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RadTherapy
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The total body response to radiation is presented in terms of 3 radiation syndromes:
- Hematopoietic Syndrome
- Gastrointestinal Syndrome
- Cerebrovascular Syndrome
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The 3 specific exposure conditions that apply in dealing with radiation syndromes:
- Exposure must be acute (minutes)
- Total body or nearly total body exposure must occur
- Exposure must be from an external penetrating source rather than ingested, inhaled, or implanted radioactive sources
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What syndrome is induced by total body dose of 100-1000 cGy
Hematopoetic Syndrome
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Which syndrome has LD50/60 for humans is estimated to be between 350 and 450 cGy but varies with age, health, and gender; typically, females are more resistant than males and the extremely young and old tend to be a little more sensitive than middle-age persons?
Hematopoietic Syndrome
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Which radiation syndrome is the most likely to see?
Hematopoietic syndrome
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What is the depression of all blood cell counts, results in anemia, hemorrhaging and serious infection.
Pancytopenia
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No record exists of human survival when the total body dose exceeds what dose?
1000cGy
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Which syndrome is induced by total body dose between 1000 and 10,000 cGy
Gastrointestinal syndrome
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This syndrome may also be induced by a dose as low as 600cGy and overlaps with the cerebrovascular at doses of 5000cGy or more
Gastrointestinal Syndrome
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Which two syndromes overlap at doses of 5000cGy
Gastrointestinal & Cerebrovascular Syndrome
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Facts about the Hematopoetic Syndrome:
- Most patients receiving less than 300cGY will survive and eventually recover over 3-6 month period
- After 300-500 cGy death may occur in 4-6 weeks
- After 500-1000 cGy death is likely within 2 weeks
- No record exists of human survival when the total body dose exceeds 1000 cGy
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Which syndrome has the mean survival time 3 to 10 days or up to 2 weeks with medical support and is largely independent of the actual dose received; the prodromal stage occurs within hours after exposure and is charaçterized by nausea, vomiting, diarrhea and cramps
Gastrointestinal Syndrome
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Which syndrome death occurs during the second week exposure, occurs as a result of the damage to the gastrointestinal tract and bone marrow
Gastrointestinal Syndrome
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In Gastrointestinal syndrome, which organ is the most radio sensitive portion of the digestive system?
Small intestine
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Which syndrome is the occurs exclusively after doses of 10,000 cGy or more but can overlap with the gestational syndrome because it can be induced by a dose as low as 5000 cGy?
Cerebrovascular Syndrome (central nervous system syndrome)
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Which syndrome death after such high total-body occurs in several day or less; prodromal stage last only minutes to several hours and is characterized by nervousness, confusion, severe nausea and vomiting, loss of consciousness and burning sensation in the skin?
Cerebrovascular Syndrome
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What is the dose range for Hematopoietic syndrome
100-1000 cGy
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Which organ/system is damaged with Hematopoietic Syndrome
Bone marrow
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Which Syndrome has a recovery time that is dose dependent - 3 weeks to 6 months; some individuals do not survive?
Hematopoietic syndrome
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What is the dose range for Gastrointestinal syndrome?
1000-5000 cGy (which has NO recovery time)
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Which organ/system is damaged with Gastrointestional Syndrome
Small intestine
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What is the dose range for Cerebrovascular Syndrome
>5000 cGy (which has no recovery time)
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Which organ/system is damaged with Cerebrovascular Syndrome
Brain
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What does LD50/60 for humans in this dose range (450cGy) means:
Entire body Lethal Dose, 50% in 60 days will die
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With radiation exposure can developing _____ and _____ in utero.
Embryo and Fetus
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What radiation damage is manifested as lethal effects, congenital abnormalities present at birth or late effects observed years later?
Utero radiation damage
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What are the two effects of the response of the embryo and fetus that can be produced:
- Irradiation of the sperm or ovum before fertilization, thus resulting in inherited effects or
- Exposure of the fetus to radiation, thus resulting in congenital defects
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What are the newly formed ball of cells, then implanted in the uterine wall and begins the major organogensis stage?
Embryo
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What is at the end of the sixth week, and enters the fetal growth stage in which it continues to grow until birth?
Fetus
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At what fetal development stage is from day 10 to week 6?
Embryo
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*Note*
The maxium permissible dose to the fetus during the entire gestational period from occupational exposure of the mother should not exceed 0.5 rem (5 mSv), with monthly exposure not exceeding 0.05 rem (0.5 mSv)
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What are considered to be the most radiosensitive forms of animals and humans?
Embryo and fetus
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In regard to fetal effects of radiation, what are the principal factors of importance which is delivered?
The dose and the stage of gestation
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What is the time interval between irradiation and the appearance of a malignancy?
Latent period
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What are the two late effects
- Somatic effects
- Genetic effects
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What is the difference between somatic effects and genetic effects
- Somatic effects if the body cell are involved
- Genetic effects if reproductive (germ) cells are involved
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What is the most important late somatic effect induced by radiation is
Carcinogenesis
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What is therefore classified as a carcinogen, or cancer-causing agent?
Radiation
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What is considered to be an all or nothing event, which means that any does, no matter how low, has some potential of inducing cancer?
Carcinogenesis
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Cancer induction is therefore a non-threshold event with the probability of an effect increasing as the dose (decrease or increase)
Increase
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What is an example of a stochastic effect, in which every dose carries some magnitude of risk.
Carcinogenesis
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Radiation was first implicated as a cause of what
Leukemia
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The latent period induction by radiation is usually 4 to 7 years, with peak incidence approx 7 to 10 years after exposure.
Leukemia
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The first reported case of radiation induced skin cancer (which occurred on the hand of a radiologist)
Skin carcinoma
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*Note*
Because early x-ray machines were crude, radiologists placed their hands in the beam path to check its efficiency. This led to early skin changes (erythema) that were used to gauge the output of the beam, but skin tumors were observed years later in many of these individuals.
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What are squamous cell and basal cell carcinomas that have been the most frequently observed skin cancers following radiation exposure.
Skin Cancer
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What is the moast striking example of radiation-induced is given by the group of young female watch-dial painters who used radium to pain clock faces for a company in northern New Jersey from 1915 to 1930
Osteosarcoma (bone cancer)
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What carcinoma most miners suffer from this condition, mountain sickness?
Lung Carcinoma
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What is the naturrally occurring deposits of radioactive materials in the rocks of the earth decay through a long series of steps until they reach a stable isotope of lead.
Radon gas
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