Principles exam 1
which of the following chemotherapy regimens are used to treat Hodgkin's disease? - CHOP - MOPP - ABVD
- MOPP - ABVD
the role of the radiation therapy in the treatment of patients with bone tumors includes: - education - communication - assessment - monitoring medical equipment
- education - communication - assessment - monitoring medical equipment
which of the following is an acceptable radiation therapy treatment technique for STS? - external beam - brachytherapy - intraoperative
- external beam - brachytherapy - intraoperative
preoperative radiation therapy for STS is performed to: 1. kill the reactive rim of tumor cells before they are cut into 2. decrease the risk of implantation 3. attempt to preserve as much normal function as possible
- kill the reactive rim of tumor cells before they are cut into - attempt to preserve as much normal function as possible
it is important when treating an extremity for STS to have a strip of unirradiated tissue near the treatment volume to: 1. maintain some lymphatic function 2. avoid increased fracture possibilities 3. avoid circumferential fibrosis
- maintain some lymphatic function - avoid circumferential fibrosis
treatment for multiple myeloma involves: - radiation therapy - surgery - chemotherapy
- radiation therapy - chemotherapy
primary treatment for osteogenic sarcoma involves: - radiation therapy - surgery - chemotherapy
- surgery - chemotherapy
Intraoperative radiation for STS usually involves doses in the range of ______ after tumor removal
10 to 16 Gy
what is the dose/fraction schedule for TBI?
12 Gy 6 fx BID/13.5 Gy 6 fx BID/6 Gy 2 fx BID
during which of the following timeframes is the incidence rate of primary bone cancer highest?
15-30 years old
what is the standard dose delivered for the treatment of NHL?
30-45 Gy
what is the standard dose delivered for the treatment of NHL?
3000 to 4500 cGy
Radiation therapy doses for preoperative STS are generally in the range of:
50 Gy
children are most likely to develop which type of leukemia?
ALL
the most common form of leukemia found in children is
ALL
The incidence rate of bone cancer is highest during what period
Adolescence
Acceptable radiation therapy technique for sts
All - external beam, IORT, brachytherapy
Although the exact cause of STS is unknown, a factor that has been implicated is
Appearance as a second primary 3 to 15 years after high-dose radiation therapy for other cancers
The rationale for leaving a 1-cm to 3-cm strip of skin and soft tissue rather than total circumferential irradiation of an extremity treated for STS is that it:
Avoids future excessive fibrosis and edema
the most common type of NHL is
B cell
the most common form of NHL is
B-cell
the specific gene used to identify CML is known as the
BCR-ABL
which lymphoma is most common in young African males
Burkitt lymphoma
which type of leukemia accounts for nearly 15% of all adult leukemias and is uncommon before the age of 35?
CML
Emerging treatments for bone and STS include all of the following except:
Cryotherapy
which chemotherapy agent can be used to reduce the leukemia cell load and impair the host's ability to reject the donor bone marrow?
Cyclophosphamide
Main shaft of a typical long bone is
Diaphysis
which of the following is not a B symptom?
Diarrhea
Most sts spread through
Direct invasion and hematogenously
The most common site of a primary bone sarcoma is
Epiphyseal
Location where STS most common
Extremities
Pain is the most common presenting symptom of sts
False
follicular lymphoma is the most common form of NHL
False
Standard care for sts is chemotherapy
False - it is surgery!
STS requires which dose of radiation to achieve local control and long term survival
High
Which treatment field for HD includes the para-aortic lymph node chain
Inverted Y (abd portion)
Which treatment field for HD includes the retroperitoneal lymph node chain
Inverted Y (abd portion)
Which treatment field for HD includes the inguinal lymph node chain
Inverted Y (pelvic portion)
Which FAB stage are most pediatric ALLs?
L1
What image landmark is used to determine the lower border of the abd portion
L4-5
Where are primary bone lesions most common
Lower extremity
Most common site of metastasis from a primary bone cancer
Lung
The most common site of metastasis from primary bone cancer is
Lung
Which of the following bone tumors has the worst prognosis?
