Bentel Treatment Planning

Linear accelerators produce high energy beams by accelerating _________ in a _________.

Insertion of aluminum, copper & tin filters into the x-ray beam causes:

Radiation therapy units operating at approx 50-120 kVp are:

Orthovoltage units usually operate in the energy range of:

The penumbra of a linac is ________ than that of a cobalt 60 machine.

A flattening filter reduces the _________ in the center of the beam.

The _________ beam from a linac is intercepted by ionization chambers and a flattening filter.

The secondary collimator of a linac is largely responsible for the _________ of the beam edges.

BSF is independent of _________ but depends on _________ and _________.

Dose rates in air express the dose measured without a _________ and with a _________ at a given distance.

Dose rates ________ with increased field size and

Dose rates _________ with increased distance.

PDD is dependent on:
(3)

Penumbra will __________ with increased SSD, decreased SCD, and increased source size.

The PDD at a given depth ________ with higher beam energies.

The amount of backscatter ________ with lower beam energies.

The depth of Dmax for any photon beam is reduced by ________ field sizes and ________ incidence.

In an electron beam, the ________ isodose curve bulges out and the ________ isodose curve constricts.

When POP 6mV photon beams are used in a 20 cm thick patient, the maximum dose will occur at the:

The three planes in a patient are across the body, along the body in a lateral view and along the body in an anterior view. What is each one named?

The most commonly used energies to treat H&N cancer are:

When carcinoma of the oropharynx is treated, the field junction between opposed lateral and an inferior field should be set _________ of the thyroid notch.

To include the entire maxillary sinus without including the eye when the patient is treated for maxillary sinus tumor, the chin is _________ and the head _________.

Wedges are _________ (always/never) needed when treating true vocal cord tumors.

Early vocal cord tumors w/ normal mobility are cured by XRT alone in about ____% of cases.

Retinomblastoma is a tumor of the eye that usually occurs in _________.

The most common of all intracranial malignancies is:

When adjacent fields are matched, it is more important to match the ________ precisely during a given treatment than to reproduce the ________.

To appreciate the position of the the eyes relative to the beam a radiopaque marker is placed on the ________ of each eye.

Dose heterogeneities within the brain when opposed lateral fields are used are increased when ________(lower/higher) energy photon beams are used.

To minimize the divergence into the eye on the opposite side, when treating a brain through opposed lateral fields, the beam is centered at the _____________ of the eye.

A vertex field is difficult to treat because the ________ and the ________ must be turned.

When the entire spinal axis must be treated, the patient's posterior surface should be as flat as possible to ____________.

Lateral brain fields and a posterior spinal field are matched by turning the ________ and the ________ when treating the laterals.

When a 3 field (vertex and opposed lats) is uswe to treat a pituitary lesion wedges are used in the ________ field(s).

The disadvantage of a vertex field is that it often exits in the ________ and the ________.

Of all childhood brain tumors, medulloblastoma represents about ____%.

The gross palpable extent and location of malignant growth:

The tissue volume that contains the GTV and subclinical microscopic malignant disease:

Contains the tumor and adjacent tissues:

The dose at a point that has been "forced" to 100%

What is the ratio of the absorbed dose at a given depth to the absorbed dose at a fixed reference point, usually D_max ?

What is the ratio of the absorbed dose at a given depth in tissue to the dose at the same point when it is at D_max ?

The ratio of dose on the central axis at Dmax to the dose at the same point in air is know as the __________.

Treatment fields should always be shaped so that the beam edge crosses ___________ to the spinal cord.

The attenuation of Cerrobend is about _______ less than lead.

What is make-up of Cerrobend?
(percentage of each material)

The frequency of port films varies, but they should always be taken on the _______ day of treatment.

In a typical CSI setup, to avoid having the caudal margin of the lateral brain fields diverge into the cephalad aspect of the posterior spinal field, the foot of the couch is turned:

The most commonly occurring cancer in the US is ________ cancer.

Opposed anterior and posterior fields in the chest invariably causes a higher dose near the _________ margin than at the ___________.

A lung boost is often delivered via:

Tumors in the lower two-thirds of the esophagus can be boosted via a _______ and two _________ oblique fields.

In setting up opposed oblique boost fields to treat a lung tumor it is important to know the isocenter _________ in each field.

The regional lymph nodes in breast cancer are the:
(3)

In most breast treatment techniques, field matching is a problem between the ______ & _______ fields and the ________ & ________ fields.

To avoid beam divergence from the tangential fields into the supraclavicular field, the foot of the couch is turned (kicked) ________ from the collimator/gantry.

The couch angle necessary to avoid beam divergence from the tangential fields into the supraclavicular field depends on the ________ of the _________ field in the direction of the supraclavicular field and the ________.

To avoid beam divergence into the lung by the tangential fields, the central axes of the tangential fields can be separated by slightly more than ______ until the deep margins become _________.

A boost is sometimes delivered to the tumor bed in breast cancer using a _________ beam or an interstitial implant.

The __________ lymph nodes are sometimes treated in a separate field using a photon and an electron beam or are included in the tangentials.

