Escolar Documentos
Profissional Documentos
Cultura Documentos
Ashley Coffey
Demographics
White female
58 years old
No allergies
Diagnosed 2/5/2014
Social:
pack of cigarettes a day for 30 years (current)
4-5 drinks a week
Family History
Mother: hypertension and myocardial infarction
Father: myocardial infarction
Brother: melanoma
Paternal Grandmother: breast cancer
Diagnostic Workup
Original CT done at other location and suggested
transfer to OSUMC
Epidemiology
Lung cancer leading cause of cancer death in both
men and women
Etiology
Smoking or second hand smoke (98% Small Cell
CA patients have smoking history)
Asbestos
Iron ore
Radioactive ores
Coal products (Small Cell most common)
Isopropyl oil
Anatomy
Mediastinum
Lymph Nodes
Histopathology
Small cell
Most common to have mets (50-80% will met to
brain)
More common as central lesion
Carcinoid tumors
Mixed tumors
Treatment Plan
30 Gy at 300cGy in 10 fractions
Typical total is 60-65 Gy
Palliative treatment
Concurrent chemo: cisplatin and etoposide
6x on MXE
AP/PA field with reduced AP field
0 degrees- 165MU + 25MU
180 degrees- 169MU
SVC Syndrome
Obstructing the
Patient Setup
Supine
F head rest
Arms at side
Knee sponge
DVH
Coronal
Axial
Sagittal
AP DRRs
PA DRR
Side Effects
Acute:
esophagitis
fatigue
skin reactions
airway irritation
Nausea (from chemo)
decreased blood counts
Long-term:
radiation pneumonitis
lung and esophageal scarring
radiation-induced heart disease
spinal cord injury
radiation-induced malignancy
Prognosis
60-70% of small cell lung CA patients are staged
as extensive
Common Metastasis
Liver
Adrenal glands
Bone
Brain
References
American lung association. (n.d.). Retrieved from
http://www.lung.org/lung-disease/lung-cancer/
resources/facts-figures/lung-cancer-fact-sheet.html