VAG BLEEDING, OSS APPETITE
GYN: OVARY
SPREAD: PERITONEAL SURFACES, RETROPERITONEAL, LIVER AND LUNG
WORK UP: PAP, BX, U/S, CT, CXR, LAPAROTOMY
GYN: OVARY TX
SURGERY + CHEMO
RT (SELDOM)
GYN: VAGINA
PRESENTS: VAG BLEEDING
PATH: SCC, CLEAR CELL ADENO, DES EXPOSURE

WORK UP: BX, EXAM, CT, CXR
GYN: VAGINA TX
TX:
SML LESIONS: SURGERY OR RT (INTRACAVITARY/INTERSTITIAL)

ALL OTHERS: RT WITH RT/BRACHYTHERAPHY
GYN: VULVA
PRESENTS: PAINFUL, BLEEDING, ITCHY, VULVAR LESION
PATHOLOGY: SCC
WORK UP: BX, CT, CXR
GYN: VULVA TX
SURGERY: RADICAL VULVECTOMY, INGUINAL NODE DISSECTION
GYN: SIDE EFFECTS ACUTE
ACUTE:
NAUSEA
DIARRHEA
FATIGUE
DYSURIA
SKIN IRRITATION
GYN: SIDE EFFECTS LATE
LATE:
PROCTITIS
RECTOVAGINAL FISTULA
SML BOWEL OBSTRUCTION
ENTERITIS
RETICULOENDOTHELIAL SYSTEM
HODGKINS LYMPHOMA
NON HODGKINS LYMPHOMA
ANN ARBOR STAGING
RETICULOENDOTHELIAL SYSTEM TYPICAL PRESENTS
PAINLESS ENLARGEMENT OF LYMPH NODES WITH OR WITHOUT FEVER, WEIGHT LOSS, OR NIGHT SWEATS
HODGKINS SPREAD
CONTIGUOUS NODES
BONE MARROW
LUNG
LIVER
NON HODGKINS SPREAD
DOES NOT SPREAD CONTIUOUSLY
OFTEN INVOLVES BONE MARROW EARLY
MAY INVOLVE EXTRANODAL SITES AS GI TRACT, SKIN, BONE, BRAIN
HODGKINS (BOTH) EVAL
CXR
CT
BM BX
LAPAROTOMY
NON HODGKINS LYMPHOMA TX
SURGERY- BX FOR DX
CHEMO- USUAL TX
RT + CHEMO FOR BULK DISEASE
LOCALIZED- 30-50
STAGING HODGKINS
1- SINGLE SITE
2- 2 OR MORE ON SAME SIDE
3- BOTH SIDES
4- EVERYWHERE
RETICULOENDOTHELIAL SYSTEM SIDE EFFECTS
BONE MARROW SURPRESSION
HYPOTHYROIDISM
RADIATION PNEUMONITIS AND FIBROSIS
RAD PERICARDITIS
INDUCTION OF 2ND MALIGNANCIES (AML)
CONNECTIVE TISSUE (CHONDRO/ LEIYOMYO)
ADIPOSE- LIPOSARCOMA
MUSCLE TISSUE- RHABDOMYOSARCOMA OR LEIYOMYOSARCOMA
BLOOD VESSELS- KAPOSIS SARCOMA
CONNECTION TISSUE
PRESENTS: WITH ASYMPTOMATIC MASS
SPREAD: ADJ LYMPH NODES, LUNG
EVAL: CT, BONE SCAN, BX
TX: SURGERY THEN XRT 55-68 GY
CHEMO FOR METS
KAPOSIS- LOCAL XRT (AIDS PT), LEAVE FLASH FOR LYMPHATICS TO WORK
BONE CA
OSTEOSARCOMA
CHONDROSARCOMA
FIBROSARCOMA
BONE CA
PRESENTS: PAIN, SWELLING, MASS
SPREAD: LUNG
EVAL: XRAYS, CT, MRI, BONE SCAN, BX
TX: LIMB SPARING SURGERY OR AMPUTATION
CHEMO FOR OSTEOSARCOMA
RT FOR PALLIATION OR POSITIVE MARGINS
PEDS CA
2ND LEADING CAUSE OF DEATH >15 YRS
ETIOLOGY: GENETIC, IONIZING RAD, DRUGS, VIRAL
PEDS CA TYPE/INCIDENCES
#1- LEUKEMIA- 25%
CNS (MEDULLO/EPENDIMOMA)- 17%
LYMPHOMAS- 16%
CARCINOMAS AND EPITHELIAL- 9%
GERM CELL TUMORS- 7%
SOFT TISSUE SARCOMA 7%
MALIGNANT BONE TUMORS- 6%
RENAL TUMORS- 4%
RETINOBLASTOMA- 2%
PEDS CA: LEUKEMIA
TUMOR OF BONE MARROW
DISSEMINATES THRU BLOOD
INVOVELS LN, CNS, TESTES, LIVER, SPLEEN
TX: PRIMARILY CHEMO
RT USED IN HIGH RISK PT TO THE BRAIN, SPINAL CORD, TESTES
PEDS CA: WILM'S TUMOR:
INTRARENAL TUMOR
PRESENTS ABD MASS, PAIN, FEVER, HEMATURIA
SPREAD: LN IN ABD, LIVER, LUNG
TX: SURGERY- REMOVE KIDNEY INVOLVED
CHEMO- VINCRISTIN/ACTINOMYCIN D
RT- PTS WITH LNS, RESIDUAL DISEASE, METS TO LUNGS
PEDS CA: NEUROBLASTOMA
TUMOR NEURAL CREST CELLS
IN ADRENAL GLAND/ SYMPHATHETIC GANGLIA
SPREADS: LNS, LIVER, BONE MARROW, SKIN
PRESENTS: ADB MASS, PAIN
TX: SURGERY W/ CHEMO
XRT: PALLIATION, DEBULK PREOP, STAGE 3, OR AFTER TRANSPLANT
PEDS CA: MEDULLOBLASTOMA
TUMOR OF THE CEREBELLUM OR POST FOSSA
DISSEMINATES THRU CRANIAL SPINAL INRADURAL AXIS
PRESENTS: NAUSEA, HEADACHES, VOMITT, LETHARGY, ATAXIS
TX: SURGERY TO DEBULK FOLLOWED BY CRANIOSPINAL XRT
OTHER CNS TUMORS REQUIRE CSA XRT- EPENDYMOMA IF SPINAL METS, PNET TUMORS, PIEAL REGION TUMORS (GERMINOMA)
PEDS CA: COMPLICATIONS
SOFT TISSUE/ OSSEOUS HYPOPLASIA
PULMONARY FIBROSIS
PSYCOMOTOR RETARDATION
LEARNING DISABILITIES
INFERTILITY
ENDOCREINE DEFICITS
INDUCTION OF 2ND MALIGNANCIES -OSTEOSARCOMA
GENERAL RULE FOR LOCALIZATION IMAGING
SIMULATION IMAGES MUST VISUALIZE THE TREATED VOL WITH ASSOCIATED LANDMARKS AND FIELD PARAMETERS
IMAGING LABELING: MUST INCLUDE
PT FULL NAME
INSTITUTION, MD
DATE
VIEW
FIELD PARAMETERS (FS, GANTRY/COLLIMATOR ANGLES)
ORGANS AT RISK
ANATOMIC STRUCTURES WHICH SIGNIFICANTLY INFLUENCE DELIVERABLE DOSE TO PRESCRIBED VOLUME
VOLUME ENCLOSEDD BY ISODOSE SURFACE SPECIFIED BY RADIATION ONCOLOGIST AS APPROPRIATE TO ACHIEVE PURPOSE OF TX (PERSCRIPTION)
TREATED VOLUME
IMAGE RECEPTORS
98% OF IMAGE WILL BE CREATED BY LIGHT
FACTORS AFFECTING IMAGE QUALITY
RECEPTOR: FILM, SCREENS
GEOMETRY
RAD EXPOSURE
PROCESSING
PENUMBRA
SHARPNESS IS A FUNCTION OF PENUMBRA
-FS SIZE
-SAD (OR OBJECT), SID
IMAGE QUALITY IN BEAM
CONTROLLED BY QUANTITY AND QUALITY
CONTRAST
GRAYSCALE, MEASURE OF RANGE FROM BLACK TO WHITE
DENSITY
MEASURE OF OVERALL BLACKNESS
EXPOSURE FACTORS: KVP
BEAM QUALITY=ENERGY=PENETRATING ABILITY
EXPOSURE FACTORS: MAS
BEAM QUANTITY=NUMBER OF PHOTONS
KVP & DENSITY
15% INCREASE IN KVP WILL DBL DENSITY
DENSITY & MAS
CURRENT: MA (COULOMB/SEC), - RATE OF E- PASSING THRU A CONDUCTOR
TIME OF EXPOSURE: S (SECONDS)
EXPOSURE IS THE PRODUCT: MAS
INCREASING MAS: INCREASES FILM DENSITY AND INCREASES PT DOSE
FILM: LATENT IMAGE
INVISIBLE IMAGE FORMED BY CHANGES IN THE SILVER HALIDE CRYSTAL AS A RESULT OF EXP TO PHOTON ENERGY
FILM: MANIFEST IMAGE
VISIBLE IMAGE PRODUCED THRU CONVERSION OF REMAINING SILVER IONS IN EXPOSED CRYSTALS TO METALLIC SILVER
FILM PROCESSING
1-WETTING
2-DEVELOPEMENT
3-FIX
4-WASH
5-DRY
VIRTUAL SIM
1- MARK TRIANGULATE REFERENCE POINT PRIOR TO SCAN
2- SCAN
3- PT NEED NOT BE PRESENT FOR REMAINDER
4- DEFINE TARGET
5- ESTABLISH ISOCENTER LOCATION FIELDS AND FIELD SHAPES RELATIVE TO PRE-SCAN REFERENCES (OFFSETS OR SHIFTS)
SMALL VOLUMES IN CT
VOXELS
#1 PRIORITY WHEN PLANNING TO USE IV CONTRAST
PATIENT HISTORY
ANAPHYLAXIS AND EMERGENCY RESPONSE
MUST BE ON HAND
PHYSICIAN
BENADRYL
ADRENALYN
CRASH CART
CARDIAC ARREST AND CPR
1- VERIFY UNRESPONSIVENESS "ARE YOU OK"?
2- CALL FOR HELP
3- POSITION PT ON BACK AND HARD SURFACE
4- OPEN AIRWAY (FINGERS UNDER CHIN, HAND ON FOREHEAD, LIFTING JAW)
CPR
LOOK, LISTEN, FEEL FOR BREATHING 5-10 SEC
CPR: COMPRESSIONS
HEEL OF HAND AT CENTER OF BARE CHEST, LOWER HALF OF STERNUM, LEVEL OF NIPPLES
30 COMPRESSIONS TO 2 BREATHS
2 RESCUERS SWITCH EVERY 2 MINUTES
THE EXTERNAL AUDITORY MEATUS OVERLIES THE ANT BORDER OF THE
FORAMEN MAGNUM
THE LARYNX IS COINCIDENT WITH WHAT VERTEBRAL LEVEL
C4-C6
THE SUPERIOR EXTENT OF THE NASOPHARYNX MAY BE LOCATED LEVEL WITH THE
OUTER CANTHUS OF THE EYE
THE INFERIOR EXTENT OF THE HYPOPHARYNX IS LEVEL WITH THE
C6 & CRICOID CARTILAGE
THE COMMON ILIAC NODE CHAIN BRANCES FROM THE PARAAORTIC CHAIN AT THE LEVEL OF
L4 & ILIAC CREST
THE SPINAL CORD IN THE ADULT EXTENDS TO
L2
TO INCREASE RADIOGRAPHIC DENSITY ONE SHOULD
INCREASE MAS
TO INCREASE RADIOGRAPHIC CONTRAST ONE SHOULD DECREASE
KVP
ADVANTAGES OF NETWORKED DIGITAL IMAGE MANAGEMENT DO NOT INCLUDE
COMPUTER DISK SPACE IS NOT AN ISSUE
CONTRAST MEDIA MAY BE ADMINISTERED BY WHICH OF THE FOLLOWING
IV
ORAL
CATHETER
THE MOST COMMON TYPE OF SKIN CA IS
BASAL CELL CA
THE HISTOLOGIC TYPE OF LUNG CA WHICH IS OFTEN PRESENTS WITH METS IS
SMALL CELL
KREBS CYCLE
THE FINAL COMMON PATHWAY IN THE OXIDATION OF CARBOHYDRATE, PROTEIN AND FAT METABOLISM. IT IS THRU THIS CYCLE THAT ENERGY IS RELEASED
H&N FOOD SUGGESTIONS
VERY SOFT TO THICK LIQUIDS, MOIST TEXTURES
TEMP: WARM TO COOL
SEASONINGS: MILD, NON ACIDIC
CANCER CELLS CAN PRODUCE MORE THAN 40 TIMES MORE ________ THAN NORMAL CELLS
LACTIC ACID
RADIATION TO INTESTINAL AREA
LOW FIBER
LOW FAT
LOW LACTOSE
INCREASE FLUIDS
FOR NAUSEA
LOW FIBER
LOW FAT
FREQUENT SNACKS
FOR VOMITING
CLEAR LIQUIDS
PUSH FLUID
INCREASE SODIUM CONTAINING LIQUIDS
TO PREVENT DENTAL CARIES WITH XEROSTOMIA NEVER USE
REGULAR CANDIES OR GUM OR ANY HIGH SUGAR CONTENT FOOD
SERUM ALBUMIN
IS AN INDICATOR OF VISCERAL PROTEIN STORES
URINE CREATININE
EXTRETED IN LARGE AMOUNT IN CONDITIONS WHERE THERE IS BODY PROTEIN BREAKDOWN
TUBE FEEDING RISKS
THE PUMP SHOULD BE OFF 1/2 HOUR TO 45 MIN BEFORE PERSON LIES DOWN FLAT
BECAUSE INCREASED RISK OF ASPIRATION
CANCER CACHEXIA
A CLINICAL SYNDROME THAT DEVELOPES WHEN THERE IS NUTRITIONAL AND METABOLIC ABNORMALITIES IN ADVANCED CANCERS
PSYCHOLOGICALLY RELATED
DEPRESSION
SOCIALIZATION DISRUPTED
FINANCIAL BURDEN INCREASED
PATIENT BILL OF RIGHTS
RESPECT
QUALITY HEALTH CARE
INFO YOU CAN UNDERSTAND
CARE FOR YOU AND YOUR FAMILY
PARTICIPATE IN DESCISIONS
EMOTIONAL SUPPORT
CODE OF ETHICS IN RAD THERAPY
INFORMED CONSENT
CONFIDENTIALITY
HIPPA
BENEFICENCE
DOING GOOD
NONMALEFICENCE
PREVENTING HARM
AUTONOMY
RESPECTING OTHER'S INDEPENDENCE
VERACITY
TELLING THE TRUTH
FIDELITY
BEING FAITHFUL
JUSTICE
BEING FAIR OR EQUITABLE
MALPRACTICE
IMPROPER TX OF A PT RESULTING IN INJURY, DAMAGE, OR LOSS
NEGLIGENCE
FAILURE TO USE SUCH CARE AS A REASONABLE PRUDENT PERSON WOULD USE UNDER LIKE CIRCUMSTANCES
BATTERY
UNLAWFUL TOUCHING WITHOUT CONSENT
ASSAULT
THREAT OF TOUCHING TO INJURE
RES IPSA LOQUITOR
A RULE OF EVIDENCE WHEREBY THE NEGILGENCE OF AN ALLEGED WRONGDOER CAN BE INFERRED FROM THE FACT THAT THE ACCIDENT HAPPENED
RESPONDEAT SUPERIOR
THE EMPLOYER IS RESPONSIBLE FOR NEGLIGENT ACTS OF ITS EMPLOYEES
SIDE EFFECTS OF RAD THERAPY
SKIN REACTIONS:
DRY, ITCH, BURNING
ERYTHEMA (2000 CGY)
DRY DESQUAMATION
MOIST DESQUAMATION
CEREBRAL EDEMA
DESTRUCTION OF BLOOD-BRAIN BARRIER
WHOLE BRAIN XRT
LIMB WEAKNESS
VISUAL CHANGES
SEIZURES
SPEECH PROB
ALOPECIA
HAIR FOLICLES HAVE HIGH MITOTIC RATE
OCCURS AT 2400 CGY
REGROWHT 3-6 MO
LOSS PERMANENT > 6000 CGY
MUCOSITIS
MUCOS MEMBRANE VERY RADIOSENSITIVE
METAL FILLINGS INCREASE REACTION DUE TO SCATTER
USUALLY 2-3 WKS IN RT (3000 CGY)
INCREASED WITH CHEMO
MUCOSITIS RISK FACTORS/ MANAGEMENT
RISK FACTORS: POOR NUTRITION AND ORAL HYGIENE, CONT TOBACCO/ETOH, POOR FITTING DENTURES

