SEP 2023 ONCOLOGY CARTOONS

Kanhu Charan
Kanhu Charanradiation oncologist
DR KANHU CHARAN PATRO
M.D, D.N.B[RT], MBA, FICRO, FAROI, PDCR,
CEPC
SEPTEMBER 2023 ISSUE/90th VOLUME
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SEP 2023 ONCOLOGY CARTOONS
SEP 2023 ONCOLOGY CARTOONS
H. VON DER MAASE/JCO/2023 16th AUG 2023/BLADDER
Metastatic urinary bladder  GC VS
MVAC
Patients with stage IV -TCC and no prior systemic chemotherapy were randomized to
GC (gemcitabine 1,000 mg/m2 days 1, 8, and 15; cisplatin 70 mg/m2 day 2) or standard
MVAC every 28 days for a maximum of six cycles.
1. More GC patients completed six cycles of therapy, with fewer
dose adjustments. The toxic death rate was 1% on the GC arm
and 3% on the MVAC arm.
2. More GC than MVAC patients had grade 3/4 anemia (27% v
18%, respectively) and thrombocytopenia (57% v 21%,
respectively).
3. Overall survival was similar on both arms (hazards ratio [HR],
1.04; 95% confidence interval [CI], 0.82 to 1.32; P = .75),
4. As were time to progressive disease (HR, 1.05; 95% CI, 0.85 to
1.30), time to treatment failure (HR, 0.89; 95% CI, 0.72 to 1.10),
and response rate (GC, 49%; MVAC, 46%).
MATTHEW T. BALLO/JNO/2023 17th AUG 2023/BRAIN
TUMOR TREATING FIELDS THERAPY GLIOBLASTOMA
Association of Tumor Treating Fields
(TTFields) therapy with survival
in newly diagnosed glioblastoma:
a systematic review
and meta-analysis
TJ WHELA/NEJM/2023 18th AUG 2023/BREAST
CAN WE OMIT RADIOTHERAPY AFTER BCS IN LUMINL VARIANT?
Breast cancer groups include - Group 1 (luminal A).
This group includes tumors that are ER positive and
PR positive, but negative for HER2
19th AUG 2023/BRACHY
Sources Commonly Used in Sealed-Source Brachytherapy
RADIOBIOLOGY AND TREATMENT PLANNING
Oncologic Imaging A Multidisciplinary Approach BOOK 20th AUG 2023/OAR
Approximate Dose/Volume/Outcome Data for Several Organs after
Conventionally Fractionated Radiation Therapy
Oncologic Imaging A Multidisciplinary Approach BOOK 21st AUG 2023/SBRT
M. D. ANDERSON RESPONSE CRITERIA FOR BONE
METASTASES
WHAT A ONCOLOGIST WANT IN LUNG CANCER IMAGING?