Metastatic bone tumor
Highest incident of bone tumors
Metastatic disease
A bone lesion that results from primary sites elsewhere in the body is a(n):
Metastatic tumor
A non osseous malignant tumor of the bone marrow is a(an):
Multiple myeloma
Most common form of primary bone cancer
Osteosarcoma
Examples of primary bone tumors
Osteosarcomas Multiple myeloma Pleomorphic sarcomas (MFH)
Most common presenting symptom of patients with bone tumors
Pain
Most important prognostic factor for osteosarcoma
Presence of mets
Important to have a strip of skin that is not irradiated because:
Preserve lymph drainage and circumferential control
Regional lymph nodes are generally not included in the treatment portals for STS because:
STS tend to spread via the blood
Advantages of preoperative radiation therapy for STS include all of the following except:
Skin involvement increase when using postoperative radiation therapy
Bone scans are used to evaluate the
Spread of metastatic disease
_________ is most commonly used radionuclide in treating metastatic bone disease that results from primary prostate or breast cancer
Strontium-89 m
Treatment for MFH is
Surgery Chemo RT
What image landmark is typically used to determine the lower border of the mantle field
T10
what landmark is typically used to determine the lower border of the mantle field?
T10
Radiation treatment of sts typically include
The affected muscle compartment plus margin
Most common sts in children is rhabdomyosarcoma
True
Most primary bone tumors are radio-resistant
True
Outcomes with LSS (limb sparing surgery) are equal to those with amputation
True
The incidence of primary bone tumors is low
True
The incidence of primary bone tumors is low.
True
Factors that are incorporated into the Federation of Cancer centers Sarcoma Group histologic grading for STS include
Tumor differentiation Mitotic count Tumor necrosis
Type of bone marrow is in the diaphysis of long bones
Yellow
which of the following stages in the natural history of CML is also known as blast crisis?
acute
Where should the upper and lower field edges be placed for the treatment of metastatic spine cancer?
at the intervertebral disk space one vertebra above and below the diseased vertebra
what is the treatment of choice for leukemias?
bone marrow transplant
which lymph node chain is more likely to be the original site of Hodgkin lymphoma?
cervical
the primary treatment for early-stage Hodgkin lymphoma is
chemotherapy
which of the following is also known as maintenance therapy?
continuation therapy
in which anatomical location are STSs most common?
extremities
NHL's are highly curable in comparison to HL's
false
the presence of Reed-Sternberg cells in NHL is the main factor that distinguishes it from HD
false
Explain A symptoms
having no symptoms
Aggressive NHL tumors are referred to as:
high grade
which treatment field for HD includes the para-aortic lymph node chain?
inverted-Y (abdominal portion)
which treatment field for HD includes the iliac lymph node chain?
inverted-Y (pelvic portion)
Primary sites common to bone except
kidney however, Breast, lung, and prostate do
when used with radiation therapy, which of the following reduces the loss of function and improves overall control?
limb-sparing surgery
the most common metastatic site in STSs is:
lung
what is the most common site of metastasis from a primary bone cancer?
lung
Both Non-hodgkins and Hodgkins lymphoma can be treated with
mantle
Which treatment field for HD includes the axillary lymph node chain?
mantle
Which treatment field for HD includes the cervical lymph node chain
mantle
Which treatment field for HD includes the mediastinal lymph node chain
mantle
which treatment field for HD includes the mediastinal lymph node chain?
mantle
Combined treatment fields to the neck, chest, and axilla are called _______ fields
mantle fields
which of the following has the highest incidence of bone tumors?
metastatic bone lesions
In what general anatomical location is Waldeyer ring located?
mouth
which of the following cells are not considered part of hematopoiesis? - neutrophils - basophils - platelets - neurons
neurons
what is the most common presenting symptom of HD?
painless mass
the spleen is commonly associated with which of the following blood cell types?
red blood cells
_________ are large lymphoid cells that contain multiple nuclei that are an indicator of Hodgkin lymphoma
reed-sternberg cells
what is the most common long-term side effect of total lymphoid irradiation
secondary malignancies
in which anatomic location are metastatic bone lesions most common?
spine
in which anatomical location are metestatic bone lesions most common
spine
Organs most closely associated with the lymphatic system
spleen
The abdominal para-aortic treatment includes the
spleen
A bone scan is a nuclear medicine procedure used to detect the presence of metastatic bone cancer.
true
B symptoms include unexplained weight loss of more than 10% of body weight in the 6 months before diagnosis, night sweats, and unexplained fevers higher than 100.4 degrees F.
true
HD can be treated with mantle, para-aortic, and inverted fields
true
Hodgkin lymphoma has an unpredictable, contagious pattern of spread that mimics the route of the lymphatic system
true
Treatment of pelvic and paraaortic fields together is referred to as the inverted Y
true
infections with certain viruses are a risk factor for HD.
true
leukemia is the most common pediatric cancer.
true
most primary bone tumors are radioresistant.
true
radiation exposure is risk factor for leukemia
true
the incidence of NHL is higher than that of HD
true