MANAGEMENT: SEE DENTIST FIRST
SALINE/BAKING SODA RINSE QID
SOFT TOOTHBRUSH
DIETARY CONSULT
XEROSTOMIA
SALIVARY GLANDS EXTREMELY RADIOSENSITIVE
SALIVA BECOMES THICK AND ROPY
RISK FOR DENTAL CARRIES/ INFECTIONS
DOSE AS LITTLE AS 10 GY CAN DECREASE SALIVA OUTPUT 60-90%
XEROSTOMIA MANAGEMENT
MODIFY DIET
INCREASE FLUID
PILOCARPINE
AMIFOSTINE
DYSGUESIA
TASTE CHANGES
TASTE BUDS ARE RADIOSENSITIVE
HEARING CHANGES
RARE
OCCUR IF MIDDLE EAR IS IN TX FIELD
OSTEORADIONECROSIS: DELAYED
DECREASED VASULARITY/CELLULARITY OF BONE
WEAKENS BONE
MANDIBLE VER SENSITIVE
CAN OCCUR 6 MO AFTER RT
PAIN OR FRACTURE
TRISMUS; DELAYED
CONTRACTION OF THE JAW MUSCLE FROM FIBROSIS
OCCURS FEW MO TO YRS AFTER RT
CHEST/LUNG SIDE EFFECTS
RADIATION PNEUMONITIS: ACUTE
DAY TO WKS OF STARTING RT
ENDOTHELIAL LINING BEGINS TO SLOUGH AND CAN OCCLUDE THE LUMEN OF THE LUNG
CHEST/LUNG SIDE EFFECTS
RADIATION PNEUMONITIS
PULMONARY FIBROSIS
COLLABORATIVE MANAGEMENT
NUTRITION CONSULT
WEEKLY WEIGHTS
CONTROL CONTRIBUTING SYMPTOMS: NAUSES, DIRRHEA
ABD RT: SIDE EFFECTS
ANOREXIA
N/V
PREMEDICATE
PELVIC RT: SIDE EFFECTS
DIARRHEA
PROCTITIS
FREQ URINATION
DYSURIA
SEX DYSFUNCTION
SKIN REACTIONS
RED BLOOD CELLS
CARRY OXYGEN TO CELLS THRU OUT BODY
NORMAL RBC VALUE
HEMATOCRIT: 37-51%
HEMOGLOBIN: 12-18 G/DL
WBC'S
HELP THE BODY FIGHT INFECTION
NORMAL VALUE: 4,000-11,000 K/UL
PLATELETS
HELP BODY TO STOP BLEEDING
NORMAL: 150,000 -400,000 K/UL
FACTORS THAT AFFECT BLOOD COUNTS
MEDICATIONS
UNDERLYING MED CONDITION
RADIATION- PREVIOUS AND CURRENT
CHEMO
CA IN BONE MARROW
NUTRITION
FEEDING TUBES
NO FEEDINGS WHILE LAYING DOWN
ASEPSIS
MEDIAL- REDUCE NUMBER OF INFECTOUS AGENTS
SURGICAL- STERILE TECH
PATHOGEN
ANY DISEASE PRODUCING ORGANISM
STANDARD PRECAUTIONS
AIRBORNE: TB, CHICKEN POX
CONTACT: C. DIFFICILE
DROPLET: INFLUENZA
STRICT: SARS, SMALL POX
BREAST FIELDS
TANGENTS
CHEST WALL
SUPRA CLAV
INTERNAL MAMMARY NODES
AXILLARY NODES
BREAST
2ND -6TH RIB FROM STERNUM
TAIL OF SPENCE
15-20 LOBES
EMBEDDED IN ADIPOSE TISSUE
DRAINED BY DUCTS THAT OPEN AT NIPPLE
LOBE CONTAINS LOBULES
BREAST LYMPHATICS
AXILLARY
IM
TRANSPECTORAL
SUPRACLAVICULAR
BREAST TANGENT BORDERS
SUP: 1ST OR 2ND INTERCOSTAL SPACE
INF: 1.5 CM BELOW INFRAMAMMARY FOLD
MEDIAL: MIDLINE OR 1.5 OVER MIDLINE
LAT: NEAR MID AXILLARY LINE, 2 CM BEYOND BRST TISSUE

CO-PLANER EDGE
SML VOL OF LUNG INCL
NO LUNG
BREAST: SUPRACLAV
SUP: ACROSS NECK AND TRAP TO ACROMIAL PROCESS
INF: 1ST OR 2ND INTERCOSTAL SPACE
MED: 1 CM LAT ACROSS MIDLINE TO UNAFFECTED SIDE
LAT: AC JOINT, BISECTING HUMERAL HEAD, S/C NODES TO 2/3 OF CLAVICLE
BREAST: SUPRACLAV
ANGLED 10-15* TOWARD UNAFFECTED SIDE
ANT OBL MOST COMMON
LOWER PORTION OF FIELD BLOCKED WITH 1/2 BEAM OR ASYMMETRIC JAWS
BREAST: E- CHEST WALL BORDERS
MED: MATCHING IM NODES REQ TX
LAT: MID AXILLARY
SUPERIOR: MATCH INF SUPRACLAV
INF: HORIZONTAL LINE AT LEVEL OF XYPHOID
BREAST: INTERNAL MAMMARY BORDERS
MED: MIDLINE OR 1 CM OVER MIDLINE
LAT: 5-6 CM LAT TO MIDLINE
SUP: ABUTS THE INF BORDER OF SUPRACLAV
INF: XYPHOID
PAB FIELD BORDERS
MED: 1.5 -2 CM OF LUNG, INCLUDE AXILLARY NODES CLOSE TO CHEST WALL
LAT: 1 -2 CM OF HUMERAL HEAD, LATISSIMUS DORSI MUSCLE
SUP: BISECT CLAVICLE AND HUMERAL HEAD
INF: MATCHES SUP BORDER OF TANGENTS
BREAST TX DOSE & ENERGY
4-6 MV
180-200 CGY/FX
TOTAL DOSE: 45-50 GY
BOOST TANG W/ E- OR CONE DOWN PHOTON TO 60-66 GY
LOBES LUNG
RIGHT: 3 LOBES
LEFT: 2 LOBES
MEDIASTINUM: SUP & INF (ABOVE AND BELOW CARINA)
CONTAINS ALL ORGANS EXCEPT LUNGS:
HEART
AORTA (T2)
PULM TRUNK, VEINS, ARTERIES
INF VENA CAVA
TRACHEA
MAIN BRONCHI
ESOPHAGUS
THYMUS GLAND
NERVES
RESPIRATORY LYMPHATICS
INTRAPULMANARY
HILAR
MEDIASTINAL: SUP & INF
INF PULMANARY LIGAMENT
LYMPHATIC DRAINAGE: LUNG
LLL TO SUBDIAPHRAGMATIC ORGANS
BOTTOM OF LUL TO SUBDIAPHRAGMATIC ORGANS
RUL TO AXILLA
ENTIRE LUNGS UP THE MIDLINE CHAIN OF NODES
H&N ANATOMY
ORAL CAVITY
NASOPHARYNX
OROPHARYNX
HYPOPHARYNX
LARYNX
LYMPH NODES
PAROTID
SINUSES
ESOPHAGUS LYMPHATICS; RICH LONGITUDINAL INTERCONNECTING LYMPHATIC SYSTEM
UPPER: MOST COMMON TO THE INTERNAL JUGULAR, CERVICAL, OR SUPRACLAV LN'S
MIDDLE: PRIMARILY TO SUPRACLAV, PARATRACHIAL AND MEDIASTINAL NODES
LOWER: LOWER MEDIASTINAL, GASTRIC AND CELIAC AXIS ODES
STOMACH LYMPHATICS
SPREAD IS VIA **DIRECT EXTENSION
LYMPHATICS, HEMATOGENOUS SPREAD AND SPILLAGE INTO PERITONEAL CAVITY
STOMACH BORDERS: AP/PA FIELDS
SUP: 3-4 CM MARGIN
INF: BOTTOM L3
LAT: 3-4 CM MARGIN AROUND THE TUMOR OR TUMOR BED
**EXCLUDE 3/4 OF ONE KIDNEY
PANCREAS ANATOMY
RETROPERITONEAL
LEVEL L1-L2
HEAD OF PANCREAS IN DUODENUM
TAIL EXTENDS TO SPLENIC HILUM
PANCREAS LYMPHATICS
SUP & INF PANCREATICODUODENAL NODES
PORTA HEPATIS
SUPRAPANCREATIC NODES
CELIAC NODES
ADJ PARA-AORTIC NODES
**ALSO SPREADS VIA DIRECT EXTENTION
PANCREAS
4 FIELD DOSE 45-50 GY W/ 5FU
MANY DOSE LIMITING ORGANS:
SML INTESTINES, STOMACH, LIVER, KIDNEYS, SPINAL CORD
RECTUM ANATOMY
LOCATED BETWEEN SIGMOID AND ANUS
13-15 CM LONG
3 SECTIONS: UPPER, MIDDLE, LOWER 3RD
RECTUM/SIGMOID JOIN AT S3
RECTUM LYMPHATICS
UPPER RECTUM FOLLOW SUP RECTAL VESSELS AND TERMINATES IN INF MESENTERIC NODES
MIDDLE & LOWER: RECTAL LN'S DRAIN TO THE INTERNAL ILIAC AND PRESACRAL NODES
RECTUM PORTS
MIXED ENERGIES
PA: LOW ENERGY
LATS: HIGH
DOSE 45-50 GY
ANAL CANAL ANATOMY
3-4 CM LENGTH
ANAL CANAL LYMPHATICS: 3 LYMPH NODE SYSTEMS
PERIANAL SKIN, ANAL VERGE, AND CANAL- SUPERFICIAL INGUINAL NODES AND TO EXTERNAL ILIACS

UPPER CANAL- CAN SPREAD TO INTERNAL ILIACS (HYPOGASTRIC)

