ANDREW IDOKO

RADIOLOGY
GROUP 332

1. The concept of radical and palliative treatment.

Indications, contraindications dose limits. Examples.

Radiotherapy can be used in patients with lung carcinoma as a radical treatment or as a

palliative, depending on the clinical stage of malignancy, the histological type involved, and
the patient's general status.
Palliative care is defined as the physical, social, psychological, and spiritual support of
patients with life limiting illness that is delivered by a multidisciplinary team.
Indication, such as control of pain, bleeding, dyspnoea, and obstruction
DOSE: The selection of palliative radiotherapy dose depends not only on prognosis but also
on performance status, comorbidities, risk of acute toxicity, prior treatment, delivery of
systemic therapy, and patient wishes

2. What are the dose limiting factors when deciding on radiation dose per
fraction in radiotherapy?

Giving smaller doses per fraction — hyperfractionation — allows an increase in total dose
and, therefore, in tumour-cell killing without causing significant undue morbidity in normal
tissues. Second, the fast cell proliferation that is found in a significant number of tumours
justifies shorter schedules — accelerated fractionation — to compensate for repopulation.
Both approaches require at least two radiotherapy sessions per day, with a minimum 6-hour
interval between dose fractions to allow sufficient repair in normal tissues

3. What is brachytherapy and how is it used?

Brachytherapy is a type of radiation therapy used to treat cancer. It places radioactive sources
inside the patient to kill cancer cells and shrink tumors. This allows your doctor to use a
higher total dose of radiation to treat a smaller area in less time. Brachytherapy is a cancer
treatment in which radioactive material sealed inside a seed, pellet, wire, or capsule is
implanted in the body using a needle or catheter. The radiation given off by this source
damages the DNA of nearby cancer cells. Brachytherapy is most commonly used to treat
prostate cancer.
4. General principles for the treatment of malignant tumors. Modern
possibilities of radiation therapy, drug therapy of malignant tumors.?

Radiation Therapy – High-dose X-rays are used to kill cancer cells and shrink tumors.
Systemic Treatment (Chemotherapy) – Often used to kill tumor cells when they have spread
into the bloodstream, but cannot yet be detected on tests and scans.

 Surgery. When used to treat cancer, surgery is a procedure in which

a surgeon removes cancer from your body.

 Radiation Therapy.

 Chemotherapy.

 Immunotherapy to Treat Cancer.

 Targeted Therapy.

 Hormone Therapy.

 Stem Cell Transplant.

 Precision Medicine.

5. Radiation therapy of non-tumor diseases: indications and main

limitations.

The concept of radiation therapy for the treatment of benign diseases refers to the use of

moderate to high-energy ionising radiation as part of the treatment of non-malignant, but not
necessarily harmless, diseases.

The disadvantages of radiation therapy include: damage to surrounding tissues (e.g. lung,

heart), depending on how close the area of interest is located to the tumor. inability to kill
tumor cells that cannot be seen on imaging scans and are therefore not always included on the
3D models (e.g. in near-by lymph nodes.
6. Radiation therapy in the treatment of lung cancer. Dose limits, methods
used exposure. Possible radiation reactions.

The radiation is aimed at the lung cancer tumor and kills the cancer cells only in that area of
the lungs. Radiation can be used before lung cancer surgery to shrink the tumor or after
surgery to kill any cancer cells left in the lungs. Sometimes external radiation is used as the
main type of lung cancer treatment.

Dose has been escalated to up to 102.9 Gy while limiting lung dosimetry with most patients
tolerating treatment, and post treatment radiation injuries considered to be acceptable

some common side effects of radiation therapy for lung cancer include: General weakness

and fatigue. Dry, red, itchy or peeling skin. Shortness of breath.

7. Radiation therapy in the treatment of breast cancer. Dose limits applied

irradiation techniques. Possible radiation reactions.

Radiation therapy may be used to treat breast cancer at almost every stage. Radiation therapy
is an effective way to reduce your risk of breast cancer recurring after surgery. In addition, it
is commonly used to ease the symptoms caused by cancer that has spread to other parts of the
body (metastatic breast cancer). The main types of radiation therapy that can be used to treat
breast cancer are external beam radiation therapy (EBRT) and brachytherapy.
The radiation treatment procedure is painless, but it may cause some skin discomfort over
time. The total dose of external radiation therapy is usually divided into smaller doses called
fractions. The most common way to give it is daily, 5 days a week (Monday through Friday)
for 5 to 8 weeks. Weekend rest breaks allow time for normal cells to recover.

8. Radiation therapy in pediatric practice. Dose limits, methods used

exposure. Possible radiation reactions. Limit exposure to children.

Radiation therapy (also called radiation oncology) uses special kinds of energy waves or

particles to fight cancer.

Radiation therapy is a special kind of X-ray treatment. It is different from regular X-rays

because it does not take pictures of what is inside the body. Instead, it uses high-energy rays.
These rays get rid of cancer cells in your child's body that make him or her sick.

Bone growth may also be affected, especially with young children who are still having
significant bone growth. Height stature and/or limbs may be shortened because of the effect
of radiation. Skin changes. The skin may be more sensitive, reddened or irritated after
having radiation.
The recommended treatment doses of KI are 16 mg/day for newborns from birth to 1 month,
32 mg/day for infants over 1 month after birth through 3 years of age, and 65 mg/day for
adults. As summarized in the guidance, 0.05 Gy was recommended as the lowest radiation
exposure intervention threshold for KI administration. 

9. Radiation reactions are general and local. Examples of basic radiation

reactions and their paths prevention.

. The systemic reactions of fatigability, anorexia, nausea and vomiting began with the first
session of treatment and gradually increased with the course. Local reactions in the treated
area appeared later and were related to field size and dose.When people are exposed to
ionizing radiation from sources outside or inside the body, the radiation may interact with
molecules in cells in their path. As described earlier in this chapter, some ionizing radiation
can travel through a few or several layers of cells (beta-particle radiation) or through many
cell layers into and through tissues deep within the body (x and gamma radiation), whereas
alpha-particle radiation has short paths or tracks. The rate at which radiation loses energy
along its tracks is referred to as linear energy transfer (LET) and depends on its track length.
Thus, beta-particle radiation and the electrons associated with x and gamma rays, which are
sparsely ionizing, are described as low-LET radiation, and alpha-particle radiation, which is
densely ionizing, as high-LET radiation.

10. The factor "time - dose - fractionation" with a uniform and arbitrary
mode of dose fractionation, the purpose of its use

A new approach, based on time-dose-fractionation (TDF), which has been used in

conventional radiotherapy, is advanced. This approach incorporates differences in dose rates,
biological half-lives of the antibodies, physical half-lives of the radionuclides employed and
the total doses needed for a given biological effect. The TDF concept is illustrated with
several relevant examples for radioimmunotherapy. Based on the TDF approach, it is
proposed that under certain biological conditions radionuclides with physical half-lives that
are 1-3 times the biological half-life of the radiolabeled antibodies in the tumor are more
likely to deliver sterilization doses to tumors than the shorter-lived nuclides presently in use
unless precluded by specific activity considerations. Several radionuclides that meet this
criteria are suggested with 32P being the most promising among them. Finally, a practical
method for treatment planning in radioimmunotherapy using TDF factors is recommended.