Organisation of the Body
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Scale of cancer | show 🗑
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show | Differentiation is incomplete to some extent
Described in terms of tumour grade
Grade I - well differentiated
Grade III - poorly differentiated
Has prognostic value
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Stage of tumours | show 🗑
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show | Different cancers have different clinical outcomes
Judged by survival or progression free survival
Early stage cancers have the best prognosis whilst late stage cancers have the worst
Linked to treatment options
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show | Surgery 49% - can cure local cancers by removing the tumour
Radiotherapy 40% - large contribution
Chemotherapy 11% - relatively little use except in certain tumour types
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show | Detected by damage sensors e.g. ATM
Can lead to cell cycle arrest, DNA repair or apoptosis
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Ionising radiation | show 🗑
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show | A radioactive isotope of iodine used to treat thyroid cancer and hyper-thyroidism (Grave's disease)
Thyroid is a natural scavenger of iodine, so it concentrates in the thyroid gland
Repurposed for other purposes e.g. target CD20 receptors on B cells
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Brachytherapy | show 🗑
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show | 60% of patients receive this (alone or alongside chemo/surgery)
High energy X rays delivered with a linear accelerator
Localised against the tumour to avoid normal tissue
Patient is immobilised
Planning CT performed
Can be palliative or curative
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Linear accelerator | show 🗑
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show | Ionisation of water forces out electrons
The scattered photons then have an increased wavelength
Electron has a lower wavelength - depth of the effect is pronounced -
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Distribution of dose | show 🗑
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Organs at risk | show 🗑
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Beam modification - multi leaf collimation | show 🗑
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show | Thick end absorbs the beam more that the thin part
Alters dose distribution of the beam
Steepness of the wedge determines the change in beam characteristic
Dynamic wedges more common than manual wedges
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Gross tumour volume | show 🗑
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Clinical target volume | show 🗑
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Planning Target volume | show 🗑
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Immobilisation | show 🗑
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What does the level of immobilisation depend on | show 🗑
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show | Patient undergoes a CT wearing any immobilising structures
They are in the same position as they will be for the radiation - markers are placed on the patient to ensure the same position is used each time
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3D conformal radiotherapy - Planning | show 🗑
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3D conformal radiotherapy - process | show 🗑
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Work plan of radiotherapy | show 🗑
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Stereotactic radiotherapy | show 🗑
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Intensity modulated radiotherapy | show 🗑
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