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112 Cards in this Set
- Front
- Back
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How long is the anal canal
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3-4 cm long
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anal cancer symptoms
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bleeding, anal discomfort, anal mass pruritis,rectal urgency
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anal cancer treatment
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RT, surgery and RT, RT and chemo
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positioning for anal cancer
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prone
belly board |
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borders for anal cancer
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SUP: lower border of SI joint
INF: 3 cm distal to primary tumor LAT - include inguinal nodes |
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dose for anal cancer
and beam |
AP/PA
3060 cGy / 17 fx 1440 cGy / 8 fx |
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prostate diagnostic tests
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prostate specific antigen
rectal exam gleason score |
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prostate treatment modalities
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4 field box
art and imrt |
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prostate art and imrt
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tx 5 fraction, 5 CBCT and 4 CT
replan |
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prostate - what is the process called when you inject contrast
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retrograde urethralgram
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prostate -what kind of contrast is used
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cystographin
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art1
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only prostate
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art 2
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prostate and seminal vesicles
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symtoms from prostate RT and what medicine do we give to relieve them
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diarrhea
immodium |
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the head of the pancreas located based on the vert body
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L1-L2
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what causes pancreatic cancer
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smoking, drinking, chronic pancreatitis
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symptoms of pancreatic cancer
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weight loss, jaundice, palpable abdominal mass
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where does pancreatic cancer usually occur
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head of the pancreas
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what kind of cancer is primarily in pancreatic cancers
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adenocarcinoma
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what is given pre-sim for pancreatic cancer
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oral contrast and IV contrast
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beam orientation for pancreatic cancer
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three or four field
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field borders for pancreatic cancer
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for AP/PA SUP - T11-T12INF - L3 LAT - 2-3 cm margin around tumor bed excluding 3/4 of the kidney ANT - 1-2 cm beyond tumor bed POS - split the vert body |
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critical structures for pancreatic cancer
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liver
stomach kidney small bowel spinal cord |
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what is the surgical procedure where you resect the head of the pancreas, duodenum, distal stomach, gall bladder,...
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whipple technique
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positioning for pancreatic cancer
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supine, alpha cradle
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ampulla of vater
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widened portion of the duct through which the bile and pancreatic juices enter into the intestines
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colorectal length
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13-15 cm
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risk factors for colorectal cancer
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polyps in the colon, crohns disease, person history of colorectal cancer
obesity, smoing, drinking |
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tx for colorectal cancer
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surgery, chemo, RT
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positioning for colorectal cancer
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prone, belly board
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tx fields for colorectal cancer
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3 field - PA and laterals with wedges located posteriorly
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colorectal -what is given to the patient pre-sim
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oral contrast 15-20 min before
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colorectal cancer borders
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SUP - L5-S1
INF - 2cm below obturator LAT - 2cm lateral to pelvic brim ANT - 2 cm ant to sacral promontory POS - cover the sacrum |
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bladder - etiology
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smoking, drinking, chronic bladder irritation
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symptoms of bladder cancer
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hematuria,freqent urination
dysuria |
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what does TURBT stand for
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transurethral resection of bladder tumor
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tx field for bladder cancer
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3 or f field and boost
with ledges on lateral side to prevent hot spots |
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Field borders of bladder cancer
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SUP - L5-S1
INF - inf border of the obturators LAT - 1.5 - 2 cm on either side of widest portion of bony pelvis ant - 1-1.5 ant to pubic symphasis POS - 2-2.5 cm post to visualized bladder |
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esophagus etiology for squamous cell
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drinking, smoking, diet low fresh fruits and vegetables
pummer vinson syndrome -iron deficiency Barrettes esophagus - gastric reflux Achalasia - lower 2/3 esophagus lost peristaltic activity |
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esophagus cancer symptoms
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dyphagia, weight loss
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two types of esphagus cancer
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squamous cell - thoracic esophagus
adenocarcinoma - distal esophagus |
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RT fields for distal third esophagus margin
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INF - must include the celiac axis lymph nodes
celiac lymph nodes are located T12 - L1 |
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where are the celiac lymph nodes compared to vertebral column
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T12 - L1
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beam orientation for esophagus
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AP/PA
but we use IMRT now |
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critical structures for esophagus treatment
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kidneys, liver, small bowels, lung, heart, spinal cord
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esophagus set-up
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cradle
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what is the pre-sim procedure
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barium contrast before CT to visualize esophageal stenosis
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lung cancer - main cause
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most common diagnosed cancer and leading cause of cancer- related deaths
smoking |
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lung cancer - symptoms
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shortness of breath
coughing chronic pulmonary disease |
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tx modalities
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RT and chemo
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two types of lung cancer
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small cell lung cancer
non small cell lung cancer |
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what is PCI
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given for small cell lung cancer
PCI brain metastasis is commonly seen in pt with SCLC |
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borders for PCI
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2 cm border around brain and from C2-C3
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symptoms in patients with advanced stage lung cancer
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superior vena cava obstruction
brain mets bone mets |
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set up for lung cancer
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cradle
