Indian Journal of Cancer
Home  ICS  Feedback Subscribe Top cited articles Login 
Users Online :544
Small font sizeDefault font sizeIncrease font size
Navigate here
  Search
 
  
Resource links
   Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
   Article in PDF (230 KB)
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

 
  In this article

 Article Access Statistics
    Viewed140    
    Printed1    
    Emailed0    
    PDF Downloaded24    
    Comments [Add]    

Recommend this journal

 

  Table of Contents  
MCQS
Year : 2020  |  Volume : 57  |  Issue : 1  |  Page : 25-26
 

MCQs on “Stereotactic body radiation therapy for medically inoperable early stage lung cancer: Tata Memorial Hospital perspective and practice recommendations”


1 Department of Medical Oncology and Hemato-oncology, Narayana Superspeciality Hospital, Gurugram, Haryana, India
2 Department of Radiation Oncology, Artemis Hospital, Gurugram, Haryana, India
3 Department of Surgical Oncology, Command Hospital, Bengaluru, Karnataka, India

Date of Submission28-Nov-2019
Date of Decision02-Dec-2019
Date of Acceptance11-Dec-2019
Date of Web Publication26-Feb-2020

Correspondence Address:
H S Darling
Department of Medical Oncology and Hemato-oncology, Narayana Superspeciality Hospital, Gurugram, Haryana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijc.IJC_1019_19

Rights and Permissions



How to cite this article:
Darling H S, Jayalakshmi S, Jaiswal P. MCQs on “Stereotactic body radiation therapy for medically inoperable early stage lung cancer: Tata Memorial Hospital perspective and practice recommendations”. Indian J Cancer 2020;57:25-6

How to cite this URL:
Darling H S, Jayalakshmi S, Jaiswal P. MCQs on “Stereotactic body radiation therapy for medically inoperable early stage lung cancer: Tata Memorial Hospital perspective and practice recommendations”. Indian J Cancer [serial online] 2020 [cited 2020 Mar 30];57:25-6. Available from: http://www.indianjcancer.com/text.asp?2020/57/1/25/279166


Q 1: Surgical resection is the standard treatment for early-stage non-small-cell lung carcinoma (NSCLC), even then 20% of the patients do not undergo surgery because

  1. They prefer the nonsurgical option
  2. They are unfit for surgery
  3. Surgery has no survival advantage
  4. The tumors are nonresectable


Q 2: Stereotactic body radiotherapy (SBRT) is characterized by

  1. Smaller number of fractions and bigger dose per fraction
  2. Bigger number of fractions and same dose per fraction
  3. Same dose as a conventional fraction but added stereotaxy
  4. Bigger number of fractions and low dose per fraction


Q 3: Which of the following does not clearly define the inclusion criteria for this study:

  1. No prior radiotherapy to the site of stereotactic body radiotherapy
  2. Nonmetastatic disease
  3. Karnofsky performance status >60%
  4. Histologically proven lung carcinoma


Q 4: On multivariate analysis in this study, which factors were prognostic indicators of overall and cancer-specific survival: (i) Tumor diameter >3.8 cm, (ii) histology, (iii) Charlson Comorbidity Index >3, and (iv) Planning Target value >80.6 CC

  1. (i) and (iii)
  2. (ii) and (iv)
  3. (iii) and (iv)
  4. (i) and (ii)


Q 5: The most common pattern of failure was

  1. Local failure
  2. Isolated nodal failures
  3. Locoregional
  4. Distant metastases


Q 6: The most common late toxicity observed in this study was

  1. Radiation pneumonitis
  2. Skin erythema
  3. Grade I esophagitis
  4. Exacerbation of chronic obstructive pulmonary disease (COPD)


Q 7: Patients were rendered inoperable in this study, most commonly because of

  1. Low body mass index (BMI)
  2. Coexisting infections
  3. COPD
  4. Poor cardiac function


Q 8: A patient had a 4 cm peripheral adenocarcinoma in the right lower lobe, which was treated with SBRT as per the study protocol. After 9 months of treatment completion, he developed a 2 cm lesion in the same lobe 1.5 cm away from the previous tumor site. If histologically proven to be adenocarcinoma, what kind of disease it will be, as per the study protocol

  1. Second primary
  2. Local failure
  3. Distant relapse
  4. Regional failure


Q 9: Majority of deaths in study patients were

  1. Treatment related
  2. Cancer related
  3. Comorbidity related
  4. Not reported


Q 10: The proposed reason for the least 2-year overall survival in this study as compared with six more similar studies quoted in this article, is

  1. Higher T stage
  2. Inexperienced staff
  3. Poor radiation techniques
  4. Overall survival is not the primary end-point.


Answers and explanations:

1 (b). They are unfit for surgery

“However, about 20% of the patients with stage I lung cancer do not undergo surgery owing to the poor lung, cardiac function, and perceived higher risk of mortality with surgery and frailty especially in elderly patients.”

2 (a). Smaller number of fractions and bigger dose per fraction

“For the first 20 patients (treatment year group: 2007–2012), commonly used dose fractionation for peripheral tumors was 48 Gy/6 fr (8 Gy/fr) and for central tumors was 48 Gy/8fr (6 Gy/fr). The dose was escalated for small peripheral tumors; they received 48 Gy/4 fr (12 Gy/fr).”

3 (d). Histologically proven lung carcinoma

“The tumor was histologically proven squamous or adenocarcinoma of the lung.”

4 (c). (iii) and (iv)

“On multivariate analysis, CCI >3 and PTV >80.6 remained as independent predictors of overall survival and CSS.”

5 (d). Distant metastases

“Distant failure constituted the main site of relapse, seen in 12/15 (80%) patients.”

6 (a). Radiation pneumonitis

“Grade 2 or more radiation pneumonitis, seen in 7 (17.5%) patients was the most common late toxicity.”

7 (c). COPD

“Chronic obstructive pulmonary disease was the most common cause of inoperability.”

8 (b). Local failure

“Local failure was defined as tumor progression at the irradiated site, within 2 cm of the gross tumor volume.”

9 (c). Comorbidity related

“Sixty percent of the deaths in this cohort was not due to cancer but worsening of pre-existing cardiac or respiratory diseases.”

10 (a). Higher T stage

“An advanced stage and higher CCI (>3) in more than one-third of the patients explains the lower OS in the current series.”






 

Top
Print this article  Email this article
 

    

  Site Map | What's new | Copyright and Disclaimer
  Online since 1st April '07
  2007 - Indian Journal of Cancer | Published by Wolters Kluwer - Medknow