TUMORS OF THE UPPER CANAL AND TRANSITIONAL ZONE- MAY TRAVEL TO THE INFERIOR MESENTERIC NODES
ANAL CANAL PORTALS
AP/PA OR 4-FIELD
AP SOMETIMES LARGER FOR INGUINAL NODES
BOOST INGUINAL NODES WITH E-
BOOST ANUS BENT OVER ON ANGLE BOARD
DOSE 4500 CGY
GYN LYMPHATICS
3 SEP ROUTES
1. LAT: ALONE UTERINE TO EXT ILIACS
2. POST-LAT: BEHIND URETERS TO INT ILIAC NODES
3. POST: ENTER COMMON ILIAC AND LAT SACRAL
OVARY LYMPHATICS
1. PARA-AORTIC
2. EXT. ILIAC
3. INT. ILIAC
UTERUS LYMPHATICS
1. COMMON ILIAC
2. INT ILIAC
3. EXT ILIAC
4. PARA-AORTIC
VAGINA LYMPHATICS
1. INT ILIAC
2. EXT ILIAC
3. SUPERFICIAL INGUINAL
VULVA LYMPHATICS
1. INGUINAL
2. DEEP FEMORAL NODES
3. EXT ILIAC
CERVIX BRACHY POINTS: POINT A
2 CM SUP TO EXT OS AND 2 CM LAT TO CERVICAL CANAL
CERVIX BRACHY POINTS: POINT B
2 CM SUP AND 5 CM LAT TO EXT OS
BLADDER LYMPHATICS
EXT AND INT ILIAC
PRESACRAL NODES
BLADDER DOSE
1ST COURSE: 45-50 GY
CONE DOWN: 5-70 GY
PROSTATE ANATOMY
PROSTATE GLAND COMPOSED OF 5 LOBES
URETHRA PASSES THRU
LOCATED BELOW BLADDER
PROSTATE LYMPHATICS
INT ILIAC
EXT ILIAC
PROSTATE DOSE
TOTAL 75-81 GY W/ CONFORMAL FIELDS
PROSTATE SEED IMPLANTS:
125 IODINE AND 103 PALLADIUM
WILMS TUMOR
ORIGINATES IN THE KIDNEY
LOCATED RETROPERITONEAL SPACE
BTWN 11TH RIB & L3
RIGHT KIDNEY GENERALLY 1-2 CM LOWER BECAUSE OF LIVER
TESTICULAR LYMPHATICS
PURE SEMINOMAS PRIMARILY SPREAD THROUGH LYMPHATICS
PARA AORTIC NODES
ILIAC NODES
LUNG METS
XRT ENTIRE LUNG VOLUME
INCLUDE LUNG BASES
TESTICULAR BORDERS
HOCKEY STICK
DOSE 25-30 GY
HODGKINS LYMPHATICS
**ALWAYS BEGINS IN LYMPH NODES
SPLEEN
THYMUS
WALDEYER'S RING (TONSILS, ADENOIDS,)
PEYER'S PATCHES: SML BOWEL: NEAR ILEUM AND COLON JUNCTION
HODGKINS POSITION
MANTLE
ARMS AKIMBO OR RAISED ABOVE HEAD
CHIN HYPEREXTENDED
DOSE 40 GY
HODGKINS IS BIMODAL
15-30 YR
THEN 50+ YRS
SARCOMA
ARRISE CONNECTIVE TISSUE OF BODY
INCLUDE: MUSCLES, TENDONS, FAT, FIBROUS AND SYNOVIAL TISSUE
60% ARISE IN EXTREMITIES
TX CONSIDERATIONS FOR BONE
SPARING A STRIP: 1.5-2 CM TO LIMIT DISTAL EXT EDEMA
SPARE GROWTH PLATE IF POSSIBLE
ORAL CAVITY SONG
OH MY NAME IS ORAL, ORAL CAVITY I AM MADE OF MANY PARTS.
I START FROM THE LIPS TO THE HARD PALATE, INCLUDING PART OF THE TONGUE.
MY PARTS ARE BUCCAL MUCOSA, RETROMOLAR TRIGONE TOO. GINGIVA AND FLOOR OF MOUTH ARE ALL A PART OF ME. I AM THE ORAL CAVITY.
OROPHARYNX SONG
OH, IM THE OROPHARYNX AND I HAVE SEVERAL PARTS.
I START FROM THE SOFT PALATE TO THE HYOID INCLUDING THE UVULA.
MY PARTS ARE THE ORPHARYEAL WALL, VALLECULAE, AND BASE OF TONGUE. THE BORDER OF THE EPIGLOTTIS AND TONSIL ARE WITHIN ME.
I AM THE OROPHARYNX
LARYNX SONG
OH, IM THE LARYNX OR THE VOICE BOX AND I HELP TO MAKE THE SOUND. THE THYROID CARTILAGE COVERS ME FROM THE FRONT AND ON BOTH SIDES. THY CRICOID CARTILAGE CIRCLES ME JUST BELOW THE VOCAL CORDS. SUPRAGLOTTIS, SUBGLOTTIS AND THE GLOTTIS MAKES ME
I AM THE LARYNX OR VOICE BOX.
HYPOPHARYNX SONG
OH IM THE HPOPHARYNX AND I ENVELOP THE LARYNX. I ALSO HAVE SOME DIFFERENT PARTS COMPRISING ONLY OF THREE.
I HAVE THE PERIFORM SINUS, POSTCRICOID AREA.
POSTERIOR PHARYNGEAL WALL IS THREE AND THATS WHAT MAKES ME.
I AM THE HYPOPHARYNX
NASOPHARYNX SONG
OH IM THE NASOPHARYNX JUST POSTERIOR TO THE NASAL CAVITY.
THE SOFT PALATE AND THE UVULA ARE THE BORDER TO THE 2ND CERVICAL VERTEBRA.
THE SPHENOID SINUS IS SUPERIOR, EUSTACHIAN TUBES ARE LATERAL. THE POSTERIOR PHARYNGEAL WALL IS LAST OF THE BORDERS.
I AM THE NASOPHARYNX.
WHY WOULD YOU USE AN ANGLE BOARD
TO REDUCE PT SLOPE, TO ELIMINATE OR REDUCE COLLIMATOR ANGLE
ON LRG BRST SHIFT THE BREAST TISSUE INF
WHICH LEVEL AXILLARY NODES (I,II,III) LIE SUP TO THE PECTORALIS MINOR MUSCLE.
LEVEL III
WHICH TECHNIQUES MAY BE USED TO TREAT THE INT MAMMARY LYMPH NODES ON A PT WITH LEFT BRST CA AND DELIVER THE LEAST CARDIAC DOSE
ANT PHOTON/E- FIELDS, 50 GY/5 WKS
AXILLARY NODES DRAIN INTO WHAT
SUPRACLAV NODES
INTERNAL MAMMARY NODES ARE PRIMARILY LOCATED
IN THE 1ST, 2ND, 3RD, AND 6TH INTERCOSTAL SPACE
CRITICAL STUCTURES LOCATED IN THE TX FIELD FOR LUNG CA INCLUDE?
SPINAL CORD
HEART
AP/PA OPPOSED PORTAS OF THE SUPERIOR CHEST CAUSES
A HIGHER DOSE NEAR SUP EDGE OF THE FIELD AS COMPARED WITH THE CAX
THE SUP BORDER FOR A T1 LARYNX FALLS AT
HYOID BONE
T/F: THE JOGULODIGASTRIC NODES FALL POST TO THE CERVICAL NODES
FALSE
PAROTIC GLANDS TUMORS MAY BE TX WITH
3 FIELD HEAD AND NECK
STOMACH LYMPHATICS DRAIN TO THE
CELIAC AXIS
LOWER RECTUM LYMPHATICS DRAIN TO
INT ILIACS AND PRESACRAL NODES
GYN: WHY USE A MIDLINE BLOCK? (3)
1. BOOST PARAMETRIAL NODES
2. BLOCK IMPLANT AREA
3. BLOCK BLADDER AND RECTUM
STATE THE TYPICAL FIELD ARRANGEMENT + FIRST COURSE DOSE USED FOR ESOPHAGUS AND THEN THE FIELD ARRANGEMENT USED FOR THE BOOST
1ST COURSE: AP/PA TO 3000 CGY
BOOST: AP & 2 POST OBL
THE VAGINA DRAINS INTO WHICH LYMPHATICS
INT & EXT ILIACS AND SUP INGUINALS
THE NODE OF CLOGUET IS LOCATED WHERE?
DEEP FEMORAL
TOTAL DOSE PRESCRIBED FOR A WILMS TUMOR FIELD IS WHAT?
1000-2000 CYG
TESTICULAR LYMPHATICS DRAIN TO WHERE
PARA AORTICS
THE BLADDER DRAINS TO WHAT LYMPHATICS
EXT & INT ILIACS
HODGKINS: IN ADDITION TO THE BLOCKS USED FORM THE FIRST DAY OF TX, WHAT TWO CRITICAL STRUCTURE BLOCKS DO WE ADD AS WE NEAR THEIR TOLERANCE DOSE AND STATE THE TOLERANCE DOSE FOR EACH
LARYNX- AP 2000 CGY
SPINE- PA 3000 CGY
HODGKINS: THE ANATOMY OF WALDEYERS RING IS COMPOSED OF
TONSILS, ADENOIDS, BASE OF TONGUE
HODGKINS: THE SHAPE OF THE PARA-AORTIC AND PELVIC FIELDS TOGETHER IS CALLED WHAT
INVERTED Y
THE PITUITARY IS LOCATED IN WHAT STRUCTURE
SELLA TURSICA
WHEN TREATING A CRANIOSPINAL FIELD ___ MUST BE INCLUDED ON THE SUP ASPECT OF THE BRAIN TO BE SURE ___ ARE INCLUDED
CRIBIFORM PLATE
MENINGIES
WHAT DO WE CALL THE TECHNIQUE USED TO REDUCE THE CHANCES OF A PT EXPERIENCING LYMPHEDEMA?
SPARING A STRIP
WHEN USING CRANIOSPINAL IRRADIATION, TO ELIMINATE DIVERGENCE OF THE SPINAL FIELD YOU MUST
ROTATE THE TABLE TOWARDS THE GANTRY
THE AREA OF GROWTH IN BONE IS CALLED WHAT
EPIPHYSEAL PLATE
ISOCENTER IS DEFINED AS THE POINT
-THE GANTRY ROTATES AROUND
-THE COLLIMATOR ROTATES AROUND
-WHERE ALL THE LASERS MEET
THE FIELD WIDTH OF THE TX BEAM IS DEFINED BY ___ ISODOSE LINE
50%
A 100 CM TX UNIT IMPLIES
THE FIELD SIZE IS DEFINED BY THE COLLIMATOR IS DEFINED AT 100 CM
WHICH OF THE FOLLOWING NORMALLY PREVENTS THE OPERATION OF A THERAPEUTIC UNIT
NOT ANY OF THESE
PT MOVING
FIELD SIZE MISALIGNMENT
IMPROPER GANTRY ANGLE
THE REDUCTION OF PRIMARY BEAM TRANSMISSION TO A LEVEL OF LESS THAT 5% WILL GENERALLY REQUIRED HOW MANY HVL
5 HVL
TX MACHINE BEAM MODIFIERS
WEDGE POSTITION
COMPENSATORS
IMRT
BOLUS
BLOCKS/TRAYS
MLC'S
LIGHT FIELD/ RADIATION COINCIDENCE TEST ARE DONE TO
PREVENT GEOGRAPHIC MISS OF TUMOR
WHICH OF THE FOLLOWING ARE POSSIBLE SOURCES OF LIGHT FIELD INCONGRUENCE?
MIRROR MISALIGNMENT
COLLIMATION MISALIGNMENT
THE BLOCK TRANSMISSION PENUMBRA CAN BE REDUCED BY
EMPLOYING DIVERGENT BLOCKS
THE DISTANCE A BLOCK SHOULD BE FROM A PT IS
15-20 CM
WHAT THICKNESS OF CERROBEND EQUIVILANT TO 6 CM OF PURE LEAD?
7.5 CM
A BOLUS IS APPLIED IN E- BEAM THERAPIES TO INCREASE
SURFACE DOSE
BOLUS IS USED IN MV THERAPY TO
INCREASE SKIN DOSE
THE HINGE ANGLE IS THE ANGLE
BETWEEN THE CENTRAL AXES OF 2 WEDGED BEAMS
TWO TX FIELDS HAVE A HINGE ANGLE OF 90* CALCULATE THE WEDGE ANGLE
45*
IN GENERAL, THE ACCEPTABLE AMOUNT OF PRIMARY BEAM TRANSMISSION THROUGH BLOCKS IS
5%
IN GENERAL, THE ACCEPTABLE AMOUNT OF PRIMARY BEAM TRANSMISSION THROUGH THE MLC'S
1-2%
T/F: DO MLC'S COMPLETELY ELIMINATE THE NEED FOR CERROBEND BLOCKS
FALSE
4 REASONS TO MONITOR THE PT
PATIENT SAFETY
ACCURACY OF TX
PT MOTION
MACHINE COLLISION
T/F A RECORD AND VERIFY COMPUTER BASED PROGRAM CAN IDENTIFY SET-UP ERRORS PRIOR TO TX
TRUE
ALL OF THE FOLLOWING ARE IMPORTANT PUPOSES FOR LABELING VERIFICATION IMAGES
PORT FILMS ARE LEGAL DOCUMENTS
DOCUMENTATION OF TX RECORD
PROVIDES A MEANS TO ENACT CHANGE
A MECHANISM FOR ENSURING THAT RADIAITON BEAMS ARE IRRADIATING THE ENTIRE PREDETERMINED VOLUME IS BY
TAKING PORT FILMS
WHILE TX A PT USING A ROTATIONAL TECHNIQUE, THE GANTRY ROTATES PAST THE END POINT. THIS IS MOST LIKELY A MALFUNCTION OF THE
LIMIT SWITCH
ALL OF THE FOLLOWING UNITS USE A TIMER TO TERMINATE RADIATION EXPOSURE EXCEPT
LINEAR ACCELERATOR
T/F TO PROCEED W/ TX WHEN THERE ARE FAULT LIGHT INDICATORS DURING THE WARM-UP PROCEDURE CAN CAUSE SERIOUS DAMAGE TO THE MACHINE AND THE PT.
TRUE
WHAT IS THE FIRST STEP IF A TX BEAM FAILS TO TERMINATE
BEAM OFF
T/F EMERGENCY OFF SWITCHES SHOULD BE ACTIVATED PERIODICALLY AND WHEN THERE IS EVIDENCE OF SERIOUS MALFUNCTION
TRUE
ALL OF THE FOLLOWING APPLY TO BACK UP TIMERS
FOUND ON CONTROL PANEL
SET ALON WITH THE MAIN TIMER
SET FOR A LONGER PERIOF OF TIME THAN THE MAIN TIMER
T/F INTERLOCKS ARE PROTECTIVE DEVICE DESIGNED TO SHUT DOWN A SYSTEM IF IT ISN'T OPERATING PROPERLY
TRUE
IF A LINE POWER FAILURE OCCURES ON A LINEAR ACCERLATOR DURING TX, WHAT PROCEDURE SHOULD YOU FOLLOW
RESET BREAKER
DETERMINE THE NUMBER OF MONITOR UNITS ALREADY USED AND CONTINUE TX
INCLUDED IN THE TX RECORD
MU/TIME
TUMOR DOSE/DAILY
TUMOR DOSE/ ACCUM
BEAM ENERGY
BEAM TYPE
SET-UP INSTRUCTIONS
DATE
FRACTION
ELAPSED DAYS
FIELD NUMBER
DOSE TO OTHER POINTS
TIME (BID)
MISADMINISTRATION WITH COBALT 60
-WRONG SITE, PT, MODE OF TX
-MISADMIN >10% OF TOTAL DOSE (<4 FX)
-MISADMIN > 20% OF TOTAL DOSE (>3FX)
-MISADMIN > 30% OF WEEKLY DOSE
MISADMINISTRATION MACHINE
ANY TX MACHINE > 2%
WHICH OF THE FOLLOWING ARE AREAS OF RESPONSIBILITY FOR THE RADIATION THERAPIST IN INDENTIFICATION AND MANAGEMENT OF MACHINE MALFUNCTIONS
-RADIATION
-ELECTRICAL
-MECHANICAL
STENTS AND BITE BLOCKS ARE EX OF ___ TX DEVICE CHARGE
INTERMEDIATE
A PT IS BEING TREATED TO TWO SEP AREAS, OPEN FIELD PA SPINE AND AP/PA HUMERUS WITH NO BLOCKS. CHARGE?
INTERMEDIATE
TX OF 6X SPINE FIELD WITHOUT BLOCKS IS WHAT CHARGE
SIMPLE
TX OF A E- SCAR AREA FIELD WITHOUT A CUSTOM INSERT IS WHAT CHARGE
COMPLEX
BRST CA SCREENING
START @ 40 ANNUALLY
IMAGING:
MAMMOGRAPHY
US
MRI
PET FOR STAGING METS
BRST CA HISTOLOGIC TYPES
INFILTRATING LOBULAR CA
INFILTRATING DUCT CA
IN SITU DUCT CA
RADIATION TECH- BREAST CONSERVATION
TANG/ IMRT
E- BOOST
NODAL RT- AXILLA, SUPRACLAV, BOTH
RADIATION TECH- PARTIAL BREAST RT
HDR CATHETERS
BALLOON MAMMOSITE
EXT PBI
RADIATION TECH- POST MASTECTOMY
CHEST WALL TANG, E-
NODAL RT
MAMMOSITE
BALLOON PLACED IN LUMPECTOMY CAVITY DURING SURGERY
3400 CGY IN 5 DAYS
340 CGY X 10 (BID)
CHEMO BREAST
TAMOXIFEN
ARIMIDEX
FEMARA
BREAST DOSE
180-200 CGY/DAY
4600-5000 CGY WHOLE BRST
BOOST 6000-64000 CGY TOTAL TO INVOLVED SEGMENTS WITH MARGIN
PROSTATE PSA
DRE @50
40 HIGH RISK
KIDNEY
CLEAR CELL CA
RENAL PELVIS
TRANSITIONAL CELL CA
URETER
TRANSITIONAL CELL CA
BLADDER
TRANSITIONAL AND SQUAMOUS CELL
PROSTATE
ADENOCA
TESTIS
GERM CELL
SEMINOMA
NON SEMINOMA
URETHRA
SQUAMOUS CELL CA
PENIS
SQUAMOUS CELL CA
GLIAL CELLS
ASTOCYTOMA, GLIOBLASTOMA, OLIGODENDROGLIOMA
DURA/MENINGES
MENINGIOMA
EPENDYMAL CELLS
EPENDYMOMA
EMBRYONAL CELLS
MEDULLOBLASTOMA, PNET, GERM CELL TUMOR
BRAIN METS
FROM
LUNG
BREAST
MELANOMA
GI
RENAL
RADIOSENSITIVITY CNS
FAIR- GLIOMA
GOOD- MEDULLOBLASTOMA, GERM CELL, EPENDYMOMA
ARREST OF GROWTH- PITUITARY ADENOMA
GOOD- BRAIN METS
SRS
SRT
STEREOTACTIC RADIOSURGERY
STEREOTACTIC RADIOTHERAPY
RADIOBIOLOGY: INDIRECT ACTION
ASSOC WITH XRAYS & GAMMA RAYS
IONIZATION/ WATER
80% OF A CELL IS WATER
HIGH PROBABILITY THAT INTERACTION WITH WATER
IONIZATION IS IS THE MEDIUM THAT THE CELL ARE SUSPENDED IN
FREE RADICAL
BY PRODUCT OF RAD WITH WATER
-A SINGLE UNPAIRED E- IN THE OUTHER SHELL, CHEMICALLY UNSTABLE
HYDROLYSIS OF WATER
PROCESS OF RADIATION ABSORPTION IN WATER
LET
RATE AT WHICH ENERGY IS DEPOSITED A CHARGED PARTICLE TRAVELS THRU MATTER
LET IS A FUNCTION OF
MASS AND CHARGE
LOW LET
XRAYS & GAMMA RAYS, HAVE NO MASS AND NO CHARGE
-SPARSELY IONIZING
HIGH LET
PROTONS
NEUTRONS
ALPH PARTICLES
-B/C THEIR MASS AND CHARGE
-DENSELY IONIZING
LET
EQUAL DOSES OF LET RADIATIONS DO NOT PRODUCE THE SAME BIOLOGICAL RESPONSE
RBE
COMPARES DIFFERECT TYPES OF RADIATIONS
RAD/CELL TARGETS
MANY PARTS OF THE CELL ARE DUPLICATED THROUGHOUT THE CELL
-DAMAGE TO ONE OR MORE OF THESE MAY NOT BE LETHAL TO THE CELL
CELL MEMBRANE AND DNA
ONLY PRESENT IN NECESSARY AMOUNTS
-DAMAGE TO EITHER OF THESE STRUCTURES IS CRITICAL TO THE CELLS ABILITY TO SURVIVE
CELLULAR TARGETS
-DAMAGE IN THE DNA CAN BE AND IS REPAIRED IN THE CELL
-ALL TYPES OF DNA DAMAGE ARE NOT EQUAL IN TERMS OF BIOLOGIC SIGNIFICANCE
EFFECTS ON CHROMOSOMES
-CAN OCCUR IN BOTH SOMATIC AND GERM CELLS
-CAN BE TRANSMITTED DURING MITOSIS AND MEIOSIS
-AS SERIOUS AS DNA DAMAGE
IRRADIATED CELLS 3 POSSIBLE OUTCOMES AFTER IRRADIATION
1. DIVISION DELAY- CAN BE DELAYED FROM GOING THRU DIVISION
2. INTERPHASE DEATH- CAN DIE BEFORE IT DIVIDES
3. REPRODUCTIVE FAILURE- CAN DIE WHEN ATTEMPTING MITOSIS
SURVIVAL CURVES- N
N- EXTRAPOLATION NUMBER, # OF TARGETS THAT MUST BE HIT IN EACH CELL TO CAUSE DEATH
SURVIVAL CURVES- Dq
QUASITHRESHOLD
WIDTH OF SHOULDER
MEASURE OF ABILITY TO REPAIR DAMAGE
SURVIVAL CURVES- Do
FINAL OR TERMINAL SLOPE
EXPRESSION OF RADIOSENSITIVITY OF POPULATION
LAW OF B &T
THE MOST RADIOSENSITIVE CELLS WERE THOSE WHICH
-MOST IMMATURE
-LEAST SPECIALIZED
-GREATEST REPRODUCTIVE ACTIVITY
-LONGEST MITOTIC PHASE
THE CHEMICAL THAT HAS THE MOST DRAMATIC EFFECT AND HAS UNIVERSALLY BEEN SHOWN TO ENHANCE RAD RESPONSE
OXYGEN
PRESENCE OF OXYGEN
ABSENCE OF OXYGEN
P- AERATED
A- HYPOXIC
OER (OXYGEN ENHANCEMENT RATIO)
MAMMALIAN CELLS IS BETWEEN 2-3
-OXYGEN MOST PRONOUNCED FOR XRAY AND GAMMA RAYS
-MUCH LESS FOR HIGH LET
RADIOPROTECTORS
GROUP OF CHEMICALS- SULFHYDRYLS
ACCUTE/CHRONIC EFFECTS
ACUTE- DEPLETION OF PARENCHYMA CELLS
CHRONIC- IRREVERSABLE PROGRESSIVE ACUTE CHANGES
HEALING- 2 FORMS
1- REGENERATION- REPLACE BY SAME TYPE CELL
2- REPAIR- REPLACE BY DIFF CELL TYPE
ACUTE CHANGES
INFLAMMATION
EDEMA
HEMORRHAGE
DENUDATION OF MUCOSAL SURFACE
CHRONIC CHANGES
FIBROSIS
ATROPHY
ULCERATION
STRICTURE
STENOSIS
OBSTRUCTION
TBI: BONE MARROW SYNDROME
AKA HEMOPOIETIC OR HEMOTOLOGIC SYNDROME
-BTWN 1-10 GY TBI
-NO HUMAN CAN SURVIVE TBI >10 GY
LD 100 FOR HUMANS IS 10GY
GI SYNDROME
6-100 GY
FULL SYNDROME SEEN AT 10 GY
CNS SYNDROME
50-100 GY
100 GY TBI DEATH OCCURS 2-3 HRS
WHICH OF THE FOLLOWING ARE RELATIVELY INDEPENDANT OF SOURCE TO SKIN DISTANCE
TAR
BSF
TMR
THE INVERSE SQUARE LAW IS NOT AN ABSOLUTE CONCEPT FOR
E- BEAMS
THE BEAM INTENSITY OF A CO 60 TELETHERAPY SOURCE HOUSING WITH THE BEAM "ON" IS THE MAX OF
1.0 R/HR AT 1 METER
0.1% OF THE USEFUL BEAM AT ONE METER
HIGH RADIATION AREA WARNING SIGNS MUST BE POSTED IN ALL AREAS WHERE A PERSON, IF CONTINUOUSLY PRESENT, COULD RECIEVE AN EXPOSURE IN EXCESS OF ____ MR IN ANY 1 HR
100 MR/HR
THE LEAKAGE LIMITS OF A TELETHERAPY SOURCE HOUSING WITH THE BEAM "OFF" IS A MAX OF ____ AT ANY SINGLE POINT
10 MR/HR @ 1 METER
THE MAX PERMISSIBLE DOSE LIMIT OF EXPOSURE TO THE FOREARM IS
50 REM/YR
THE ____ IS THE DEGREE OF USE OF AN X OR GAMMA RAY SOURCE
WORKLOAD
FOR RADIATION PROTECTION PURPOSES, IT IS USUALLY ASSUMED THAT AN INDIVIDUAL IS AT LEAST ___ INCHES AWAY FROM A PROTECTIVE BARRIER
12 INCHES
THE NORMAL LRG BOWEL TOLERANCE IS APPROX ____ RADS, AND THE SML B TOLERANCE IS APPROX ___ RADS
6000- LRG
5000- SML
THE SPINAL CORD TOLERANCE IS APPROX ____ RADS CONSIDERING TX IS GIVEN OVER A 5-6 WK PERIOD
45-50 GY
WIPE TEST ARE USED TO
ASSESS LEAKAGE OF BRACHYTHERAPY SOURCES
ASSESS THE AMOUNT OF RADIOACTIVITY LEFT AFTER AND DURING A SPILL
PT WHO HAVE RADIOACTIVE IMPLANTS
-PERMANANT IMPLANTS MAY LEAVE WHEN 1 METER DOES NOT EXCEED 5R/YR
-CHILDREN/BABIES 9 FT FROM PT
-PRIMARY CARE GIVER OVER 45 YR
A CO 60 SOURCE HAS JUST BEEN REPLACED. WHAT AMOUNT OF RADIOACTIVITY IS THE MOST REASONABLE
90 mCi
WHICH FILTRATION WOULD LLOW FOR THE GREATEST SKIN DOSE
**1 MM AL**
1MM CU
2MM AL
2MM CU
A CUTIE PIE IS A TYPE OF
IONIZATION CHAMBER
HAVE THE SAME NUMBER OF PROTONS
ISOTOPES
WHICH IS REPRESENTED BY 13/6 C
THE NUCLEUS CONTAINS 7 NEUTRONS
A 1 MEV PHOTON
HAS 1/10 THE WAVELENGHT OF A 100 KEV PHOTON
WHAT IS EMITTED IN BETA DECAY
E-
PHOTON
NEUTRINO
POSITRON
59 Co 60 Co are
ISOTOPES
THE AVERAGE ENERGY REQUIRED TO REMOVE A NUCLEON FROM A TYPICAL NUCLEUS (BINDING ENERGY) IS
8 MEV
ISOTOPES HAVE THE SAME NUMBER OF
PROTONS
EXAMPLES OF ELECTROMAGNETIC RADIAITON
-XRAYS
-RADIOWAVES
-VISIBLE LIGHT
-RADAR
THE ALPHA PARTICLE IS MOST SIMILAR TO
HELIUM NUCLEUS
KENETIC ENERGY OF CHARGED PARTICLES LIBERATED PER UNIT MASS
KERMA
THE MOST PREDOMINATING RADIATION INTERACTION OCCURING IN MATTER FOR 75 KV SUPERFICIAL BEAM
PHOTOELECTRIC
WHAT IS THE HEAVIEST PART OF AN ATOM
NEUTRON
ONE SIEVERT IS EQUAL TO
100 REM
THE INTERACTION OF XRAYS WITH MATTER THAT IS MOST COMMON IN THE ENERGY RANGE BETWEEN 150 KEV AND 3 MEV IS
COMPTON SCATTERING
GAMMA DECAY
-PRECEEDED WITH ALPHA & BETA DECAY
GAMMA DECAY
-PRECEDED BY ALPHA & BETA DECAY
-RESULT IN THE EMISSION OF GAMMA RAYS OF SPECIFIC ENERGIES
AUGER E-
-PRODUCED IN SOME NUCLEAR DISINTEGRATION PROCESS
-CAN RESULT FROM E- CAPTURE
- HAVE REST MASS OF 0.511 MEV
FACTORS THAT INFLUENCE THE OUTPUT OF AN XRAY UNIT
FILTRATION
MA
FIELD SIZE
DISTANCE
WHY SHOULD YOU NOT ENTER THE TX ROOM IMMEDIATELY FOLLOWING AN 18MV TX
BECAUSE OF NEUTRON CONTAMINATION
THE QUANTITY THAT AN IONIZATION CHAMBER USUALLY MEASURES IS
KERMA
THE UNIT OF ABSORBED DOSE IS
JOULE
GRAY
RAD
REGARDING STOCHASTIC EFFECTS
THE EFFECTS CAN BE ON THE INDIVIDUAL EXPOSED
THE SERVERITY OF THE EFFECT IS RELATED TO DOSE
EX OF A NON STOCHASTIC EFFECT
CATARACTS
DOSE EQUIVILANT IS
EQUAL TO THE QUALITY FACTOR MULTIPLIED BY THE ABSORBED DOSE
MEASURED IN REM SV
EMBRYO/FETUS WILL HAVE SEVERVE ABNORMALITIES WHEN IRRADIATED
4-11 WKS
AVE SURVIVAL TIME FOR GI SYNDROME
3-10 DAYS
WHERE IS BENDING MAGNET FOUND
GANTRY HEAD
PRIMARY RADIATION PRODUCED BY AN XRAY MACHINE INCLUDES
CHARACTERISTIC
BREMSSTRAHLUNG
TEST WITH FILM SHIELD BY 2 LEAD BLOCKS EXPOSED AT 180* APART IS
SPLIT FIELD TEST
RECOMMENDED THAT THE FETUS SHOULD NOT EXCEED
.5 REM (.005 SV)
THE EFFECTIVE ANNUAL DOSE, WHOLE BODY TO RAD WORKER
5,000 MREM (50 SV)
THE PRINCIPLE OBJ FOR FIELD SYMMETRY AND FLATNESS IS TO DETERMINE
DOSE RATE CONSISTENCY ACROSS FIELD
A COMMON CAUSE OF A LONGITUDINAL SHIFT BETWEEN RADIATION FIELDS DURING A SPLIT FIELD TEST IS INCORRECT WEDGE PLACEMENT
SAGGING GANTRY ARM
EMERGENCY BUTTONS SHOULD BE CHECKED
MONTHLY
TEST IF DOSE IS EQUAL ON EITHER SIDE OF THE CENTRAL AXIS
SYMMETRY
REQ ON PERSONNEL MONITORING REPORT
BIRTH DATE
CUMULATIVE LIFETIME EXPOSURE
NCRP 91 RECOMMEND DOSE LIMITS: TOTAL BODY ANNUALLY
5 REM
50 MSV
NCRP 91 RECOMMEND DOSE LIMITS: LENSE OF EYE ANNUAL
150 MSV
NCRP 91 RECOMMEND DOSE LIMITS: SKIN ANNUAL
500 MSV
MISADMIN IN XRT
WRONG PT
TOTAL DOSE OVER 20%
WEEKLY DOSE OVER 30%
E- BEAM INSTEAD OF PHOTON
VISITORS OF BRACHY PT
20 MIN/DAY
AFTER INJECTION IODINE 131 WHERE DISPOSE SYRINGE
SEND TO MANUFACTURER
SELLA TURSICA IS A DEPRESSION OF
SHENOID
C VERTEBREA WITH NO BODY OR SPINOUS
FIRST
C1
WALDEYER'S RING IS A GROUP OF LYMPHOIOD ORGANS CONSISTING OF
PALATINE T
LINGUAL T
NASOPHARYNGEAL TONSILS
HYPOPYSIS OTHER NAME IS
PITUATARY
LYMPHATIC DUCT OPENS INTO THE BLOOD STREAM AT THE JUNCTIONS OF THE RT SUBCLAVIAN VEIN WITH THE ____ VEIN
INTERNAL JUGULAR
MOST COMMON SITE OF BREAST CA
UPPER OUTER QUAD
STENSONS DUCT IS LOCATED IN THE
PAROTID
VIRCHOWS NODES OTHER NAME
LEFT SUPRACLAV NODE
MITOSIS ORDER
INTERPHASE
PROPHASE
METAPHASE
ANAPHASE
TELOPHASE
OXYGENATED BLOOD RETURNS FROM THE LUNG VIA THE ______ AND ENTERS THE _____ OF THE HEART
PULMONARY VEIN
LEFT ATRIUM
PEYERS PATCHES FOUND IN
SML INTESTINES
A BLAST CELL
LEAST DIFFERENTIATED BLOOD CELL
IMMATURE STEM CELL
THE BRACHIAL PLEXUS LOCATED
LOWER CERVICAL
UPPER CHEST
ANGLED FORMED BETWEEN DIAPHRAGM AND RIBS
COSTOPHRENIC
DIRECT LYMPH DRAIN FOR VULVA
SUPERFICIAL INGUINAL
NOT FOUND IN LYMPH FLUID
PLATELETS
RBC'S
LYMPH OF THE TONGUE DRAIN TO
JUGULAR
BIFURCATION OF AORTA AT WHAT VERT LEVEL
L4-L5
ANGLE OF LOUIS IS A LANDMARK FOR
BREAST
PANCOAST SYNDROME ASSOCIATED W/
LESIONS IN THE APEX LUNG
BRACHIAL PLEXUS INVOLVEMENT
ARM WEAKNESS
PRIMARY PRESENTING SYMPTOM OF BLADDER CA
HEMATURIA
MOST COMMON PATH FOR ANAL TUMORS
SQUAMOUS CELL
RISK FACTORS FOR COLORECTAL CA
1ST DEGREE RELATIVE
CHRONIC ULCERATIVE COLITIS
GARDNERS SYNDROME
DIET INCREASE INCIDENCE OF COLORECTAL CA
HIGH ANIMAL FAT
HIGH FRUITS VEGGS
LOW IN FIBER
CHEMO MOST USED FOR GI
5FU
STAGING SYSTEM FOR CERVICAL CA
FIGO
SYMPTOMS COMMON IN CA OF NASOPHARYNX
LUMP IN NECK
DIFFICULTY HEARING
STUFFY NOSE
SMALL ORAL CAVITY LESIONS ARE TX
SURGERY
MOST COMMON PATH FOR THYROID CA
PAPILLARY
EARLY LESION OF TRUE VOCAL CORDS
RARELY MET TO ANY LYMPH NODES
CELL ASSOCIATED WITH HODGKINS
REED STERNBERG CELL
SCREENING FOR BRST CA INCLUDE
MONTHLY SELF EXAM AFTER 20YR
CLINICAL BREAST EXAM EVERY 3 YRS AFTER 20
GLEASON SCORE FOR PROSTATE CA INDICATES
HISTOLOGIC GRADE OF TUMOR
SCREENING METHOD FOR PROSTATE CA HAS HIGHEST SENSITIVIEY IN DETECTION OF THE PROSTATE
TRUS
FOR XRT OF UP ABD FOR PANCREATIC CA, MOST RADIOSENSITIVE DOSE LIMIT STRUCTURE
SPINAL CORD
45 YR OLD WOMEN
DISCOMFORT 6 MO
3 MO SKIRTS DONT FIT
NO SIGNIFICANT WEIGHT GAIN
PROBLEM?
OVARIAN CA
AS KVP INCREASES SCATTER RAD WILL
INCREASE BECAUSE OF MORE COMPTON INTERACTION
AN INCREASE IN KVP RESULTS IN
AN INCREASE IN QUANTITY
CONTRAST FOR ILIAC ARTERIES
IV CONTRAST
REDUCES VISCOSITY OF AN IV CONTRAST AGENT
WARMING
DAILY QA FOR CT SIM
LASER POSITION VERIFICATION
E- DENSITY VERIFICATION
WATER PHANTOM SCAN
INCREASE IMAGE MATRIX WITH SAME FIELD OF VIEW WILL
INCREASE RESOLUTION
INPUT PHOSPHOR ON AN IMAGE INTENSIFIER CONVERTS
XRAYS TO LIGHT
COMMON ILIAC NODES BIFRICATE AT
S2`
ESOPHAGUS BEGINS AT LEVEL
C6
POINT "A"
2 CM SUP AND 2 CM LAT FROM EXT OS
URETER CROSSES UTERINE ARTERY
RAD THERAPY TECHN FOR ENDOMETRIAL CA WITH RADIOACTIVIE SOURCES CARRIED IN METAL CAPSULES AND PACKED INTO UTERUS
FLETCHER SUIT
TYPICAL LUNG FIELD DOSE/TX
AP/PA TO 3960 OBL TO 6000
TRANSMISSION THRU LEAD BLOCK SHOULD BE
NO MORE THAN 5%
WEDGE ANGLE REFERS TO
ANGLE WHICH ISODOSE CURVE AT SPECIFIC DEPTH IS TILTED WITH RESPECT TO CENTRAL AXIS OF BEAM
TD 5/5 TESTIS
100 CGY
FOR MANTLE XRT, PT ARMS ABOVE HEAD WHY
MOVES AXILLARY NODES AWAY FROM CHEST WALL
PITUATARY FOSSA LOCATED BY
2 CM ANT AND 2 CM SUP TO EAM
COMMON VALUE FOR FIELD FLATNESS OVER THE CENTRAL 80% OF THE LRGST FIELD SIZE AT ISOCENTER
+-3%
INTEGRAL DOSE
IS A MEASURE OF THE TOTAL ENERGY DEPOSITED IN THE PT
CHANGING THE TFD ACCOMPLISHED BY
MOVING THE COUCH
TD 5/5 FOR 3/3 OF ESOPHAGUS
5500
ONLY "R" THAT SELECTIVELY INCREASES TUMOR CELL KILL AND ITS ABSENCE IS RESPONSILBLE FOR TUMOR RECURRENCE
REOXYGENATION
INCREASES GEOMETRIC PENUMBRA
INCREASE SOURCE SIZE
DECREASE SOURCE-COLLIMATOR DIST
INCREASE SOURCE-CALCULATION DIST (SSD+D)
DENSITY ON A CT SCANNER WHERE PIXEL IS ASSIGNED VALUE
HOUNSFIELD UNIT
CONTOUR OF PT SHOULD INCLUDE WHAT INFO
PTV
CENRAL AXIS
DOSE LIMITING STRUCTURES
THE EFFECT OF TISSUE INHOMOGENEOUS ON DOSE DEPENDS UPON
BEAM ENERGY
VOL OF INHOMOGENEITY
TISSUE DENSITY
DOCUMENTED DURING SIM
FIELD SIZE
PT POSITION
WHEN SECTOR IS SKIPPED IN ARC THERAPY
HIGH DOSE AREA IS SHIFTED AWAY FROM HE SKIPPED SECTOR
WIDTH OF PENUMBRA INCREASES WITH`
INCREASED SSD
DECREASED SOURCE-COLLIMATOR DIST
INCREASED SOURCE SIZE
A LESION TREATED USING 100* ARC ROTATION, MIDPT OF TUMOR 5 CM. ISOCENTER SHOULD BE PLACED AT
7.5 CM
WHAT INFO NEEDED FOR FABRICATING DIVERGENT BLOCKS
MACHINE TAD, TFD, TTD
THE USE OF BOLUS
COMPENSATES FOR SURFACE IRREGUALARITIES
INCREASES THE SKIN DOSE BY ELIMINATING SKIN SPARRING
LEGAL DOCTRINE OF BORROWED SERVANT REFERS
DR OVERSEEING THE R.R. MAY BE HELD RESPONSIBLE FOR THE RT'S ACTIONS
WHAT LEVEL AN IV BAG HANG ABOVE IV SITE
18''-24"
CPR COMPRESSIONS TO BREATHS
15 COMPRESSIONS TO 2 BREATHS
WHEN PT SHOWS SIGNS OF SHOCK
KEEP PT CALM AND MAINTAIN NORMAL BODY TEMP
PURPOSE OF ASRT CODE OF ETHICS
ASSIST TECHS IN MAINTAING HIGH LEVEL OF ETHICAL CONDUCT
MOST COMMON MEANS INFECTIONS TO SPREAD
DIRECT CONTACT
PT W/ URINARY CATHETERS, DRAIN BAG SHOULD BE LOWER THAN BLADDER TO
PREVENT INFECTION
METHODS OF STERILIZATION
DRY HEAT
AUTOCLAVE
CHEMICALS
GAS
HEMOPTYSIS MEANS
BLOOD IN SPUTUM
MOST IMPORTANT SIDE EFFECT FOR HODGKINS PT WITH XRT
DEPRESSION OF BONE MARROW
CARDIAC TOXITICIY FROM BREAST XRT
SOMETIMES A SERIOUS PROBLEM
XRT OF SALIVARY GLANDS MAY RESULT IN
DENTAL CARIES
GINGIVITIS
CHANGE OF ORAL BACTERIA
SHOCK WHERE MASSIVE BUILD UP OF BACTERIA AND TOXIC BY PRODUCTS
SEPTIC SHOCK
FOR XRT OF GI AND CAUSING DIARRHEA, DIET SHOULD BE
LOW RESIDUE DIET
INCREASED LIQUIDS
DECREASE LACTOSE
DECREASE EXERCISE
SWEATING, ANXIETY AND TACHYCARDIA ASSOCIATED WITH THE EXCESS PRODUC OF INSULIN BY ISLET CELL PANCREATIC CA MOSTLY DUE TO
HYPOGLYCEMIA
PARENTERAL HYPERALIMENTATION CAN BE ADMINISTERED VIA
IV
LEAST LIKELY TO AFFECT ISODOSE CURVES
BOLUS**
(WEDGE, COMPENSATOR)
POINT -30MM ON Y-AXIX ON AP SUPINE PT. REFERENCE POINT IS
3 CM INF
GANTRY ROTATES AROUND HORIZON AXIS WHICH IS
PARALLEL TO NORMAL COUCH POSITION
THICKNESS OF LEAD CUTOUT NEEDED FOR 10 MEV E-
5 MM
COMPENSATING FILTERS USED TO
COMPENSATE FOR IRREGULAR SURFACE
PERSCRIPTION SHOULD INCLUDE
TX TECHN
ANATOMICAL SITE
FRACTIONATION
PROTRACTION
ACCEPTABLE STORAGE FOR FILM
16* C AND 10% HUMIDITY
CONSIDERED ARTIFACT
PRESSURE MARK
IN PORT FILMS OF POP ISOCENTRIC FIELDS OF LUNG TUMOR THE
ANT PORTAL WILL APPEAR TO TREAT MORE SPINE
ALPHA PARTICLES
COMPOSED OF 2P & 2N
1 CURIE IS EQUAL TO __ Bq
3.7 X 10 10
AVERG ENERGY DEPOSITED PER UNIT PATH LENGTH TO A MEDIUM BY IONIZING RAD AS IT PASSES THRU THAT MEDIUM IS
LET
RADIAITONS THAT DEPEND LEAST ON THE AMOUNT OF OXYGEN IN THE CELL
NEUTRONS
ALPHA PARTICLES
DESCRIBES TERMINAL SLOPE PORTION OF THE CELL SURVIVAL CURVE
Do
PROPERTY OF XRAY EFFECT ON BIOLOGICAL SYSTEMS IS THAT THEY
CAUSE IONIZATION IN MATTER
CELLS IN THE BODY THAT IS MOST RADIOSENSITIVE
LYMPHOCYTES
EXPOSURE IS
IONIZATION IN AIR
AMOUNT OF CHARGE PER UNIT MASS
MEASURED USING IONIZATION CHAMBER
SHORT TERM SOMATIC EFFECTS OF RAD
NAUSE
FATIGUE
BLOOD AND INTESTINAL DISORDERS
DIFFUSED REDNESS OF SKIN AND SHEDDING OUTER LAYER
FOLLOWS SIGMOID DOSE-RESPONSE CURVE
CATARACTS
SKIN ERYTHEMA
NEUTRON CONTAMINATION AS A RESULT OF PHOTON INTERACTION WITH HIGH Z MATERIALS
PHOTODISINTEGRATION
PHASE WHERE CHROMATIDS REPEL EACH OTHER AND MIGRATE ALONG SPINDLE TO OPP POLES
ANAPHASE
IN CELL CYCLE Go REFERS TO
A NON DIVIDING CELL
BLOOD CELLS FROM MOST RAD SENSITIVE TO LEAST
LYMPHOCYTES
NEUTROPHILS
PLATELETS
RBC
IN STOCHASTIC EFFECTS
DOSE AND PROBABILITY ARE DIRECTLY RELATED
NO THRESHOLD
CAUSE SIMILAR DISEASES SEEN IN UNIRRADIATED POPS
AN INCIDENT XRAY INTERACTS AND IONIZES AN INNER SHELL E- AND EJECTS AN E-, IS
PHOTOELECTRIC ABSORPTION
INELASTIC INTERACTION IS THE IONIZATION OF AN FREE E- AND RESULTS IN SCATTERED XRAY
COMPTON SCATTER
WHEN TREATING WITH E- BEAMS, WHAT MOVES OFF AXIS
TARGET AND FLATTENING FILTER
DURING EXTERNAL BEAM, COLLIMATOR AND OR ANY LEAD BLOCKS AT MIN DIST, WHY
REDUCE E- CONTAMINATION
TO PROPERLY CALIBRATE ION CHAMBERS, TEMP AND PRESSURE
0*C -760 MMHG
FIRST NOTICABLE REACTION TO TBI TO SUBLETHAL DOSE
LEUKOPENIA
PROTECTIVE SOURCE HOUSING OF A GAMMA-BEAM MACHINE, IN "ON" POSITION, MUST BE THICK ENOUGH ABLE TO REDUCE BEAM INTENSITY TO AN AMOUNT LESS THAN
O.1% OF THE USEFUL BEAM AT 1 METER
SUPERFICIAL XRAY THERAPY UNITS OPERATE AT
50-120 KVP
IN LINAC, CATHODE IS ANALOGOUS TO
THE ELECTRON GUN
MECHANICAL DIST INDICATORS CAN BE EMPLOYED TO VERIFY
ACURACY OF OPTICAL DIST
THE POINT OF MAX BUILD UP OF CESIUM UNIT IS
0.1 MM
LET IS MEASURED IN
KEV/MICRON
WHICH IS NOT NEEDED IN CONSTRUCTING LOW MELTING ALLOW SHIELDING BLOCKS
SOURCE TO SKIN DIST
WHAT THICKNESS OF LEAD IS EQUIV TO 7.5 CM OF CERROBEND
6 CM
BEST TECH TO TX NON MIDLINE PRIMARY BRAIN
WEDGE PAIR
WHEN TX OF TANG BRST, NO MORE THAN ____ OF LUNG
3 CM
CHILD TX WITH CRANIOSPINAL, THE POST SPINAL FIELD SELDOM EMPLOYS PHOTONS. WHY?
EXIT DOSE WOULD IRRADIATE MEDIASTINUM, STERNUM, AND THYROID
WHEN TX EWINGS TUMOR WITH XRT
IF TUMOR IS MID BONE, BOTH EPIPHYSEAL PLATES RADIATED
AVOID THE ENTIRE LIMB FOR LYMPH DRAIN
WHEN IS FETUS MOST SENSITIVE
1ST TRIMESTER
CONGENITAL ABNORMALITIES INCREASE WHEN IRRADIATED DURING
MAJOR ORGANGENESIS OR
10TH TO 6TH WK
@ .25 GY
RADIATION DURING FETAL GROWTH STAGE OR AFTER 6TH WK
INCREASED CA LATER IN LIFE
RADIATION IN CONCEPTION TO 10TH DAY OR PRE-IMPLATATION PHASE IS EITHER
LETHAL OR FETUS SHOWS NO EFFECT
LATE EFFECTS
MANIFEST AFTER LONG PERIODS OF TIME
REMAIN DORMANT FOR YRS
MAY SHOW UP IN SUCCEEDING GENERATIONS
LATE EFFECT ARE EITHER
NONSTOCHASTIC
OR STOCHASTIC
NON STOCHASITC- HAS THRESHOLD
EFFECT IS DOSE RELATED (CATERACTS)