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sim protocol for lung cancer
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iv contrast
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beam orientation for lung cancer
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AP/PA
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lung cancer - margin
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2 cm around tumor and nodes involved
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lung cancer - total cgy treated
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4500 cGy
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Lung cancer - stereotactic RT
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considered as hypofractionation
1-4 fx within 2 weeks |
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lung cancer 4D lung
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tumor motion changes with breathing
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lung cancer - critical structure
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heart, lung, esophagus, spinal cord
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larynx - facts
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most common head and neck cancer
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cause of larynx cancer
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smoking
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type of larynx cancer
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squamous cell
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symptoms of larynx cancer
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sore throat, odynophagia, hoarseness
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larynx cancer - garbage can node
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jugulodigastric lymph node located in the supraglottic area of larynx
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larynx cancer - anatomical landmarks
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thyroid bone
cricoid bone hyoid bone |
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positioning for larynx cancer
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aquaplast mask under the nose over the neck with a clear C headrest and shoulder pulls
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beam orientation for larynx cancer
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rt and left lat and pedastal if neck is small
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field border for larynx cancer
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5x5
SUP - thyroid notch INF - cricoid ANT - 1cm flash POST - anterior aspect of the vert body |
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larynx sim protocol
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do not swallow when beam is on
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brain tx - about primary
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spreads invasively
does not metastasize through lymphatics CNS lymphoma tends to spread thru CSF |
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brain tx - primary dose and margin
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6000 cGy at 180 - 200 cGy
2-3 margin around tumor |
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brain tx - orbit
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graves disease a thyroid disorder
posterior sweling of the eye |
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brain tx -orbit beam orientation
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rt and left lat, preventing tx to the eyes
tip gantry 10 degrees to avoid lens |
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brain tx - metastatic
-whole brain - dose and beam orientation |
2 opposed lateral
2000-3000 cGy in 10 fractions |
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brain tx- metastatic
-whole brain border |
2cm border entirely and inferiorly bordering splitting C1-C2
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brain tx - metastatic
stereotactic radiosurgery |
high dose of radiaiton delivered in a single session
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brain tx - metastatic
gamma knife |
under local anesthesia, a rigid frame is attached to the patient with screws
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brain tx - metastatic
fractionated stereotactic radiotherapy |
lower dose radiation delivered over many visits. Patient receive treatment and return after several weeks off to complete rt
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brain - metastatic immobalization devices
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clear b or F, base plate, aquaplast
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beam orientation for whole brain
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rt and left lat
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borders for whole brain
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sup - 2 cm flash
ant and post - 2cm flash inferior - split c1 and c2 |
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pituitary tumors are presented with...
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endocrine abnormalities as result of hyper secretion of hormones caused by tumor
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pituitary tumors - visual impairment encroachment of tumor on...
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optic chiasm
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where is the pituitary gland located
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sella turcica
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pituitary tumors are usually
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benign
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pituitary tumors are usually tx with
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transpenoidal resection
large tumors - craniotomy RT - 2 lat fields with vertex or AP or Arc |
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beam orientation for pituitary tumor
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RT LT beam and vertex
rotation arc with wedges RT LT and anterior wedged ields |
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field border of pituitary tumor
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6x6
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why are wedges used for pituitary tumors
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wedges are used to decrease dose to optic chiasm
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orbits - immobalization devices
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clear B or F with base plate and aquaplast
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orbit - beam orientation
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RT and LT beams and tilted 10 degrees to avoid radiation to the lens
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borders for the orbits
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SUP/INF - bony orbit
POS - anterior edge of sella turcica ANT - lateral fleshy canthus marked with a wire |
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spine tx is used for what 4 things
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metastasis
SVC syndrome spinal cord compression primary tumors |
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spine tx
-metastatic which is more common, metastatic bone disease or primary bone lesion |
metastatic bone disease
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which is likely to develop bone mets
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breast, kidneys, thyroid, lung
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most common area with bone mets
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ribs
vertebral column pelvic bone |
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spine treatment - metastatic
palliative or curative |
palliative
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spine tx - widespread disease occurs in
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humerus, femur, scapula, sternum, skull, clavicle
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spine tx - svc syndrome
- most commonly caused by -tx dose |
lymphoma and lung cancer
3-4 fx 300-400 cgy |
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spinal cord compression
-symptoms |
pain, weakness, loss of bowel and bladder control
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spinal cord compression beam orientation
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PA field
but lateral beams for C spine |
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spinal cord compression margin
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3-4 cm margin of 2 cert bodies above and below cord compression
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T spine
L spine immobalization devices |
B or F headrest, hand at side
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borders of T/L spine
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SUP - based on physician
LAT - 8 cm width |
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critical structures for T/L spine
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T - stomach, esophagus, lungs, trachea
L - kidney, small bowel, bladder |
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C-spine - immobalization devices
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upper C- spine - B or F headrest
lower C-spine - A or C headrest and arm pulls |
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c-spine - beam orientation
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lateral for C5 and above
PA for C5 and below |
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borders for c-spine
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sup inf is determined by the physician
and lateral is 8 cm width |
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critical structures for c-spine tx
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esophagus, trachea, lungs, spinal cord and brain stem
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