Principles of Radiation Oncology

2.13.1 What are the effects of radiation on a cellular/molecular level?

2.13.2 Discuss the 4 "Rs" of radiation therapy: Reassortment/Redistribution, Repair, Regeneration, and Reoxygenation.

2.13.3 Discuss the differences between Brachytherapy, Conventional Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT).

2.13.4 Discuss the Compton Effect as it applies to radiation therapy.

2.13.5 How do dose-response curves differ for radiosensitive and radioresistant tumors? Explain the therapeutic ratio as it applies to radiation therapy.

2.13.6 Name some commonly utilized radiosensitizers and radioprotectors.

2.13.7 What are the commonly used doses (Gy) for primary radiation of the head and neck? Adjuvant radiation doses?

2.13.8 What is fractionation? Describe the typical schedule used in treatment of H&N cancer. Are hyperfractionation and/or accelerated fractionation schedules “superior”?

2.13.9 What are the complications of primary radiation therapy? What are the acute and late effects of radiation therapy.

2.13.10 What is the management of acute mucositis? Late/chronic xerostomia?

2.13.11 Why are dental care and oral hygiene important in patients receiving radiation therapy to the H&N?

2.13.12 What are the indications for adjuvant radiation for laryngeal cancer? For node-positive regional metastatic disease? For salivary gland malignancy?

2.13.13 What are some absolute and relative contraindications to radiation therapy?

2.13.14 What is intensity modulated radiation therapy (IMRT)? What are its proposed benefits as compared to "conventional" radiotherapy?

Lee N, Puri DR, Blanco AI, Chao KS. Intensity-modulated radiation therapy in head and neck cancers: an update. Head Neck. 2007 Apr;29(4):387-400. PMID:16358297

2.13.15 What are the different types of “particle radiation”? What are the advantages and relative indications of each?

Mendenhall NP, Malyapa RS, Su Z, Yeung D, Mendenhall WM, Li Z. Proton therapy for head and neck cancer: rationale, potential indications, practical considerations, and current clinical evidence. Acta Oncol. 2011 Aug;50(6):763-71. PMID:21767172

2.13.16 What is the maximum size of a neck node, whereby radiation is still likely to produce primarily control (support this with literature).

2.13.17 What is Radiosurgery and what are its current applications to head and neck cancers?

2.13.18 What is the rationale for waiting 6 weeks after surgery to start radiation?