STOCHASITIC: NO THRESHOLD
ANY DOSE, NO MATTER HOW SMALL CARRIES PROBABILITY
(CXR CAUSING DNA BREAK)
CARCINOGENESIS IS THE SINGLE IMPORTANT ______ INDUCED BY RADIATION
LATE SOMATIC EFFECT
SOMATIC EFFECTS
BODY CELLS
GENETIC EFFECTS
REPRODUCTIVE CELLS
MUTENGENS
FREQ OF SPONTANEOUS MUTATIONS CAN BE ALTERED BY VIRUSES, CHEMICALS AND RADIAITON.
PERMANANT AND INHERITABLE
4 R'S OF FRACTIONATED RADIOTHERAPY
REDISTRIBUTION
REOXYGENATION
REGENERATION
REPAIR
REDISTRIBUTION
IN FX SCHED
RESULT IN CELL KILL IN TUMORS AND ACUTELY RESPONDING NORMAL TISSUES. BUT NO EFFECT ON LATE RESPONDING NORMAL TISSUES
MOST SENSITIVE PHASES
M AND G2
MOST RESISTANT PHASES
S
REOXYGENATION
HYPOXIC CELLS ARE 3X MORE RESISTENT THAN OXYGENATED CELLS
R THAT SELECTIVELY INCREASES TUMOR CELL KILL
REOXYGENATION
REGENERATION
OCCURS IN TUMOR AND ACUTELY RESPONDING TISSUES
REPAIR
REFERS TO CELLULAR REPAIR OF RAD DAMAGE
BIGGEST ROLE IN SPARING EFFECT OF FX., B/C IN BOTH NORMAL AND ACUTELY AND LATE RESPONDING , AND TUMORS
IRRADIATION DISTURBS MITOTIC INDEX BY
DIVISION DELAY
IN DIVISION DELAY CELLS BECOME DELAYED IN WHAT PHASE
G2
CELL LINE THAT DOES NOT FIT THE B&T MODEL OF RADIOSENSITIVITY
LYMPHOCYTES
OER FOR MAMMALS HAS BEEN SHOWN TO BE BETWEEN
2 & 3
ALTHOUGH LUNGS DO NOT CONTAIN STEM CELLS, THEY ARE RADIOSENSITIVE, AND CHANGES SEEN AT
20GY
LD 50/30 FOR HUMANS IS
2.5 AND 3.0 GY
PRE-IMPLANTATION IS
CONCEPTION TO DAY 10
CONDITIONS THAT NEED TO BE MET FOR RAD SYNDROME TO OCCUR
EXPOSURE ACUTE (IN MIN)
TOTAL OR NEAR TOTAL
EXTERNAL SOURCE RAD
BASED ON ATOMIC BOMB SURVIVORS, GEN DBLING DOSE IS
156 REM
NOT CONSIDERED MUTAGENIC
BACTERIA
SHOULDER OF CELL SURVIVAL CURVE IS
THE REPAIR CAPACITY OF THE CELL
TERMINAL EXPONENTIAL PORTION OF CELL CURVE IS EQUAL TO
37%
LAW OF B&T, WHAT CELLS MOST RADIOSENSITIVE
GREATEST REPRODUCTIVE ACTIVITY
OYGEN WORK IN 3 WAYS
ENHANCMENT OF FREE RADICAL FORMATION
REPAIR CAPABILITIES OF CELL BLOCKED
FIXES THE DAMAGE THUS MAKING IT PERMINANT
ACUT DOSE OF RAD THAT INDUCES 100% OF POP
2 GY
DOSES AS LOW AS ___ IN FETUS CAUSES MALIGNANCIES IN ADULTS
.25 GY
NON STOCHASTIC EFFECTS
DERTERMINISTIC
INCREASE DOSE, INCREASE SEVERITY
CATERACTS EX
PERM STERILITY IN WOMEN AND TEMP IN MEN SEEN WHAT DOSES
W- 6.25 GY
M- 2.5 GY
DOSE OF ___ FATAL DURING PRE-IMPLANTATION PHASE
.1 GY
LD 100 FOR HUMANS
10 GY
LATENT PERIOD ASSOCIATED WITH SOLID TUMORS
20-30 YRS
PROCESS BY WHICH BROKEN ENDS OF CHROMOSOMES REJOIN WITH NO DAMAGE IS
RESTITUTION
FIRST INTERACTION IN THE HYDROLYSIS OF WATER
IONIZATION OF WATER MOLECULE
NEUTRONS HAVE DIFF EFFECT ON WHAT PART OF SURVIVAL CURVE
SHOULDER
MOST SENSITIVE PHASE OF CELL CYCLE
M
LEAST SENSITIVE PHASE
S
WHEN PRESENT, PROTECTION FACTOR FOR RADIOPROTECTORS IS
2 TIMES DOSE
MOST RADIOSENSITIVE IN GI
SML BOWEL
ONLY CA TO FOLLOW LINEAR RELATIONSHIP DOSE
BREAST
TD 5/5 FOR KIDNEY
23 GY
TD 5/5 BRAIN
45 GY
TD 5/5 LIVER
45 GY
TD 5/5 RECTUM
60 GY
TD 5/5 STOMACH
50 GY
R- THAT HAS 5X SURVIVAL BTWN MOST RESISTANT AND MOST SENSITIVE PHASE
REDISTRIBUTION
RIGHT AFTER XRT MOST CELLS IN TUMOR ARE HYPOXIC
REOXYGENATION
WITH OUT THIS R, WOULD NOT BE ABLE TO CURE ANY TUMOR
REOXYGENATION
2 R'S APPLY TO ACUTELY OR RAPIDLY DIVIDING TUMOR TISSUE
REDISTRIBUTION
REGENERATION
ONLY R THAT SELECTIVELY INCREASES TUMOR CELL KILL
REOXYGENATION
REFER TO ABILITY OF CELL TO UNDERGO SLDR AND PLDR
SUBLETHAL DAM REPAIR
POTENTIALLY LETHAL DR
REPAIR
PLAYS BIGGEST ROLE IN SPARING EFFECT IN FX
REPAIR
FEDERAL ANGENCY RESPONSIBLE FOR REACTOR PRODUCED ISOTOPES
NRC
WHO LICENSE RADIUM
STATE RADIATION CONTROL AGENCY
DIRECT EFFECT DEPENDS ON OXYGEN. T/F
FALSE, DIRECT EFFECTS ARE DENSELY IONIZING
WHERE ARE E- SCATTERING FOILS LOCATED
HEAD OF LINAC
AVG BODY TEMP
98.6*F OR 37*C
AVG PULSE RATE
60-90 BEATS/MIN
AVG RESPIRATIONS
10-20 BREATHS/MIN
SYSTOLIC (TOP NUMBER)
DIASTOLIC (BOTTOM NUMB)
110-140 MM HG (ADULT)
60-80 MM HG
AN AP FILM OF THE PELVIS IS GOOD FOR INTERPRETATION OF ALL EXCEPT
ANT/POST
PERSON MOVES IN CT SIM, WHAT HAPPENS
MOTION, MUST REPEAT
WHAT IS A HAZARD IN CERROBEND
BLTC
BISMOUTH
LEAD
TIN
CADMIUM
PT IMMUNOSURPRESSED, ISOLATION?
REVERSE OR PROTECTIVE ISOLATION
VISUAL GOES DOWN DURING TX
STOP
WHY DO YOU ANGLE FOR SUPRACLAV?
GET OFF CORD
10-15*
WHAT ARISES IN MESENCYMAL CELLS
SARCOMAS
ENDOMETRIAL CA IS WHAT HISTOLOGY
ADENO CA
WHAT HISTOLOGY IS PROSTATE CA?
ADENO CA
LEIOMYOSARCOMA ARISE FROM
SMOOTH
RHABDOMYO
STRIATED
WHAT STRUCTURES ARE OF CONCERN WHEN TX PANCREAS
C LOOP OF DUEDENUM
CORD
KIDNEY
SML BOWEL
CRITICAL STRUCTURES OF ADB
KIDNEY
LIVER
SML
WHEN IS CONSENT SIGNED
BEFORE, DURING CONSULT
WILM TUMOR PRESENTS AS
PAINLESS MASS
KVP RANG FOR CT
120-140 KVP
WHERE COULD PT DIE OF INFECTION
GI
NOT: BM OR CNS
CHARGE FOR 3D CONFORMAL TX
COMPLEX, BECAUSE CT
MOST SENSITIVE PERIOD FOR FETUS
1ST TRIMESTER
1-3 MO
DIET FOR OVERWEIGHT ESOPHAGEAL CA
PROTEIN
NO SPICES
BLAND DIET
NO ALCOHOL
BEST WAY TO TX ESOPHAGUS
OBL TO STAY OFF CHORD
BEST WAY TO TX EXTREMITIES
AP/PA, BUT LEAVING STRIP FOR LYMPH DRAIN
MOST COMMON SKIN CA
BASAL CELL
CAUSES OF WEDGE FAULT
WEDGE NOT IN ALL THE WAY
WRONG WEDGE
WHAT CAUSES METS TO PROSTATE
ADV STAGES
SIMPLE TX DEVICES
-SIMPLE BLOCK (SQ, RECTANG, CIRCLES)
-BOLUS
-PASSIVE, MULTI-USE DEVICE (RESTRAINTS, PILLOWS, STRAPS, WINGBOARD)
INTERMEDIATE TX DEVICES
-BLOCKS- (STANDARD, NOT CUSTOMED TO PT)
-STENTS
-BITE BLOCKS
-SPECIAL BOLUS- CUSTOM
COMPLEX TX DEVICE
-BLOCKS- CUSTOM
-IMMOBILATION DEVICE- VAC LOCKS
-WEDGES
-COMPENSATORS
-EYE SHIELDS
SPEED OF LIGHT
3X10^8
PHOTONS
-NO MASS
-NO CHARGE
-PACKETS OF ENERGY IN STRAIGH LINE
AMPLITUDE IS ___ OF THE WAVE
HEIGHT
WAVELENGTH IS
CREST TO CREST
VELOCITY IS
WAVELENGTH X FREQ
ENERGY=
PLANKS CONSTANT
4.15 X 10^15 EV X FREQ`
DIFFERENCE BTWN GAMMA AND PHOTON
GAMMA COMES FROM NUCLEUS
PHOTON COMES FROM ORBITING E-
XRAYS DISCOVERED BY AND WHEN
WILLIAM ROENTGEN
NOV. 11, 1895
DIAGNOSTIC XRAYS
50-120 KVP RANGE
THERAPEUTIC XRAYS
40-300 KVP
CATHODE
NEGATIVE (-)
2 PARTS: FILAMENT & FOCUSING CUP
FILAMENT
SML COIL OF THORIATED TUNGSEN WIRE
FOCUSING CUP
NEGATIVE CHARGE DIRECTS E- TOWARD ANODE
ANODE
POSITIVE (+)
TARGET
RECIEVES E- FROM CATHODE
POTENTIAL DIFFERENCE
KVP
TARGET INTERACTIONS
BREMSTRAHLUNG AND CHARACTERISTIC
XRAY INTERACTIONS WITH MATTER
ATTENUATION
COMPTON SCATTERING
PHOTOELECTRIC
MATTER CAN NEITHER CREATED OR DESTROYED
IT CAN ONLY CHANGE STATE
FILM 3 COMPONENTS
BASE
EMULSION
PROTECTIVE COAT
MITOSIS
CELL DIVISION
OUTCOME 2 IDENTICAL DAUGHTER CELLS
MITOSIS PHASES
G0, G1, S, G2, AND M
G0
CELLS FULLY FUNCTIONING AND NOT PREPARING FOR DUPLICATION
G1
1ST GROWTH PHASE, RAPID GROWTH
SYNTHESIZES RNA
S
SYNTHESIS:
DNA IS REPLICATED ENSURING DAUGHTER WILL HAVE IDENTICAL GENETIC MATERIAL
G2
CELL PREPARES FOR DIVISION
M
MITOSIS OR CELL DIVISION
WELL DIFFERENTIATED
CLOSELY RESEMBLE CELL ORIGIN
UNDIFFERENTIATED
(ANAPLASTIC)
DO NOT RESEMBLE ORIGIN
BENIGN
(NON CANCER)
GROW SLOW, WELL DIFFER
NO DISTANT SPREAD
METS
SPREAD TO OTHER PARTS OF BODY
SARCOMAS
TUMORS FROM MESENCHYMAL CELLS LIKE BONE AND CARTILAGE
CARCINOMAS
TUMORS FROM EPITHELIUM CELLS (COVER OF LINE CAVITY)
ADENCOCARCINOMAS
TUMORS FROM GLANDS (PROSTATE)
BODY CELLS (SOMATIC CELLS) REPRODUCE BY____
REPRODUCTION OF GAMETES OR SEX CELLS BY _____
BODY CELLS- MITOSIS
SEX CELLS- MEOSIS
INTERPHASE
RESTING PHASE
PROPHASE
DNA DBLED
CHROMOSOME PAIRS DUPLICATE TO FORM TWICE THE NORMAL DIPLOID
METAPHASE
CHROMOSOMES LINE UP IN THE CENTER AND ATTACHED TO THE SPINDLE THREADS
ANAPHASE
SEPARATION OF THE CHROMOSOME PAIR
TELOPHASE
ALL CHROMOSOMES BEGIN TO UNCOIL AND LENGTHEN.
DIVIDES INTO 2 EQUAL PORTIONS, 46 CHROMOSOMES
VICTOREEN CONDENSER R METER
GAS FILLED TO CALIBRATE XRAY EQUIP
MOST COMMONLY USED
PRIMARY BARRIERS
GENERALLY LINED WITH LEAD
1.6 MM OR 1/16TH IN. THICK
SECONDARY BARRIERS
.8 MM OR 1/32TH IN. THICK
RULE OF THUMB FOR RADIOACTIVE WASTE
LET DECAY FOR 10 HALF-LIVES
MOST COMMON BRAIN PRIMARY
ASTROCYTOMA
GLIOBLASTOMA MULTIFORME, WHICH IS GRADE IV LESION 5 YEAR SURVIVAL
0%
MOST COMMON FOR HEAD AND NECK CANCER
LARYNX
LARYNX STAGING: T1
TUMOR LIMITED TO VOCAL CORDS W/ NORMAL MOTILITY
LARYNX STAGING: T1A
TUMOR LIMITED TO ONE VOCAL CORD
LARYNX STAGING: T1B
TUMOR INVOLVES BOTH CORDS
LARYNX STAGING: T2
TUMOR EXTENDS TO SUPRAGLOTTIS AND /OR SUBGLOTTIS AND /OR WITH LIMITED VOCAL CORD MOBILITY
LARYNX STAGING: T3***
TUMOR LIMITED TO LARYNX WITH VOCAL CORD FIXATION
LARYNX STAGING: T4
TUMOR INVADES THROUGH TYROID CARTILAGE AND /OR EXTENDS TO OTHER TISSUES BEYOND THE LARYNX (IE OROPHARYNX, SOFT TISSUES OF NECK)
SMALL CELL BRAIN METS
INCIDENCE IS AS HIGH AS 50% AND PROJECTED TO BE AS HIGH AS 80% IN THOSE SURVIVING 5 YRS OR MORE
BREAST CA INFLAMMATORY STAGE
STAGE 4
BREAST CA: EXCISIONAL BX
REMOVAL OF ALL GROSS DISEASE WITH AXILLARY NODE SAMPLING FOLLOWED BY PRIMARY XRT
BREAST CA: MODIFIED RADICAL MASTECTOMY
REMOVAL OF ENTIRE BRST WITH PRESENTATION OF THE PECTORALIS MUSCLES INCLUDING AN AXILLARY NODE SAMPLING
BREAST CA: RADICAL MASTECTOMY
REMOVES FAT, ADJ TISSUE, MUSCLE, NODES, BRST TISSUE, AND SKIN
BREAST CA: MOST OFTEN USE AS BOOST TECHN
E-
BREAST CA: MOST OFTEN REOCCURANCE
SCAR AREA
BREAST CA: CHEMO DRUGS
CISPLATIN
5FU
METHOTREXATE
ADRIAMIOCIN
MOST COMMON GI CANCER
COLORECTAL
COLORECTAL LABS
CEA (CARCINOEMBRYONIC ANTIGEN)
CBC
CRITICAL STRUCTURES OF COLORECTAL
SML BOWELL
5YR SURVIVAL FOR ESOPHAGUS
LESS THAN 10%
ESOPHAGUS TX MARGINS
GENERALLY INCLUDE 5-6 CM SUP/INF THE LESION
PANCREATIC CA: MOST COMMON PRESENTING SYMPTOMS
JAUNDICE, PAIN, WEIGHT LOSS, AND ANOREXIA
PANCREATIC CA: SURGERY
STANDARD SURGICAL TX IS THE PANCREATODUODENECTOMY
(WHIPPLE)
PANCREATIC CA: TX/ CHEMO
5FU WITH XRT
CERVICAL CA STAGING: STAGE 0
CARCINOMA IN SITU
CERVICAL CA STAGING: STAGE I
CONFINED TO CERVIX
CERVICAL CA STAGING: STAGE IA1
MINIMAL MICROSCOPIC INVASION (<3MM)
CERVICAL CA STAGING: STAGE IA2
LESIONS NOT DEEPER THAN 5MM OR HAVE HORIZONTAL SPREAD GREATER THAN 7MM
CERVICAL CA STAGING: STAGE IB1
LESIONS GREATER THAN IA1 BUT CONFINED TO CERVIX CORPUS
OVARIAN CA: DX WORKUP
ROUTINE LABS: CBC, BLOOD UREA NITROGEN, CREATNINE, LIVER ENZYMES, AND CA 125 LEVEL

