What is Chemotherapy?
Systemic anti-cancer treatment using cytotoxic drugs to kill or inhibit rapidly dividing cells. Can be curative, adjuvant (post-surgery), neoadjuvant (pre-surgery), or palliative.
Key Chemotherapy Drugs for Radiotherapists
- Cisplatin – radiosensitiser used in H&N, cervix, oesophagus
- Carboplatin – used in lung, brain, cervix
- Capecitabine – oral prodrug of 5-FU, used in GI cancers
- 5-FU (Fluorouracil) – radiosensitiser in rectal, anal, oesophageal cancers
- Temozolomide – used with RT in glioblastoma
How does chemotherapy affect radiotherapy scheduling and daily workload?
- RT must align precisely with chemo cycles (especially concurrent regimens)
- Side effects like neutropenia or mucositis may delay RT or require breaks
- Increased toxicity monitoring and MDT coordination impacts daily workload
Symptoms of Sepsis
- Fever or low temperature
- Fast heart rate and breathing
- Confusion or altered mental state
- Low blood pressure
- Reduced urine output
- Mottled or cyanotic skin
If Suspected
- Escalate immediately — it’s an oncology emergency
- Initiate Sepsis 6: oxygen, blood cultures, IV antibiotics, IV fluids, lactate check, urine output monitoring
- Inform CNS or medical team urgently
How is sepsis treated?
- Broad-spectrum IV antibiotics
- IV fluids to support circulation
- Source control (e.g. drain abscess)
- ICU support if unstable
What is the typical treatment regimen for Small Cell Lung Cancer (SCLC)
- Chemotherapy (cisplatin + etoposide) with concurrent thoracic RT
- Prophylactic cranial irradiation (PCI) if good response
RT Considerations: Early start (day 1–3), small fields, monitor neutropenia
What is the regimen for Non-Small Cell Lung Cancer (NSCLC)?
- Surgery ± chemotherapy
- Stage III: concurrent chemoradiotherapy (cisplatin-based)
RT Considerations: Thoracic RT, risk of oesophagitis, SOB, image guidance essential
What is the regimen for Head & Neck cancers?
- RT + concurrent cisplatin
- Surgery for select cases
RT Considerations: High toxicity (mucositis, xerostomia), SALT input, daily setup precision
What is the regimen for Brain tumours (e.g. glioblastoma)?
- Surgery + RT ± temozolomide
RT Considerations: Immobilisation critical, monitor cognition/fatigue, steroid cover often needed
What is the regimen for Oesophageal cancer?
- Neoadjuvant chemoradiotherapy (cisplatin + 5-FU) followed by surgery
RT Considerations: Mediastinal field, risk of dysphagia and weight loss
Q: What is the regimen for Cervical cancer?
A: - RT + concurrent cisplatin
- Brachytherapy boost
RT Considerations: Bladder/bowel prep, vaginal toxicity, fertility impact
Q: What is the regimen for Anal cancer?
A: - RT + 5-FU + mitomycin C
RT Considerations: Skin toxicity, perineal care, no surgery unless residual disease
Q: What is the regimen for Rectal cancer?
A: - Neoadjuvant RT ± capecitabine
- Surgery after 6–12 weeks
RT Considerations: Pelvic toxicity (diarrhoea, fatigue), precise contouring to spare bowel
Would you like these as printable flashcards or turned into a quiz to test your recall? I can also group them by modality or toxicity if that helps your workbook flow.
What is the regimen for Cervical cancer?
- RT + concurrent cisplatin
- Brachytherapy boost
RT Considerations: Bladder/bowel prep, vaginal toxicity, fertility impact
What is the regimen for Anal cancer?
- RT + 5-FU + mitomycin C
RT Considerations: Skin toxicity, perineal care, no surgery unless residual disease
What is the regimen for Rectal cancer?
- Neoadjuvant RT ± capecitabine
- Surgery after 6–12 weeks
RT Considerations: Pelvic toxicity (diarrhoea, fatigue), precise contouring to spare bowel