Oncologic Imaging A Multidisciplinary Approach BOOK 22nd AUG 2023/LUNG
‘Five Rs’ of radiotherapy and Their Clinical
Relevance
RADIOBIOLOGY AND TREATMENT PLANNING 23rd AUG 2023/RADIOBIOLOGY
EFFECTS OF ALTERATIONS IN RADIOTHERAPY SCHEDULING ON TUMOUR AND NORMAL TISSUES
RADIOBIOLOGY AND TREATMENT PLANNING 24th AUG 2023/RADIOBIOLOGY
DOSE FRACTIONATION SCHEDULE FOR OLIGOMETASTIC DISEASES
RADIOBIOLOGY AND TREATMENT PLANNING 25th AUG 2023/STEROTAXY
CTV DEFINITION FOR STAGE IE NON-HODGKIN LYMPHOMA
RADIOBIOLOGY AND TREATMENT PLANNING 26th AUG 2023/LYMPHOMA
MAIN RCTS WHICH HAVE INFLUENCED MANAGEMENT OF RECTAL CANCER
RADIOBIOLOGY AND TREATMENT PLANNING 27th AUG 2023/RECTUM
RCT OF RADIOTHERAPY FOR ANAL CANCER
PRACTICAL RADIOTHERAPY PLANNING 28th AUG 2023/ANAL CANAL
29th AUGUST 2023/PROSTATE
Comparison of radiation and surgery in cancer prostate
PRACTICAL RADIOTHERAPY PLANNING
30th AUGUST 2023/PAED
RISK ADAPTED RADIOTHERAPY DOSE FOR LOCALISED & META. WILMS’
PRACTICAL RADIOTHERAPY PLANNING
31st AUGUST 2023/STEREO
RADIOTHERAPY IN HEAD AND NECK PARAGANGLIOMA
PRACTICAL RADIOTHERAPY PLANNING
The tumour is contoured as GTV and expanded by a small margin (3–5 mm) to form a
PTV based on department setup errors. 45 Gy in 25 fractions are prescribed, usually
delivered by IMRT or VMAT like other head and neck cancers. Stereotactic
radiotherapy (12–15 Gy) has also been used
1. These are very slow-growing tumours arising
in the neuroendocrine paraganglial cells.
2. They can present with local symptoms,
cranial nerve palsies or as incidental
findings.
3. They are usually, but not always, benign.
Common sites include the carotid
bifurcation (carotid body tumours), jugular
bulb or vagus.
4. The risks of surgery include bleeding and
nerve damage and are higher with larger
tumours. EBRT is an option for symptomatic,
progressive disease if the risks are thought
to be lower than those of surgery.
5. Ten-year local control rates are 95 percent
but with no randomized comparison to
observation
1st SEPETMBER 2023/PANC
PRESENTATIONS OF PANCREATIC NEUROENDOCRINE TUMORS
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
2nd SEPETMBER 2023/METS
KNOWN FACTORS ABOUT BONE METASTASIS
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
3rd SEP 2023/CHEMO
CHEMOTHERAPY INDUCED CARDIOPULMONARY TOXICITY
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
4th SEP 2023/TOXICITY
CHEMO & RADIOTHERAPY INDUCED PULMONARY TOXICITY
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
5th SEP 2023/TOXICITY
HALO SIGN AND REVERSE HOLO SIGN
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
The reversed halo sign, also known as
the atoll sign, on chest CT is defined
as central ground-glass opacity
surrounded by denser consolidation of
crescentic shape (forming more than
three-fourths of a circle) or complete
ring. The consolidation should be at
least 2 mm in thickness
The halo sign has been pathophysiologically
characterized as a discrete nodule of
angioinvasive aspergillosis with infarction
and coagulative necrosis surrounded by
alveolar hemorrhage. IPA is considered to be
the most common cause of angioinvasive
fungal infection in severely
immunocompromised patient
6th SEP 2023/TOXICITY
FUNGAL PNEUMONIA IN CANCER PATIENTS
MEDSCAPE.COM
1. Sudden onset
2. Fever
3. Cough, usually nonproductive
4. Pleuritic chest pain or dull
discomfort
5. Progressive dyspnea (shortness of
breath) leading to respiratory failure
1. Temperature elevation
2. Tachycardia
3. Tachypnea
4. Respiratory distress
5. Rales
6. Signs of pulmonary consolidation
7. Pleural rub
AMPHOTERECIN B/VORICONAZOLE
7th SEP 2023/TOXICITY
BLEOMYCIN INDUCED PULMONARY TOXICTY
1. A 49-year-old man with Hodgkin’s lymphoma
developed increasing shortness of breath after
completion of the first cycle of chemotherapy
(ABVD) that progressed after the second cycle.
2. The lung injury seen following bleomycin
comprises an interstitial oedema with an influx of
inflammatory and immune cells.
3. This may lead to the development of pulmonary
fibrosis, characterized by enhanced production and
deposition of collagen and other matrix
components.