LARGE CELLS WITH 2 OR MORE NUCLEI, EA W/ PROMINANT NUCLEUS
REED-STERNBERG CELLS
HODGKINS STAGING: STAGE I
INVOLVEMENT OF A SINGLE LYMPH NODE REGION (I)
OR SINGLE EXTRALYMPHATIC ORGAN OR SITE (IE)
HODGKINS STAGING: STAGE II
INVOLVEMENT OF 2 OR MORE LYMPH NODE REGIONS ON SAME SIDE OF DIAPHRAGM (II)
OR LOCALIZED INVOLVEMENT OF AN EXTRALYMPHATIC ORGAN OR SITE, AND OR MORE LYMPH NODE REGIONS ON THE SAME SIDE OF THE DIAPHRAGM (IIE)
HODGKINS STAGING: STAGE III
INVOLVEMENT OF LYMPH NODE REGIONS ON BOTH SIDES OF THE DIAPHRAGM (III)
WHICH MAY ALSO ACCOMPANIED BY INVOLVEMENT OF SPLEEN (IIIS)
OR LOCALIZED INVOLVEMENT OF AN EXTRALYMPHATIC ORGAN OR SITE (IIIE)
OR BOTH (IIISE)
HODGKINS STAGING: STAGE IV
DIFFUSE OR DISSEMINATED INVOLVEMENT OF ONE OR MORE EXTRALYMPHATIC ORGANS OR TISSUES, WITH OR WITHOUT ASSOCIATED NODE INVOLVEMENT
HODGKINS: "B" SYMPTOMS
UNEXPLAINED WEIGHT LOSS >10//5
UNEXPLAINED FEVER
NIGHT SWEATS
HODGKINS: CHEMO
MOPP OR MOPP-ABV
HODGKINS STAGES I,II,III: PRIMARY TX
XRT
HODGKINS: MANTLE FIELD
FROM INF MANDIBLE-DIAPHRAGM (T10)
HODGKINS: MANTLE FIELD: LYMPHATICS
ABOVE DIAPHRAGM NODES INCLUDE:
CERVICAL
SUBMANDIBULAR
AXILLARY
SUPRACLAV
INFRACLAV
MEDIASTINAL
HILAR NODES
HODGKINS: MANTLE FIELD: BLOCKS
LUNG BLOCKS
OCCIPITAL REGION
SPINAL CORD- POST (IF NEEDED)
LARYNX- ANT
HUMERAL HEADS- ANT/POST
HODKINS: INVERTED Y:
GENERALLY TX SEPERATELY
HODGKINS: INVERTED Y: PERIAORTIC NODES
INCLD SPLENIC HILUM OR ENTIRE SPLEEN IF NOT REMOVED
-SHOULD MATCH MANTLE FIELD W/ ADQTE GAP AND EXT TO L4-L5
HODGKINS: INVERTED Y: LYMPH NODES
ILIAC NODES
FEMORAL NODES
MIDLINE BLOCK- TO SPARE OVARIES (M &F)
CLAM SHELL MALES TO LIMIT DOSE TO TESTES
HODGKINS: TOTAL NODAL IRRADIATION:
MANTLE & INVERTED Y
HODGKINS TX: XRT: DOSE
180-200 CGY/DAY
POSITIVE NODES TO 40-45 GY
WHAT MIGHT OCCUR 1 YR AFTER TX OF HODGKINS
FIBROSIS & BONE MARROW DEPRESSION
DISEASE OCCURS USUALLY 3 MO AFTER MANTLE XRT
LEHERMITES- HAND AND ARM TINGLING
USED EXCLUSIVELY TO TREAT NHL
CHEMO
MOST COMMON CA IN US MEN
PROSTATE
BEST TUMOR MARKER FOR PROSTATE CA & IMPORTANT PROGNOSTIC INDICATOR
PSA (SERUM AND ACID PHOSPHATASE)
ELEVATED W/ METS
FULL OR EMPTY BLADDER FOR PROSTATE XRT
FULL
BLADDER CA LYMPH DRAINAGE
EXTERNAL AND INT ILIAC AND PRESACRAL LN'S
BLADDER CA HISTOLOGY
92% TRANSITIONAL CELL
TESTICULAR CA
1% OF ALL MALE CA
AVE AGE 32
15-39 YRS
TESTICULAR CA: HISTOLOGY
SEMINOMAS
TESTICULAR CA: LAB TEST: TUMOR MARKERS
ALPHA FETA PROTIEN
BETA HCG
CBC
TESTICULAR CA: TX
CHEMO- CISPLATIN
TESTICULAR CA: WHEN INDICATED, SCROTOM MAY BE TX WITH E- IN SEP FIELD
HOCKEY STICK
2ND LEADING CAUSE OF DEATH IN CHILDREN
CANCER
ACCIDENTS #1
MOST COMMON CHILD CA
1-LEUKEMIA
2-CNS
3-LYMPHOMAS
4-SOLID TUMORS
EWINGS SARCOMA: MOST OFTEN BONES EFFECTED IN LOWER HALF OF BODY
1-FEMUR
2-PELVIS
EWINGS SARCOMA: TX:
SURGERY (LOWER EXT)
WILMS TUMOR
INVOLVES KIDNEYS
BILAT FOUND IN 5% OF CASES
-ABD SWELLING
WILMS TUMOR: OVERALL SURVIVAL
80-90%
RHABDOMYOSARCOMA
-HIGHLY MALIGNANT SOFT TISSUE SARCOMA
-ARISES FROM SKELETAL MUSCLE
RHABDOMYOSARCOMA: SITE OCCURANCE
ANY SITE ON BODY
-CHILDREN H&N
-ADOLESCENCE TRUNK & EXT
-INFANTS BLADDER & VAGINA
RHABDOMYOSARCOMA: SPREAD BY LYMPH NODES AND LOCAL INVASION: 20% @ TIME DX
MOST COMMONLY SEEN
LUNGS
BONE MARROW
BONE TUMORS
HIGHEST DURING ADOLESCENCE
MOST COMMON MALIGNANT IS METS OCCURING IN SPINE OR PELVIS
MOST COMMON PRIMARY MALIGNANT BONE TUMOR
OSTEOSARCOMA
RADIORESISTANT TUMORS
OSTEOSARCOMA
CHONDROSARCOMA
FRIBROSARCOMA
RADIOSENSITIVE TUMORS
EWINGS SARCOMA
RETICULUM CELL
LYPOSARCOMA
MULTIPLE MYELOMA
SOFT TISSUE SARCOMA LOCATIONS
1-LOWER EXT (THIGH MAINLY)
2-TRUNK
3-UPPER EXT
4-H&N
SOFT TISSUE SARCOMA: TX
HIGH RECURRENCE RATE WITH SURGERY-ADJ XRT
1 CM STRIP (AT LEAST) IN EXT FOR LYMPHODEMA
SOFT TISSUE SARCOMA: METS
CHEST
PITUATARY TUMORS: LOCATION
MIDLINE STRUCTURE: LIES IN SELLA (2M ANT & SUP FROM EAM)
PITUATARY TUMORS: XRT
-ARC ROTATION WITH FLYING WEDGES
-POP W/ 15* WEDGES HEELS ANT TO DECREASE DOSE TO OPTIC CHIASM
PITUATARY TUMORS: XRT DOSE
ENERGY LOWER THAN 10 MV, VERTEX CAN BE ADDED TO DECREASE DOSE TO TEMPORAL LOBE
THYROID CA: TX
TOTAL THYROIDECTOMY FOLLOWED BY IODINE (I 131) TO ABLATE THE GLAND AND TREAT METS
MELIGNANT MELANOMA STAGING
BY DEPTH OF INVASION
CLARKS LEVEL AND LYMPH NODE INVASION AND SURVIVAL
TUMOR DEPTH AND THICKNESS HAVE PROGNOSTIC SIGNIFICANCE
GTV
CTV
PTV
GROSS TUMOR VOL
CLINICAL TUMOR VOL
PLANNED TARGET VOL
PRESCRIBED DOSE AKA
GIVEN DOSE
DMAX
CO60
4MV
6MV
10MV
18MV
CO60- 0.5 CM
4MV- 1.0 CM
6MV- 1.5 CM
10MV- 2.5 CM
18MV- 3.5 CM
PHOTON ENERGY: THE HIGHER THE ENERGY THE ___ THE DOSE TO SKIN
LOWER
E-: HIGHER ENERGY ___ DOSE TO SKIN SURFACE
HIGHER
HIGHER ENERGY PHOTONS HAVE ____ PDD BEYOND DMAX DEPTH
HIGHER