________ toxicity from breast irradiation is sometimes a serious problem.

The most important considerations to avoid radiation-induced pneumonitis are:
(3)

What is the most common type of glioma?

What are the average stats for a generic whole brain treatment?

(field size, dose, energy, fractions)

What are the borders of a generic whole brain set-up?

Which type of CNS malignancy represents approx 20% of all primary brain tumors and are considered to be benign in overall nature, but locally malignant?

The gantry angles for tangent fields are usually separated by _______°.

When treating the supraclavicular LN of a breast cancer patient, the gantry is angled _____° away from the side of the cancer.

The Abdomen is defined as the portion of the body that lies between the _______ & the ________ and that contains the __________.

Generally speaking, the kidney tolerance dose to irradiation in the adult is:

The cephalad margin of a whole abdomen irradiation field should be set at the ________ aspect of the ___________ during quiet breathing.

The radioisotope _________ is sometime administered intraperitoneally in the treatment of gynecologic malignancies.

The most common site of pancreatic tumors is the ______ of the pancreas.

Wilms' tumor is a tumor originating in the _______.

Neuroblastoma is a tumor most often originating in the __________.

To reduce the volume of __________ within a pelvic field, the patient's position could be prone on a belly board.

The primary purpose of a testicular shield is to reduce the amount of _________ dose in the testes.

Of gynecological tumors treated with radiation therapy, the most common type is:

The depth of the deep inguinal nodes can vary from _____ to _____cm depending on the patient's size.

Dose rates _________ with field size.
(increase or decrease)

In the case of a patient that is unlikely to complete treatment, how should kidney shielding be accomplished?

The dose under a 5-HVT kidney block is approximately ______ to ______% of the dose delivered at mid-depth on the central axis.

The amount of dose under a 5-HVT kidney block depends on the beam ________, the size of the _______, and the size of the ________.

The organs in which normal tissue tolerance is of concerns when treating pancreatic tumors are:
(3)

When a three field technique (anterior and lateral opposed fields) is used in the treatment of pancreatic tumors, the best dose distribution is achieved with wedge(s) in the ________ field(s) and more weighting on the ________ field(s).

When children are treated for Wilms' tumor, the medial field margin should be include the __________.

What are three methods to reduce the volume of small bowel in the pelvis?

How much of the kidney should be excluded from the treatment field in order to preserve proper function?

When patients with advanced cervical carcinoma are treated, the majority is delivered via ________ with ________ as a possible boost.

A ____________ is sometimes used in the treatment of opposed anterior and posterior fields following intra-cavitary irradiation to protect the bladder, rectum, and tissues irradiated to a high dose via the intra-cavitary implant

In a four-field box technique used to treat a prostate tumor, the best rectal and bladder protection is achieved through ___________

The skin reaction between the buttocks is reduced when a rectal carcinoma patient is treated in the ___________ position.

Due to the dome-like shape of the diaphragm in the anterior-posterior view, it is impossible to treat the entire abdominal cavity without also including some volume of ________ and _________.

Insertion of a 1-HVT block in both fields during the entire course of treatment would deliver approx ______ of the dose in the shielded organs and the dose distribution under the shields would be similar to that of using ______ shields only during a portion of the treatment.

What are the three methods of kidney blocking?

For small bowel contrast during simulation of a four-field pelvic plan, the patient should drink the barium _______ prior to the simulation.

The 10-year survival for patients with all stages of Hodgkin's disease is approximately:

The patient position for treatment of a mantle field in Hodgkin's disease is usually supine with the ________ extended and the arms __________.

It is always important to align the patient with the ________ laser every day because if it is not, the field is rotated with respect to the patient's body.

Tattoos made in the patient's skin indicating irradiated areas can shift due to _______ and ________.

The advantages of ________ therapy are that it provides superior normal-tissue sparing and improved precision.

High- and low- dose total body irradiation is used in the preparation for a _________ and in the treatment of ____________.

The most common position for patients receiving total-skin electron irradiation is ___________.

The main goal of radiation therapy in patients with bone metastasis is to prevent ________ and reduce _________.

In patients treated for a spinal cord compression, the treatment field should include approximately two ____________ in each direction beyond demonstrable disease.

Which 6 cancers commonly metastasize to the inguinal nodes?

Total skin electron irradiation (TSEI) is often used in the treatment of cutaneous diseases such as ________ and _________, where a high dose is needed in the first centimeter of tissue over the entire body while the underlying tissues are spared.

The total dose prescribed for TSEI treatment of mycosis fungoides is ________ and typically ____ to ____ electron beam energies are used in order to limit the amount of _________.

What are the most common sites for bony metastases?
(4)

________ lesions, which appear on x-rays as a less dense area in a bone, are most frequently associated with __________ or metastasis from malignant disease in breasts, kidneys, or the thyroid gland.

___________ lesions, areas that appear denser than bone on an x-ray, are often metastatic from the breasts, prostate gland, or Hodgkin's disease.

