What is the rationale for combining chemotherapy and radiotherapy? What are the side-effects of such combined therapies

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What is the rationale for combining chemotherapy and radiotherapy? What are the
side-effects of such combined therapies? 2 Define Knudson’s ‘two-hit’ hypothesis. To
which broad class of cancer-associated genes does it refer? Illustrate your answer with
reference to a tumour type to which it is relevant.
Clinical Radiobiology – Previous Examination Papers
3 Overall treatment time has long been recognised as a determinant of the outcome of
radiotherapy. Discuss the evidence supporting this statement and describe the resulting
clinical approaches/endeavours designed to address the problem.
4 A 70-year-old lady with metastatic melanoma is being treated with radiation therapy to
her left thigh for multiple subcutaneous deposits of melanoma. The treatment schedule
is 6 Gy per fraction, 2 fractions per week for a total of 6 fractions over a 3-week period
with orthovoltage energy. Assume all relevant late reacting tissues have an alpha/beta
of 2 and acute reacting tissues and tumour a value of 10. Calculate the BED
(biologically effective dose). How should the patient be counselled on the potential
disadvantages of this fractionation compared with standard fractionation of 36 Gy in
18 fractions over 25 days? Give an account of the radiobiology of late radiation toxicity
in the skin.
5 Write short notes on any three of the following:
a) Molecular aspects of apopotsis
b) Cisplatin radiosensitisation
c) The comet assay, including the biological endpoints it can measure
d) Radiation retinopathy

 

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