2019 AAPM Annual Meeting
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Session Title: Contemporary Pediatric Radiation Therapy: Perspectives from Children's Oncology Group
Question 1: What is the abscopal effect?
Reference:Yilmaz MT, Elmali A, Yazici G. Abscopal effect, from myth to reality: from radiation oncologists' perspective. Cureus. 2019 Jan 9;11(1):e3860.
Choice A:An immune-mediated killing of tumor cells
Choice B:A lung toxicity syndrome seen after TBI
Choice C:The synergistic activity of radiation combined with Cytoxan
Choice D:Hyperthermia after anesthesia for children receiving radiotherapy
Question 2: In what childhood tumor has SBRT been most frequently used?
Reference:Brown LC, Lester RA, Grams MP, Haddock MG, Olivier KR, Arndt CA, Rose PS, Laack NN. Stereotactic body radiotherapy for metastatic and recurrent Ewing sarcoma and osteosarcoma. Sarcoma 2014:Article ID 418270.
Choice A:Wilms tumor
Choice B:Neuroblastoma
Choice C:Ewing sarcoma
Choice D:Craniopharyngioma
Question 3: Which of the following is true regarding lung doses in TBI?
Reference:Esiashvili N, Lu X, Ulin K, Laurie F, Kessel S, Kalapurakal JA, Merchant TE, Followill DS, Sathiaseelan V, Schmitter MK, Devidas M, Chen Y, Wall DA, Brown PA, Hunger SP, Grupp SA, Pulsipher MA. Higher reported lung dose received during total body irradiation for allogeneic hematopoietic stem cell transplantation in children with acute lymphoblastic leukemia is associated with inferior survival: a report from the Children's Oncology Group. Int J Radiat Oncol Biol Phys. 2019 Feb 23. pii: S0360-3016 19 30266-4.
Choice A:Lung dose calculation is uniform across institutions.
Choice B:Lung doses ≤ 800 cGy is safe and does not seem to increase relapse.
Choice C:Lateral fields is associated with lower lung doses.
Choice D:AP/PA technique is associated with higher lung doses.
Choice E:There is no association between lung doses and treatment outcome.
Question 4: Craniospinal irradiation (CSI) is a challenging technique because
Reference:Fogliata A, et al. Cranio-spinal irradiation with volumetric modulated arc therapy: a multi-institutional treatment experience. Radiother Oncol 2011 Apr;99(1):79-85.
Choice A:of the length of treatment and its inherent junctions.
Choice B:IMRT have to be used.
Choice C:children have to be treated.
Choice D:CT scan of the entire target cannot be obtained.
Choice E:All of the above.
Question 5: Prescription dose for whole lung irradiation for Wilms tumors:
Reference:D'Angio GJ, Breslow NE, Beckwith JB et al. The treatment of Wilms tumor: Results of the Third National Wilms Tumor Study Cancer 1989; 64: 349-360.
Choice A:12 Gy at 1.5 Gy per fraction
Choice B:15 Gy at 1.5 Gy per fraction
Choice C:12.6 Gy at 1.8 Gy per fraction
Choice D:None of the above
Question 6: PTV definition for Cardiac-Sparing IMRT:
Reference:Kalapurakal J, et al. Cardiac-sparing whole lung IMRT in patients with pediatric tumors and lung metastasis: final report of a prospective multicenter clinical trial. Int J Radiat Oncol Biol Phys 103(1):28-37, 2019.
Choice A:PTV = CTV + 5mm
Choice B:PTV = CTV + 1cm
Choice C:PTV = MLE CTV+ 5mm
Choice D:None of the above
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