THERAPEUTIC BEAM CONSIST OF WHAT KIND OF RADIATION
PRIMARY AND SCATTER
1 CURIE =
3.7 X 10^10 DISINTIGRATIONS PER SECOND
CBC: HEMOGLOBIN: OXYGEN CARRYING MOLECULE IN RBC'S
MEN- 13.5-18 G/DL
WOMEN- 12-16 G/DL
CBC: HEMATOCRIT: MEASURE OF PACKED VOLUME OF RBC EXPRESSED AS %
MEN- 43-49%
WOMEN- 27-43%
CBC: PLATLETS: AKA THROMBOCYTES, SMLST OF CELLS IN BLOOD
NORMAL VOLUME: 200,000-300,000 ML^3
STOP TX IF FALLS BELOW 60-70,000 ML^3
CBC: WBC: MOST RADIOSENSITIVE
5,000-10,000/ MM^3
(NEUTROPHILS, LYMPHOCYTES, MONOCYTES, EOSINOPHILS, ETC)
GENERAL FUNCT OF BLOOD
-TRANSPORTATION
-REGULATION
-PROTECTION
CHEMOTHERAPY: CATEGORIES
ANTIMETABOLITES
ALKYLATING AGENTS
ANTI-TUMOR ANTIBIOTICS
VINCA ALKALOIDS
HORMONES
CHEMO: MOPP
MECHLORETHAMINE
VINCRISTINE
PROCARBAZINE
PREDNISONE
REVERTING POST MITOTIC CELLS IN
LIVER
FIXED POSTMITOTIC CELLS
BRAIN, RBC

