Radiation Oncology In-service Exam Review: GI Cancers

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Radiation Oncology In-service exam review: GI cancers


Questions and Answers
  • 1. 
    Which major rectal cancer trial showed an overall survival benefit to pre-op radiation?
    • A. 

      German Rectal Cancer Trial (NEJM 2004)

    • B. 

      Dutch Colorectal Cancer Group (NEJM 2001)

    • C. 

      Swedish Rectal Cancer Trial (NEJM 1997)

    • D. 

      GITSG 7175

  • 2. 
    What is the treatment of choice for gastric MALT?
    • A. 

      Low dose RT alone

    • B. 

      Chemotherapy alone

    • C. 

      Antibiotics directed at H. pylori

    • D. 

      Surgical resection followed by chemoradiation

  • 3. 
    Via what drainage do rectal cancer metastases reach the liver?
    • A. 

      Superior rectal vein

    • B. 

      Inferior rectal vein

    • C. 

      Middle rectal vein

    • D. 

      Inferior mesenteric vein

  • 4. 
    What was the chemoradiation used in the pre-op arm of the German Rectal Cancer Study (NEJM 2004)?
    • A. 

      50.4 Gy with concurrent Xeloda

    • B. 

      50.4 Gy with a 5.4 Gy boost with concurrent 5-FU

    • C. 

      54 Gy with concurrent 5-FU

    • D. 

      50.4 Gy with concurrent 5-FU

    • E. 

      25 Gy in 5 fractions with concurrent 5-FU

  • 5. 
    What is the appropriate superior border of the PA field for a rectal cancer plan?
    • A. 

      L2-L3

    • B. 

      L5-S1

    • C. 

      L4-L5

    • D. 

      Top of obturator foramen

    • E. 

      L3-L4

  • 6. 
    What is the appropriate dosing of concurrent 5-FU when given with RT for rectal cancer?
    • A. 

      225 mg/m2 over 24 hours, 7 days per week during RT

    • B. 

      150 mg/m2 over 24 hours, 7 days per week during RT

    • C. 

      250 mg/m2 over 6 hours, 7 days per week during RT

    • D. 

      250 mg/m2 over 12 hours, 5 days per week during RT

    • E. 

      225 mg/m2 over 12 hours, 5 days per week during RT

  • 7. 
    Which of the following was a finding of the UKCCCR anal cancer trial working party (Lancet 1996?
    • A. 

      Chemoradation with 5-FU and mitomycin improved 3 year OS from 35 to 48% as compared to RT alone

    • B. 

      Chemoradiation with cisplatin and 5-FU improved LC from 36% to 59% as compared to RT alone

    • C. 

      Addition of post-op RT after surgery improved OS at 3 years from 35 to 48%

    • D. 

      Dose escalation from 45 Gy with 50.4 Gy improved LC from 36% to 59%

    • E. 

      Chemoradation with 5-FU and mitomycin improved 3 year LC from 36% to 59% as compared to RT alone

  • 8. 
    What is Courvoisier's sign?
    • A. 

      Palpable tumor nodule at the umbilicus

    • B. 

      Palpable gallbladder

    • C. 

      Migratory thrombophlebitis

    • D. 

      Palpable axillary lymphadenopathy

  • 9. 
    What was the randomization of the GITSG 91-73 trial for pancreatic cancer?
    • A. 

      Surgery alone vs surgery followed by chemoradiation with 54 Gy and concurrent 5-FU

    • B. 

      Definitive RT to 54 Gy versus Definitive CRT wtih 54 Gy and concurrent 5-FU

    • C. 

      Surgery alone vs surgery followed by chemoradiation with a 40 Gy split course followed by adjuvent gemcitabine

    • D. 

      Surgery alone vs surgery followed by chemoradiation with a 40 Gy split course and concurrent 5-FU

    • E. 

      Surgery alone vs surgery followed by radiation with a 40 Gy split course

  • 10. 
    What was a major finding of the GITSG 91-73 trial for pancreatic cancer?
    • A. 

      Addition of adjuvent CRT with 5-FU and 40 Gy split course to surgery improved 5 yr OS from 5% to 14% in resectable pancreatic cancer

    • B. 

      Addition of adjuvent CRT with 5-FU and 40 Gy split course to surgery improved 5 yr LC but had no effect on OS.

    • C. 

      Addition of adjuvent RT with a 40 Gy split course to surgery improved LC at 2 years from 22% to 43%

    • D. 

      Addition of adjuvent gemcitabine to defintive RT for pancreatic cancer improved 1 year LC from 18% to 32%

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