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RadiationTherapy
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Most common histology of cervical ca:
Squamous cell
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Where are cervical ca lesions most likely to arise?
In the posterior lip of the cervix
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Clear cell carcinoma is linked to:
- DES
- women whose mothers used DES
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Cervical ca peak age:
50-60 yrs old
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3 common metastasis sites for cervical ca:
- lungs, bone, liver
- (hematogenous)
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Who sets the staging standards for GYN cancers?
- FIGO
- International Federation of Gynecology and Obstetrics
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T-is and T-1 pre-cancerous lesions of the cervix can be treated by:
Hysterectomy, Cryosurgery, Electrocautery & Laser vaporization
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Point A:
Dose significance?
Location?
- Associated with dose to uterus
- 2cm superior and 2cm lateral to external os
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Point B:
Dose significance?
Location?
- Associated with nodal dose
- 2cm superior and 5cm lateral to external os
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Cervical Ca FIGO Staging:
Carcinoma in situ
T-is
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Cervical Ca FIGO Staging:
Confined to cervix
- depth of invasion: 3mm or less
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What is the most radio-sensitive structure?
the Ovaries
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What is the most radio-resistant structure?
the Endocervix
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Cervical Ca FIGO Staging:
Confined to cervix
- depth of invasion: greater than 3mm
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Cervical Ca FIGO Staging:
Extension in to the vagina (upper 2/3)
- extension in to the vagina
T-2a
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Cervical Ca FIGO Staging:
Extension in to the vagina (upper 2/3)
- extension to the parametrium
T-2b
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Cervical Ca FIGO Staging:
Extension to the lower third vagina/parametrium/pelvic wall
- extension to the lower third of the vagina
T-3a
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Cervical Ca FIGO Staging:
Extension to the lower third vagina/parametrium/pelvic wall
- extension into parametrium & pelvic wall
T-3b
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Cervical Ca FIGO Staging:
Extension to bladder, rectum or beyond true pelvis
T-4
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What is the most common histology of ovarian ca?
Epithelial
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List four ways ovarian ca can spread?
- 1. Direct
- *2. Transcolemic (seeding)*
- 3. Lymphatic
- 4. Hematogenous (to liver & lungs)
*most common
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The main lymphatic drainage from the ovaries is into the:
Para-aortic lymph nodes
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The most common sites of metastasis from ovarian ca are?
Liver & lungs
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Overall 5yr survival rate for ovarian ca:
30%
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An elevated level of serum marker ________ may indicate ovarian cancer.
CA-125
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Edema of the abdomen:
"jelly-belly"
Ascites
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Use of the drug Tamoxifen can lead to:
Endometrial Ca
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Vaginal tumors are most often found:
on the posterior wall of the upper third of the vagina
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_______ cancer can spread along the surface of the uterine cavity.
Endometrial
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The most common histological type of endometrial ca:
Adenocarcinoma
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Overall 5yr survival rate for endometrial ca:
75%
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Vulvar ca in most common in the:
Labia majora
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The most common histological type of vulvar ca:
Squamous cell
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The most common histological type of vaginal ca:
Squamous cell
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Cervical Ca Tx:
Stage Ia1
- TAH w/ a small amount of vaginal tissue (vag cuff) or
- Tandem & Ovoid implant 45-55 Gy to point A
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Cervical Ca Tx:
Stage Ia2
- TAH w/ more vag tissue or
- Tandem & Ovoid implant to 70-80 Gy
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Cervical Ca Tx:
Stage Ib1 and IIa
- TAH
- RT (ext beam 45Gy and implant to 80-85Gy)
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Cervical Ca Tx:
Stage IIb - IV
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