CATARACTS
2-7 GY
OCCUPATIONAL EYE DOSE
15 REM

CNS SYNDROME DOSE
20-50 GY
ROENTGEN: 1R=
2.58 X 10^-4 C/KG
NCRP
NATIONAL COUNCIL ON RADIATION PROTECTION AND MEASUREMENTS: RECOMMEDATIONS ON RAD PROTECTION AND UNITS
NRC
NUCLEAR REGULATORY COMMISSION: WHAT LAWS FOR RAD. MAY OR MAY NOT BE A AGREEMENT STATE
CO 60 DECAYS TO ___ WITH WHAT AVE ENERGY
NICKEL 60
1.25 MEV
BASIC COMPONENTS OF LINAC
MODULATOR
ELECTRON GUN
MAGNETRON/KLYSTRON
WAVEGUIDE
CIRCULATOR LOOK
ACCELERATING GUIDE UP
BENDING MAGNET
TRANSMISSION TARGET
FLATTENING FILTER
MONITORING ION CHAMBERS
SCATTERING FOIL
WHAT BASIC COMPONENT OF A LINAC IS USE FOR PHOTONS? E-?
PHOTONS- FLATTENING FILTER
E- : SCATTERING FOIL
WHAT GAS IS IN LINACS
SULFERHEXAFLOURIDE 6
SF6
CONSTANCY OF CALIBRATION MUST BE CHECKED ___ FOR LINACS ___ FOR CO 60
LINACS- WEEKLY
CO 60- MONTHLY
LIGHT FIELD MALFUNCTION CAN BE DUE TO
TARGET, COLLIMATORS, LIGHT SOURCE
TELL IF MISTAKE ON PT:
IF PROBLEM W/ MACHINE
PT: ONCOLOGIST
MACHINE: PHYSCIST
IF TABLE MOVES SPONTANEOUSLY
EMERGENCY OFF
TAR AT THE LEVEL OF DMAX IS
BACKSCATTER

