2022 AAPM 64th Annual Meeting
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Session Title: Outcome-driven and Risk-adapted Personalized Treatment Planning
Question 1: Lymphomas are highly radiosensitive, and conventional dose constraints used in solid tumors can often not be used because:
Reference:Brodin NP, Maraldo MV, Aznar MC, Vogelius IR, Petersen PM, Bentzen SM, Specht L. An interactive decision-support tool for risk-based radiotherapy plan comparison for Hodgkin lymphoma. Int J Radiat Oncol Biol Phys 2014; 88: 433-45.
Choice A:There is little repair of radiation induced DNA damage in lymphoma cells.
Choice B:Lymphomas may be located anywhere in the body.
Choice C:The prescribed dose for the lymphoma is often below the conventional dose constraint.
Choice D:Indolent lymphoma cells undergo apoptosis when irradiated with small doses.
Question 2: During radiation therapy planning for lymphomas we need to consider:
Reference:Modiri A, Vogelius I, Rechner L, Nygård L, Bentzen SM, Specht L. Outcome-based multi-objective optimization of lymphoma radiation therapy plans. BJR 2021; 94: 20210303.
Choice A:The chance of curing the lymphoma
Choice B:The risks of serious side effects in each of the organs at risk close to the lymphoma
Choice C:The patient’s age and comorbidities
Choice D:All of the above
Question 3: What is the primary reason why outcome driven treatment planning (ODTP) has not yet been widely adopted?
Reference:Allen Li X, Alber M, Deasy JO, Jackson A, Ken Jee KW, Marks LB, Martel MK, Mayo C, Moiseenko V, Nahum AE, Niemierko A, Semenenko VA, Yorke ED. The use and QA of biologically related models for treatment planning: short report of the TG-166 of the therapy physics committee of the AAPM. Med Phys. 2012 Mar;39(3):1386-409. doi: 10.1118/1.3685447. PMID: 22380372.
Choice A:Most commercial treatment planning (TP) systems do not provide models for optimization but primarily/only for plan quality evaluation.
Choice B:Most commercial TP systems provide models for optimization and plan quality evaluation.
Choice C:Most commercial TP systems provide models neither for optimization nor plan quality evaluation.
Choice D:None of the above
Question 4: What's the most frequently considered model/cost function and in what range is it considered convex?
Reference:Choi B, Deasy JO. The generalized equivalent uniform dose function as a basis for intensity-modulated treatment planning. Phys Med Biol. 2002 Oct 21;47(20):3579-89. doi: 10.1088/0031-9155/47/20/302. PMID: 12433121.
Choice A:Mean dose for ≥5Gy
Choice B:gEUD for a≥-10
Choice C:Mean dose for ≥10Gy
Choice D:gEUD for a≥1
Question 5: What is the difference between an endpoint and a surrogate endpoint?
Reference:Anand IS, Florea VG, Fisher L. Surrogate end points in heart failure. J Am Coll Cardiol. 2002 May 1;39(9):1414-21. doi: 10.1016/s0735-1097(02)01773-4. PMID: 11985901.
Choice A:They differ in when they can be assessed.
Choice B:The former is of clinical importance to the patient, whereas the latter is a biological signature of the disease process.
Choice C:The assessment of the latter allows preventive action while the assessment of the former does not.
Choice D:All of the above.
Question 6: An effective approach to addressing cardiovascular toxicity in non-small cell lung cancer (NSCLC) survivors entails
Reference:Pérez-Callejo D, Torrente M, Brenes MA, Núñez B, Provencio M. Lung cancer as a cardiotoxic state: a review. Med Oncol. 2017 Aug 9;34(9):159. doi: 10.1007/s12032-017-1012-4. PMID: 28795306.
Choice A:Managing risk factors
Choice B:Monitoring for early signs of toxicity
Choice C:Coordinating patient management among the disciplines of oncology, cardiology, and primary care
Choice D:All of the above
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