When a patient requires half-body treatment but the necessary distance cannot be achieved, one can turn the collimator _____° taking advantage of the diagonal direction of the field or angle the _______ a few degrees.

______ ______ photon fields can be used to spare underlying lung tissue when treating rib metastasis.

What is the average depth of the spinal cord?

To assure inclusion of the palpable lymph nodes within the xrt field, the lymph nodes should be indicated with __________ during the simulation procedure.

The average dose and fractionation schedule for multifocal brain metastasis treatment is _____ cGy in ____ week
or
_____ cGy in ____ weeks

A __________ technique is usually the preferred field arrangement when treating bladder tumors.

When a posterior and opposed lateral fields with wedges are used to treat a rectal tumor, to reduce the hot spot under the thin portion of the wedges, one can _________  (increase/decrease) the weight on the lateral fields and ________________.

The gap between the mantle & para-aortic fields, assuming the same field length and SAD, is calculated and set correctly if the patient is in the same position and the _________ border of the posterior para-aortic field coincides with the marker indicating the _________ border of the anterior mantle field.

The most serious late consequence of high-dose TBI is __________ but thrombocytopenia occurs after _____ to _____ cGy.

When higher energy beams are not available to treat a prostate, heavier weight should be placed on the _________ & _________ fields.

Lesions in the lower 1/3 of the vagina require that the _______ and _______ lymph nodes be treated.

Name the types of bone marrow transplant:
1. Marrow is removed from the patient during remission and re-infused after the treatment regimen is completed.
2. Marrow is removed from a sibling who is immunologically compatible with the patient.
3. Marrow is removed from an identical twin

What does DICOM stand for?

Factors to consider in deciding btw an SSD or SAD technique are: 
1. the importance of ________ in the particular patient
2. the amount of _____ delivered through the field
3. the actual _______ between the collimator and the patient's skin surface.

Where is Point A located?

(gyn brachy)

Where is Point B located?

(gyn brachy)

In a CT simulator, the window level influences the __________ of an image.

In a CT simulator, the window width influences the __________ of the image.

CT's operate in the energy range of _____ to _____ kev and are highly collimated.

Positron emission tomography utilizes beta ______ decay.

Nuclear medicine utilizes beta _______ decay.

Patients are not to eat for ____ hours prior to a PET/CT.

An off axis point is any point not on the ____________. The off axis point is used as a __________ point to tell the Dr what the dosage and effect on the tissue at that point will be as well as to find the __________.

What is the typical width of spinal cord fields?

The staging system for Hodgkin's disease is the __________ system.

A _______________ is a computer generated 2D radiograph displaying skeletal anatomy rendered from a three dimensional data set, such as CT or MRI.

Wilm's tumor, which is primarily a tumor of the kidney (peds), has been know to metastasize to the ______ which requires ___________ treatments.

Lymph nodes above the diaphragm treated in a typical Mantle field:
(6)

Lymph nodes below the diaphragm treated in a typical Hodgkin's:

In the Paris system, the reference dose is ____% of the basal dose.

The radioactive source used in a tandem and ovoid apparatus usually is _________ and is frequently in the shape of __________.

In which of the following situations is the use of a tandem and ovoid least useful?
A.  Pt has undergone radical hysterectomy for squamous cell ca of the cervix & now has a recurrence in the vaginal apex
B.  Pt has undergone a supracervical hysterectomy & now has a recurrence in the cervical stump
C.  Pt has large exophytic lesion in the cervix extending into the vaginal apex

Ophthalmic plaques can be constructed for use with:
A. Cobalt 60
B. Iodine 125
C. Ruthenium 106
D. Iridium 192
E. All of the above

High-activity iodine 125 seed (40mCi/seed) are frequently used in ________ implants.

To produce approximately the same dose rate on the surface of an ovoid, the source activity must be ________ as the ovoid diameter increases.

The isotope most frequently used in nasopharyngeal implants is:
A. Gold 198
B. Strontium 90
C. Cesium 137
D. Iodine 125

The use of intraluminal implants has been described for various sites except for the:
A. Esophagus
B. Bronchus
C. Biliary Duct
D. Duodenum

The tissue to air ratio (TAR) at Dmax is also known as the _________.

Identify & describe each whole brain set-up (including borders)

The _______ is defined as the ratio of dose at a specified point in tissue (or in a phantom) to the dose at the same distance in the beam at a reference depth, usually 5 cm.

When using a vertex field to treat a pituitary lesion, the neck must be __________ or the if the head is to remain neutral, the gantry must be angled and the couch turned _____°.

What is a common treatment technique of pituitary lesions?

When treating a maxillary antrum tumor, a bite block can be used to:

In a fixed SSD technique, the dose is usually normalized (or weighted) at ________. 

In an isocentric technique, the dose is usually normalized (or weighted) at _________.

Dose rates ________ with increased field size & ________ with increased distance.

Name that fractionation:
Irradiating a patient twice daily with a smaller than normal daily dose, making it possible to deliver 15-20% more dose over the same period of time.

Name that fractionation:
Delivering the same or a higher dose over a shorter period of time or in fewer fractions.