1. Bronchoscopy did not show any organisms.
Bleomycin was discontinued and the patient was
treated with steroids with clinical resolution of
shortness of breath.
2. Chest CT scan 4 years after completion of
chemotherapy shows that some of the acute
changes that were seen in resolved, although
nonreversible peripheral bleomycin-induced
pulmonary fibrosis remained (arrows).
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
8th SEP 2023/BOWEL
KEY POINTS ABOUT SMALL BOWEL CARCINOID
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
9th SEP 2023/GIST
KEY POINTS ABOUT SMALL BOWEL GIST
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
10th SEP 2023/BMT
TYPES AND STEPS IN BONE MARROW TRANSPLANT
POCKET GUIDE TO ONCOLOGIC
EMERGENCIES
11th SEP 2023/NET
KEY POINTS ON PANCREATIC NEUROENDOCRINE TUMORS
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
12th SEP 2023/RADIOLOGY
RADIOLOGICAL PICTURES OF THYMIC NEOPLASMS
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
13th SEP 2023/RADIOLOGY
RADIOLOGICAL PICTURES OF MEDIASTINAL TUMORS(GERM CELL)
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
14th SEP 2023/RADIOLOGY
RADIOLOGICAL PICTURES OF NEUROGENIC MEDIASTINAL MASS
ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
15th SEP 2023/PUBLIC
SEXUAL LIFE DURING CANCER TREATMENT
Google
1. Cancer is not contagious; you can have it.
2. Your intimacy with your partner gives
confidence to your partner.
3. Do not force or put pressure your partner
for sex.
4. During chemotherapy it is allowed but
use barrier method as some
chemo/immuno drugs secreted in body
fluids
5. During radiotherapy you can have it but
if radiation is around genital part, please
avoid
6. After surgery period you can have but
wait till your partner becomes healthy.
7. During radioactive treatment and
investigation avoid for few days as per
doctor’s advice
8. Never hesitate to ask your doctor
1 of 34

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SEP 2023 ONCOLOGY CARTOONS

  • 1. DR KANHU CHARAN PATRO M.D, D.N.B[RT], MBA, FICRO, FAROI, PDCR, CEPC SEPTEMBER 2023 ISSUE/90th VOLUME www.facebook.com/oncologycartoons/photos_albums www.slideshare.net/search/slideshow?searchfrom=header&q=oncology+cartoons
  • 4. H. VON DER MAASE/JCO/2023 16th AUG 2023/BLADDER Metastatic urinary bladder  GC VS MVAC Patients with stage IV -TCC and no prior systemic chemotherapy were randomized to GC (gemcitabine 1,000 mg/m2 days 1, 8, and 15; cisplatin 70 mg/m2 day 2) or standard MVAC every 28 days for a maximum of six cycles. 1. More GC patients completed six cycles of therapy, with fewer dose adjustments. The toxic death rate was 1% on the GC arm and 3% on the MVAC arm. 2. More GC than MVAC patients had grade 3/4 anemia (27% v 18%, respectively) and thrombocytopenia (57% v 21%, respectively). 3. Overall survival was similar on both arms (hazards ratio [HR], 1.04; 95% confidence interval [CI], 0.82 to 1.32; P = .75), 4. As were time to progressive disease (HR, 1.05; 95% CI, 0.85 to 1.30), time to treatment failure (HR, 0.89; 95% CI, 0.72 to 1.10), and response rate (GC, 49%; MVAC, 46%).
