| Question 1: Current adaptive radiotherapy reacts to changes based on any of the following except: |
| Reference: | Sonke JJ, Aznar M, and Rasch C. Adaptive Radiotherapy for Anatomical Change. Semin Radiat Oncol; 29(3):245-257, 2019 |
| Choice A: | Changes in patient position |
| Choice B: | Changes in the size of the treated tumor |
| Choice C: | Changes in the position of normal structures |
| Choice D: | Changes in incident beam energy |
| Question 2: Potential advantages of PULSAR include all of the following except: |
| Reference: | The presentation |
| Choice A: | Reduced toxicity compared to a typical daily or qod SAbR course |
| Choice B: | Greater opportunity for meaningful adaptation with long intervals between pulses |
| Choice C: | Fostering of improved immune response and combination immunotherapy |
| Choice D: | Ideal gating of treatment with the cardiac cycle |
| Question 3: Interrogations possibly triggering adaption of the next pulse used in PULSAR potentially include any of the following except: |
| Reference: | The presentation |
| Choice A: | Immune signaling |
| Choice B: | New metastatic progression |
| Choice C: | Functional imaging of oxygenation |
| Choice D: | None of the adaptations currently used for conventionally fractionated adaptive radiotherapy |
| Question 4: Which of the statements about plan dose prediction in 4Pi therapy is false? |
| Reference: | Angelia Landers, Daniel O’Connor, Dan Ruan, Ke Sheng, Automated 4π radiotherapy treatment planning with evolving knowledge‐base Med. Phys. 46 (9), 0094-2405 |
| Choice A: | 4π dose for a new patient can be predicted based on existing manually tuned 4π plans. |
| Choice B: | 4π plans cannot be predicted based on coplanar VMAT plans. |
| Choice C: | The dose prediction methods for coplanar plans cannot be applied to the 4π plan prediction. |
| Choice D: | 4π plans can be fully automated. |
| Question 5: There is some evidence that the underlaying biological mechanisms in SFRT are: |
| Reference: | the presentation |
| Choice A: | Bystander effects |
| Choice B: | Immune modulation |
| Choice C: | Differential vascular effects between the tumor and normal tissues |
| Choice D: | all the above |
| Question 6: Spatially fractionated radiation therapy (SFRT) differs significantly from conventional seamless radiation therapy in terms of |
| Reference: | Griffin R. et al Understanding High-Dose, Ultra-high Dose-Rate and Spatially fractionated radiotherapy Int. J of radiation oncology, biology, physics; 107(4), p766, 2020 |
| Choice A: | Treatment prescription total dose |
| Choice B: | Radiation dose spatial distribution |
| Choice C: | Radiation temporal fractionation |
| Choice D: | all of above |
| Question 7: Which of the following statements is correct in terms of temporal fractionation in spatially fractionated radiation therapy (SFRT): |
| Reference: | The presentation |
| Choice A: | Clinically, a single fraction of SFRT treatment followed by a course of conventional RT is commonly used |
| Choice B: | Preclinically, a single fraction of SFRT treatment alone is used |
| Choice C: | a&b |
| Choice D: | None of above |
| Question 8: Peak dose has been used to prescribe spatially fractionated radiation therapy because it has been demonstrated to be closely associated with |
| Reference: | The presentation |
| Choice A: | Treatment tumor control |
| Choice B: | Treatment toxicity |
| Choice C: | a&b |
| Choice D: | Historical reasons |
| Question 9: Which of the following SFRT dosimetric parameters have shown the best correlation with tumor control in animal spatially fractionated radiation therapy studies? |
| Reference: | The presentation |
| Choice A: | Peak dose |
| Choice B: | Peak dose to valley dose ratio |
| Choice C: | Volume average dose |
| Choice D: | Valley dose |
| Question 10: Which of the following is not a major roadblock in the clinical implementation of 4p non-coplanar therapy? |
| Reference: | Daniel O'Connor, Victoria Yu, Dan Nguyen, Dan Ruan and Ke Sheng 2018 Fraction-variant beam orientation optimization for non-coplanar IMRT Phys. Med. Biol. 63 045015 |
| Choice A: | The lack of planning algorithms to effectively use the non-coplanar beam space |
| Choice B: | Cumbersome clinical linacs that are slow and prone to collision |
| Choice C: | Unclear achievable dosimetry with 4π planning |
| Choice D: | Concerns about the integral dose |
