2019 AAPM Annual Meeting
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Session Title: The Promise of FLASH
Question 1: When did the first report of ultra-high dose rates of electron radiotherapy causing hypoxia in normal tissue get published?
Reference:Vozenin M –C, Hendry JH, Limoli CL. Biological benefits of ultra-high dose rate FLASH radiotherapy: sleeping beauty awoken. Clin Onc 2019: (19)30151-7.
Choice A:1980s
Choice B:1990s
Choice C:2010s
Choice D:1970s
Question 2: What are some of the proposed mechanisms of action to explain the protective effect conferred to normal tissues by FLASH-RT from the Vozenin team?
Reference:Vozenin M –C, Hendry JH, Limoli CL. Biological benefits of ultra-high dose rate FLASH radiotherapy: sleeping beauty awoken. Clin Onc 2019: (19)30151-7.
Choice A:FLASH-RT potentially causes rapid, transient radiation-induced hypoxia.
Choice B:FLASH-RT preferentially spares normal tissues due to the differential oxygen tensions between tumor and normal tissues.
Choice C:FLASH-RT causes an instantaneous larger cascade of reactive species than conventional radiation which is metabolized more efficiently in normal tissues with lower pro-oxidant burdens than tumors.
Choice D:All of the above
Question 3: Which dosimeters were utilized to confirm FLASH-RT dosimetry by Vozenin et al?
Reference:Vozenin M-C, De Fornel P, Petersson K et al. The advantage of FLASH radiotherapy confirmed in mini-pig and cat-cancer patients. Clin Canc Res 2019: 25:35-42.
Choice A:TLDs
Choice B:Gafchromic film
Choice C:Alanine pellets
Choice D:All of the above
Question 4: Which one is the fundamental reason for normal tissue sparing when using FLASH proton therapy?
Reference:Harrington, Kevin J. "Ultrahigh dose-rate radiotherapy: Next steps for FLASH-RT." Clinical Cancer Research 25.1 (2019): 3-5.
Choice A:5Rs (Repair, Reoxytenation, Redistribution, Repopulation, Radiosensitivity)
Choice B:Immune response
Choice C:Patient motion
Choice D:Bragg Peak
Choice E:it is still unknown
Question 5: The major challenge of measuring ultra-high dose rate using an ion chamber is
Reference:Petersson, Kristoffer, et al. "High dose‐per‐pulse electron beam dosimetry—A model to correct for the ion recombination in the Advanced Markus ionization chamber." Medical physics 44.3 (2017): 1157-1167.
Choice A:Build-up insufficient
Choice B:Ion recombination correction
Choice C:TRS-398 protocol was not designed for FLASH dose calibration
Choice D:Induced secondary radiation
Question 6: The key challenge in using FLASH proton therapy is
Reference:Patriarca, Annalisa, et al. "Experimental set-up for FLASH proton irradiation of small animals using a clinical system." International Journal of Radiation Oncology* Biology* Physics 102.3 (2018): 619-626.
Choice A:Normal tissues in the beam path
Choice B:Size of the target volume
Choice C:Bragg Peak uncertainties
Choice D:All of the Above
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