GTV + CTV =
PTV
PLANNED TUMOR VOL

WHAT % LINE DEFINES THE TX FIELD ON LINEAR ACCERLERATORS
50% LINE
RADIATION UNITS
1 Ci= 3.7 x 10^10 Bq
1 R= .873 rad
1 Gy= 100 rad
1 cGy= 1 rad
1 Sv= 100 rem

DOSE EQUIV
ACCOUNTS FOR LET & RBE
HVL =
.693/ LINEAR ATTENTUATION COEFFICIENT
1 R= _________ C/KG IN AIR
2.58 X 10^-4 C/KG IN AIR
QUALITY OF XRAY BEAM
OBTAINED FROM THE AVERAGE XRAY ENERGY OF THE XRAY SPECTRUM
BEAM HARDENING REFERS TO
PREFERENTIAL LOSS OF LOWER ENERGY PHOTON ENERGIES, THEN AVE XRAY ENERGY IS NOW INCREASED
THE ____ THE ENERGY, THE ____ THE HVL THE MORE PENETRATING
HIGHER ENERGY
HIGHER HVL
HIGHER PENETRATING
POLYCHROMATIC?
FLUCTUATION OF TUBE POTENTIAL (BREMSTRAULUNG)

WHERE MOST ENERGY IS DEPOSITED AT END OF RANGE
BRAGG PEAK
BRAGG-GRAY THEORY
IONIZATION PRODUCED IN A GAS FILLED CAVITY PLACED IN A MEDIUM, IT IS RELATED TO THE ENERGY ABSORBED IN THE SURROUNDING MEDIUM
COMPENSATORS
USED TO FILL IN GAPS DURING TX, NOT TO BE CONFUSED WITH BOLUS

INFORMED CONSENT
NATURE OF PROCEDURE
EXPECTATIONS
REASONABLE ALTERNATIVES
RISKS

DMAX
BUILD UP REGION TO ALLOW TO REACH 100%
GAMMA RAYS ARE
NATURALLY OCCURING
BODY TEMP IS CONTROLLED BY
HYPOTHALAMUS
PYREXIA
FEVER
PULSE AREAS
APICAL-HEART
RADIAL
CAROTID
FEMORAL
POPLITEAL
DORSALIS PEDIS
POST TIBIAL
BRACHIAL

ONLY STERILE GOWN AREAS
WAIST TO SHOULDERS IN FRONT AND SLEEVES
ELIZABETH KUBLER-ROSS 5 PSYCHOLOGICAL STAGES OF DYING PT
DENIAL
ANGER
BARGAINING
DEPRESSION
ACCEPTANCE

TUMOR MARKER: CA 19-9 FOR
COLORECTAL & PANCREATIC

TUMOR MARKER: PSA FOR
PROSTATE REOCCURANCE
TUMOR MARKER: PHOSPHATASE
PROSTATE
TUMOR MARKER: HCG
GERM CELL TUMORS
PURE SEMINOMAS
TUMOR MARKER: CEA

COLON: METS
BREAST: AVANCED STAGE
LUNG

H&N ABOVE EPIGLOTTIS
VALLECULA
WHAT ATTENUATES LEAST
TRAY- .9
BOLUS- 1
WEDGE- >1
ACITES ASSOCIATED WITH
OVARIAN CA
AORTA BRANCHES
CILLIAC ARTERY
SUP MESENTARY
RENAL ARTERY
INF MESENTARY
ILLIACS

GERMAN HELMET: TX CNS:
WHOLE BRAIN PLUS C2
EYEBROWS TO MASTOID

WHAT ATTACHES BOTH LOBES OF BRAIN
CORPUS COLLOSUM

WHAT IS RIGHT ABOVE WHERE BRAIN STEM STARTS
THALAMUS/HYPOTHALAMUS
WHAT LEVEL IS FORAMEN MAGNUM
C1

STEREOTACTIC IS _______ BUT CAN BE KNOCKED OUT IN 1 DAY
SIZE DEPENDANT

PRIMARY BRAIN BORDER
2-3 CM MARGIN, AND ALSO ENOUGH MARGIN AROUND EDEMA

WHOLE BRAIN TX

3-4000 CGY

DESCRIBE CRANIOSPINAL XRT

KID MAINLY
EXT DIST
MATCH LINES
PRONE
BOOST IS JUST TO BRAIN
TD FOR SPINE IS 4 GY
CNS IMAGING
NEEDS MRI
MEDULOBLASTOMAS & EPENDIMOMAS SPREAD
SEED DOWN CORD
-DIST METS RARE
LYMPHOMAS ARE
EASY TO TREAT

PITUATARY CA IS
RARE
TD 5/5 BRAIN
50 GY
MOST COMMON BRAIN IN CHILDREN
MEDULLOBLASTOMA
MOST COMMON CA IN CHILDREN
LUEKEMIA
FUNCTION OF PITUATARY GLAND
MASTER GLAND FOR HORMONES
AFTER TX GIVE SYNTHETIC HORMONES

MOST COMMON GYN CA
ENDOMETRIAL

TAH
BSO

TOTAL ABD HYSTORECTOMY
BILATERAL SALIPING OOPHERECTOMY

CERVIX LYMPH NODES
1ST- ILLIACS
THEN PARAAORTICS
MOST DEADLIST GYN CA
OVARIAN

UGI: LYMPH NODES
SUPERCLAV (UPPER/MIDDLE) THEN MEDIASTINAL (LOWER) THEN CELIAC

POSITION FOR ESOPHAGUS XRT

PRONE- PULL IT AWAY FORM CORD

MOST COMMON GI

RECTUM
COMMON MET SITE: LUNG

LIVER
BONE
BRAIN

COMMON MET SITE: BREAST

LUNGS
BONE
BRAIN
COMMON MET SITE: STOMACH
LIVER
COMMON MET SITE: ANUS
LIVER
LUNG
COMMON MET SITE: BLADDER
LUNGS
BONE
LIVER

COMMON MET SITE: PROSTATE

BONE
LIVER
LUNGS
UTERINE CERVIX
LUNGS
BONE LIVER
DNA: PURINES
ADENINE
GUANINE
DNA: PYRIMIDINES

THYMINE
CYTOSINE
5 VITAL NECESSITIES BODY NEEDS TO MAINTAIN BALANCE
WATER
TEMP
OXYGEN
PH
ELECTROLYTES
CELL

UNIT OF LIFE
UNIT OF DISEASE
RESPONSE TO STRESS
ABLE TO ADAPT
REVERSIBLY INJURED
MAY DIE
4 TYPES OF NECROSIS

COAGULATIVE
LIQUEFACTIVE
CASEOUS
FAT
WHERE IS THE FIELD SIZE DEFINED
ISOCENTER
RADIATION BEAM IS COMPOSED OF WHAT?
WHICH IS MADE UP OF WHAT?

PRIMARY AND SCATTER
MADE OF PHOTONS AND E-

OTHER NAMES FOR DMAX

GIVEN DOSE
PRESCRIBED DOSE
INTERACTION OF AXIS OF ROTATION OF GANTRY AND COLLIMATOR
ISOCENTER
DIST FROM SOURCE OF PHOTONS TO ISOCENTER OF TX MACHINE
SAD

DIST FROM SOURCE OF TX MACHINE TO SURFACE OF PT OR PHANTOM
SSD

CALC PT (ISO) HAS TO BE ___CM AWAY FROM BLOCK FIELD DUE TO ____
2 CM
PENUMBRA
MEASUREMENT OF PT THICKNESS FROM THE POINT OF BEAM ENTRY TO EXIT
SEPERATION

EFS
PDD
TPR
TMR
GTV
CTV
PTV
OAR
DVH

EFFECTIVE FIELD SIZE
PERCENTAGE DEPTH DOSE
TISSUE AIR RATIO
TISSUE PHANTOM RATIO
TISSUE MAX RATIO
GROSS TUMOR VOL
CLINICAL TUMOR VOL
PLANNED TX VOL
ORGANS AT RISK
DOSE VOL HISTOGRAM
3 GENERAL POINTS NEED TO PERFORM TX CALC

-DOSE AT POINT
-DOSE RATE AT THAT POINT
-DOSE AND DOSE RATE MUST BE IN SAME MEDIUM

LENGTH OF TIME UNIT IS PHYSICALLY ON
TX TIME
MU SETTING

DIST BENEATH THE SKIN WHERE PRESCRIBED DOSE IS DELIVERED
DEPTH
PDD IS USED FOR WHAT KIND OF TX
SDD (NON ISOCENTRIC)

HD "A" SYMPTOMS
NO SYMPTOMS
THE COMBO OF SCATTER FROM FLATTENING FILTER AND COLLIMATOR
HEAD SCATTER

HERPES VIRUS ASSOCIATIED W/ NASOPHARYNGEAL CA & BURKITTS LYMPHOMA
EPSTEIN-BARR VIRUS
(EBV)
LARYNX
(3 AREAS)
SUPRAGLOTTIS
GLOTTIS
SUBGLOTTIS
HD SUBTYPES
LYMPHOCYTE PREDOMINANT
NODULAR SCHLEROSIS
MIXED CELLULANT
LYMPHOCYTE DEPLETION
SMALL CELL LUNG CA ALSO CALLED
OAT CELL
-PROPHYLACTIC XRT TO BRAIN

LRGST LYMPH ORGAN
ACTIVATES LYMPHOCYTES
STORES PLATELETS
DESTROYS WORN RBC'S W/ MACROPHAGES
SPLEEN

WHAT KIND OF CA IS MYCOSIS FUNGOIDES?
HOW IS IT TX?

LYMPHOMAS
TX W/ TBI E-
LIPS CONTROLLED BY
ORBICULARIS ORIS MUSCLE
AKA VERMILLION
ORAL CAVITY DIVIDED BY
ANT 2/3 ORAL TONGUE
POST 2/3 BASE TONGUE

MOST COMMON ORAL CAVITY CA

LIP CA
PAROTID DRAINS BY
STENTSENS DUCT

KAPOSI'S SARCOMA ASSOCIATED WITH

AIDS
IMMUNOCOMPROMISED
DISEASE OF THE ELDERLY 65+
SQUAMOUS CELL CA

HD W/ LIVER INVOLVEMENT
ALWAYS STAGE IV
HD: LYMPH STRUCTURES
LYMPH NODES
SPLEEN
THYMUS
WALDEYERS RING
APPENDIX
PEYERS PATCHES

ONLY CA TRULY CONSIDERED GENETICALLY TRANSMITTED
NEUROBLASTOM OF THE RETINA
SYNERGEISTIC INTERACTION
ADDING CIGARRETTS (21X) OR ASBESTOS (7X) INCREASES CHANCES
PROMOTION
SECOND EXPOSURE
PORT WINE STAIN OR BIRTHMARK
ANGIOMA
FAMILY TENDANCIES IN DEVELOPING CA (3)
BRST CA
FAMILIAR POLYPOSIS
XERODERMA PIGMENTOSUM
PATHALOGICAL STAGING FOR HD
STAGING LAPRATOMY
REMOVAL OF SPLEEN
LIVER BX @ 3 SITES
REMOVAL OF SUSPECT ABD LYMPH NODES

PITUITARY GLAND LOCATED
IN THE SELLA TURCIA
2 CM ANT 2 CM SUP FROM EAM
"MASTER GLAND"
ADRENAL GLANDS SIT
ON TOP ON THE KIDNEYS
CORTICOSTEROIDS ARE
ANTI-INFLAMMATORY AND PERSCRIBED FOR BRAIN TX

PANCREAS SECRETES
INSULIN

WHAT STAGE OF CERVIX CANCER?


BEYOND THE UTERUS, BUT


NOT IN THE PELVIC WALL OR THE LOWER 1/3 OF THE VAGINA


WITHOUT PARAMETRIAL INVASION
T2a, NO,MO
WHAT KIND ON STAGING IS USED IN UTERINE CERCVIX CA
FIGO
WHAT KIND OF STAGING IS USED FOR LARYNX CA

TNM

WHAT KIND OF STAGING IS USED IN HODGKINS DISEASE
ANN ARBOR

DIRECT ACTION:


18 MV, ALPHA, NEUTRONS:
LIKELY TO HAPPEN WITH HIGH LET
DAMAGES DNA DIRECTLY

INDIRECT EXPOSURE:


6MV, GAMMA, XRAYS:

MOST COMMON REACTION
RADIATION INTERACTS WITH H20

WHAT IS PRODUCED THRU IONIZATION OF H20

FREE RADICAL

IN LET RADIATIONS, GENERALLY AS LET INCREASES, RBE (RELATIVE BIOLOGICAL EFFECTIVENESS)____

INCREASES

WHAT ARE THE 3 THINGS THAT HAPPEN TO CELLS AFTER IRRADIATION
1. DIVISION DELAY
2. INTERPHASE DEATH
3. REPRODUCTIVE FAILURE
*EARLY* RESPONDING NORMAL TISSUE MANIFEST INJURY WITHIN
A FEW MONTHS OF RADIATION COMPLETED

*LATE* RESPONDING NORMAL TISSUE MANIFEST INJURY WITHIN
3 MONTHS OR LONGER
(LUNG, CNS, KIDNEY, LIVER)
CAN A PACEMAKER BE IN THE TX FIELD
NO
MAX DOSE IS 250CGY

NTTD
TOLERANCE DOSES ESTABLISHED FOR NORMAL TISSUES FOR THE TOTAL DOSE DELIVERED BY A STANDARD FX SCEDULE THAT CAUSES COMPLICATIONS RATE WITHIN 5 YEARS

IF A WEDGE IS LEFT OUT OR IT CALLED FOR 30* AND A 15* WAS IN DURING TX, THE PATIENT WOULD BE
OVERDOSED
WHAT IS MOST TOXIC IN CERROBEND

CADMIUM

HVL

INCREASE IN THICKNESS AFTER THE 1ST HVL DUE TO BEAM HARDENING


(MEANING A THICKER PIECE TO COMPENSATE SINCE THE BEAM GETS HARDENED AFTER THE 1ST HVL)

COORDINATES
X
Y
Z
X: TRANSVERSE
Y: SAGGITAL
Z: CORONAL

PHOTOELECTRIC EFFECT IS WHEN A PHOTON INTERACTS WITH
AN INNER SHELL ELECTRON

IN BREMSSTRAHLUNG A HIGH SPEED E- INTERACTS WITH

THE ELECTROSTATIC FIELD OF A NUCLEUS




BRAKING E-

CELSIUS
FAHRENHEIT CALCULATIONS
C# X 9 /5 +32 =
F# -32 X5 /9 =

SPLIT FIELD TEST FOR BEAM ALIGNMENT USES


USES POP 180* FIELDS

CNS MOSTLY COMPOSED OF _____
WHAT SURROUNDS IT

CNS COMPOSED OF WHITE MATTER
GREY MATTER SURROUNDS THE WHITE MATTER
LARGEST ORGAN OF THE BODY
SKIN

MAJOR VEIN THAT EMPTIES BLOOD INTO THE HEART
SVC