  • 5. MATTHEW T. BALLO/JNO/2023 17th AUG 2023/BRAIN TUMOR TREATING FIELDS THERAPY GLIOBLASTOMA Association of Tumor Treating Fields (TTFields) therapy with survival in newly diagnosed glioblastoma: a systematic review and meta-analysis
  • 6. TJ WHELA/NEJM/2023 18th AUG 2023/BREAST CAN WE OMIT RADIOTHERAPY AFTER BCS IN LUMINL VARIANT? Breast cancer groups include - Group 1 (luminal A). This group includes tumors that are ER positive and PR positive, but negative for HER2
  • 7. 19th AUG 2023/BRACHY Sources Commonly Used in Sealed-Source Brachytherapy RADIOBIOLOGY AND TREATMENT PLANNING
  • 8. Oncologic Imaging A Multidisciplinary Approach BOOK 20th AUG 2023/OAR Approximate Dose/Volume/Outcome Data for Several Organs after Conventionally Fractionated Radiation Therapy
  • 9. Oncologic Imaging A Multidisciplinary Approach BOOK 21st AUG 2023/SBRT M. D. ANDERSON RESPONSE CRITERIA FOR BONE METASTASES
  • 10. WHAT A ONCOLOGIST WANT IN LUNG CANCER IMAGING? Oncologic Imaging A Multidisciplinary Approach BOOK 22nd AUG 2023/LUNG
  • 11. ‘Five Rs’ of radiotherapy and Their Clinical Relevance RADIOBIOLOGY AND TREATMENT PLANNING 23rd AUG 2023/RADIOBIOLOGY
  • 12. EFFECTS OF ALTERATIONS IN RADIOTHERAPY SCHEDULING ON TUMOUR AND NORMAL TISSUES RADIOBIOLOGY AND TREATMENT PLANNING 24th AUG 2023/RADIOBIOLOGY
  • 13. DOSE FRACTIONATION SCHEDULE FOR OLIGOMETASTIC DISEASES RADIOBIOLOGY AND TREATMENT PLANNING 25th AUG 2023/STEROTAXY
  • 14. CTV DEFINITION FOR STAGE IE NON-HODGKIN LYMPHOMA RADIOBIOLOGY AND TREATMENT PLANNING 26th AUG 2023/LYMPHOMA
  • 15. MAIN RCTS WHICH HAVE INFLUENCED MANAGEMENT OF RECTAL CANCER RADIOBIOLOGY AND TREATMENT PLANNING 27th AUG 2023/RECTUM
  • 16. RCT OF RADIOTHERAPY FOR ANAL CANCER PRACTICAL RADIOTHERAPY PLANNING 28th AUG 2023/ANAL CANAL
  • 17. 29th AUGUST 2023/PROSTATE Comparison of radiation and surgery in cancer prostate PRACTICAL RADIOTHERAPY PLANNING
  • 18. 30th AUGUST 2023/PAED RISK ADAPTED RADIOTHERAPY DOSE FOR LOCALISED & META. WILMS’ PRACTICAL RADIOTHERAPY PLANNING
  • 19. 31st AUGUST 2023/STEREO RADIOTHERAPY IN HEAD AND NECK PARAGANGLIOMA PRACTICAL RADIOTHERAPY PLANNING The tumour is contoured as GTV and expanded by a small margin (3–5 mm) to form a PTV based on department setup errors. 45 Gy in 25 fractions are prescribed, usually delivered by IMRT or VMAT like other head and neck cancers. Stereotactic radiotherapy (12–15 Gy) has also been used 1. These are very slow-growing tumours arising in the neuroendocrine paraganglial cells. 2. They can present with local symptoms, cranial nerve palsies or as incidental findings. 3. They are usually, but not always, benign. Common sites include the carotid bifurcation (carotid body tumours), jugular bulb or vagus. 4. The risks of surgery include bleeding and nerve damage and are higher with larger tumours. EBRT is an option for symptomatic, progressive disease if the risks are thought to be lower than those of surgery. 5. Ten-year local control rates are 95 percent but with no randomized comparison to observation
