Charity Rogstad

April Case Study

Sarcomatoid Lung Cancer

I. History of Present Illness

a. Emergency room 12/17/16
b. Chest CT 1/19/17
c. Aspiration 1/24/17
d. Emergency room 1/29/17
e. CT angiography 1/31/17
II. Past Medical History
a. Sleep apnea
b. Gastric reflux
c. Benign prostatic hyperplasia
III. Social History
a. Smoking 30 pack year
b. Alcohol rare
c. Family history mother, father, sisters
IV. Medications
a. Wellbutrin
b. Meclizine
c. Multivitamin
V. Diagnostic Imaging
a. Chest xray
b. Chest CT
c. CT angiography
VI. Radiation Oncologist Recommendations
a. Palliative RT
b. Concurrent Chemo
c. Advantages of Adjuvant chemo
d. Plan if tumor response/nonresponse
VII. The Plan (prescription)
a. Prescription
b. Imaging
c. 3D vs Vmat
VIII. Patient Setup/Immobilization
a. Ct Sim Phillips Big Bore
b. Position
i. Wingboard
ii. Knee cushion
iii. Toes banded
iv. 5 tattoos
 IX. Anatomical Contouring
a. TPS
b. Contouring
i. PTV Lt Lung
ii. Lt Lung
iii. Rt Lung
iv. Airway
v. Spinal cord
vi. Heart
vii. Esophagus
viii. Combo Lung
c. Verification of tumor volume
X. Beam Isocenter/Arrangement
a. Machine type Elekta Infinity
b. Energy
c. Gantry position (angle, collimator angle)
d. Vmat arc 2
e. Blocking and MLC pattern
XI. Treatment Planning
a. Computer system - pinnacle
b. Prescription -
c. OR constraints
d. DVH
XII. Quality Assurance/Physics Check
a. Mobius
b. Tolerance between checks
c. Reviewed by physicist
XIII. Conclusion
a. Patients current status
b. What I learned
c. What I found difficult