  • 20. 1st SEPETMBER 2023/PANC PRESENTATIONS OF PANCREATIC NEUROENDOCRINE TUMORS ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 21. 2nd SEPETMBER 2023/METS KNOWN FACTORS ABOUT BONE METASTASIS ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 22. 3rd SEP 2023/CHEMO CHEMOTHERAPY INDUCED CARDIOPULMONARY TOXICITY ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 23. 4th SEP 2023/TOXICITY CHEMO & RADIOTHERAPY INDUCED PULMONARY TOXICITY ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 24. 5th SEP 2023/TOXICITY HALO SIGN AND REVERSE HOLO SIGN ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH The reversed halo sign, also known as the atoll sign, on chest CT is defined as central ground-glass opacity surrounded by denser consolidation of crescentic shape (forming more than three-fourths of a circle) or complete ring. The consolidation should be at least 2 mm in thickness The halo sign has been pathophysiologically characterized as a discrete nodule of angioinvasive aspergillosis with infarction and coagulative necrosis surrounded by alveolar hemorrhage. IPA is considered to be the most common cause of angioinvasive fungal infection in severely immunocompromised patient
  • 25. 6th SEP 2023/TOXICITY FUNGAL PNEUMONIA IN CANCER PATIENTS MEDSCAPE.COM 1. Sudden onset 2. Fever 3. Cough, usually nonproductive 4. Pleuritic chest pain or dull discomfort 5. Progressive dyspnea (shortness of breath) leading to respiratory failure 1. Temperature elevation 2. Tachycardia 3. Tachypnea 4. Respiratory distress 5. Rales 6. Signs of pulmonary consolidation 7. Pleural rub AMPHOTERECIN B/VORICONAZOLE
  • 26. 7th SEP 2023/TOXICITY BLEOMYCIN INDUCED PULMONARY TOXICTY 1. A 49-year-old man with Hodgkin’s lymphoma developed increasing shortness of breath after completion of the first cycle of chemotherapy (ABVD) that progressed after the second cycle. 2. The lung injury seen following bleomycin comprises an interstitial oedema with an influx of inflammatory and immune cells. 3. This may lead to the development of pulmonary fibrosis, characterized by enhanced production and deposition of collagen and other matrix components. 1. Bronchoscopy did not show any organisms. Bleomycin was discontinued and the patient was treated with steroids with clinical resolution of shortness of breath. 2. Chest CT scan 4 years after completion of chemotherapy shows that some of the acute changes that were seen in resolved, although nonreversible peripheral bleomycin-induced pulmonary fibrosis remained (arrows). ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 27. 8th SEP 2023/BOWEL KEY POINTS ABOUT SMALL BOWEL CARCINOID ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 28. 9th SEP 2023/GIST KEY POINTS ABOUT SMALL BOWEL GIST ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 29. 10th SEP 2023/BMT TYPES AND STEPS IN BONE MARROW TRANSPLANT POCKET GUIDE TO ONCOLOGIC EMERGENCIES
  • 30. 11th SEP 2023/NET KEY POINTS ON PANCREATIC NEUROENDOCRINE TUMORS ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 31. 12th SEP 2023/RADIOLOGY RADIOLOGICAL PICTURES OF THYMIC NEOPLASMS ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 32. 13th SEP 2023/RADIOLOGY RADIOLOGICAL PICTURES OF MEDIASTINAL TUMORS(GERM CELL) ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 33. 14th SEP 2023/RADIOLOGY RADIOLOGICAL PICTURES OF NEUROGENIC MEDIASTINAL MASS ONCOLOGIC IMAGING A MULTIDISCIPLINARYAPPROACH
  • 34. 15th SEP 2023/PUBLIC SEXUAL LIFE DURING CANCER TREATMENT Google 1. Cancer is not contagious; you can have it. 2. Your intimacy with your partner gives confidence to your partner. 3. Do not force or put pressure your partner for sex. 4. During chemotherapy it is allowed but use barrier method as some chemo/immuno drugs secreted in body fluids 5. During radiotherapy you can have it but if radiation is around genital part, please avoid 6. After surgery period you can have but wait till your partner becomes healthy. 7. During radioactive treatment and investigation avoid for few days as per doctor’s advice 8. Never hesitate to ask your doctor