Egyptian Board Clinical Oncology flashcards

35 cards. Read the term and the definition here. The deck at the top of this page is optional.

Calvert formula

Carboplatin dose (mg) = target AUC x (GFR + 25). Used to calculate carboplatin dosing based on renal function rather than body surface area, reducing toxicity and improving accuracy.

Dexrazoxane

Iron chelator used as an antidote for anthracycline extravasation and to reduce anthracycline cardiotoxicity. It is given shortly after extravasation or before high cumulative doxorubicin doses.

Mesna

Thiol compound that inactivates acrolein, the urotoxic metabolite of cyclophosphamide and ifosfamide. It prevents hemorrhagic cystitis and is given with high-dose oxazaphosphorine therapy.

Immune-related adverse events

Organ-specific toxicities from checkpoint inhibitors, including colitis, pneumonitis, hepatitis, thyroiditis, and hypophysitis. Grade 3-4 events require drug hold and high-dose corticosteroids.

Rasburicase

Recombinant urate oxidase that rapidly converts uric acid to allantoin, used to prevent or treat tumor lysis syndrome hyperuricemia. Contraindicated in G6PD deficiency because of hemolysis risk.

PTV

Planning target volume: the CTV plus a margin for setup error and patient motion. It ensures the prescribed dose actually covers the target despite daily positioning uncertainty.

V20 lung

Volume of lung receiving at least 20 Gy. Keeping V20 below about 30-35% reduces the risk of symptomatic radiation pneumonitis after thoracic radiotherapy.

Bragg peak

Characteristic dose deposition of protons: most energy is released at a specific depth, with a sharp distal falloff. This spares tissue beyond the target compared with photon beams.

Spinal cord tolerance

Maximum radiation dose to the spinal cord is about 45-50 Gy in 2 Gy fractions. Exceeding this risks radiation myelopathy, a late and irreversible complication.

CDK4/6 inhibitors

Palbociclib, ribociclib, and abemaciclib block cell-cycle progression in hormone receptor-positive breast cancer. They are combined with endocrine therapy in metastatic and high-risk early disease.

Oncotype DX

Genomic assay measuring 21 genes in hormone receptor-positive, HER2-negative early breast cancer. The recurrence score guides whether adjuvant chemotherapy adds benefit to endocrine therapy.

Trastuzumab deruxtecan

Antibody-drug conjugate linking an anti-HER2 antibody to a topoisomerase I inhibitor payload. It is active in HER2-positive and HER2-low metastatic breast cancer, with interstitial lung disease as a key toxicity.

Osimertinib

Third-generation EGFR tyrosine kinase inhibitor that targets sensitizing EGFR mutations and T790M resistance. It is first-line therapy for advanced EGFR-mutant non-small cell lung cancer and penetrates the CNS.

Limited-stage SCLC

Small cell lung cancer confined to one hemithorax and regional nodes that can be covered in one radiation field. Treated with concurrent platinum/etoposide and thoracic radiotherapy.

Prophylactic cranial irradiation

Low-dose whole-brain radiotherapy given to small cell lung cancer patients who respond to initial therapy. It reduces brain metastasis risk but carries neurocognitive toxicity.

CROSS regimen

Neoadjuvant carboplatin and paclitaxel with 41.4 Gy radiotherapy for resectable esophageal cancer. It improves survival compared with surgery alone and is a standard of care.

Milan criteria

Liver transplant eligibility for hepatocellular carcinoma: single tumor up to 5 cm, or up to three tumors each 3 cm or less, without vascular invasion or extrahepatic spread.

FOLFIRINOX

Combination of fluorouracil, leucovorin, irinotecan, and oxaliplatin. Used for metastatic pancreatic cancer and increasingly for borderline resectable disease, with significant toxicity.

PSA recurrence

After radical prostatectomy, a rising PSA above 0.2 ng/mL suggests biochemical recurrence. After radiotherapy, the Phoenix definition uses nadir plus 2 ng/mL.

BCG intravesical therapy

Live attenuated Mycobacterium bovis instilled into the bladder to treat non-muscle-invasive urothelial carcinoma. It reduces recurrence and progression but is contraindicated in immunosuppression.

BEP regimen

Bleomycin, etoposide, and cisplatin, the standard chemotherapy for advanced germ cell tumors. Bleomycin causes pulmonary toxicity, and cisplatin causes neuropathy and renal injury.

PARP inhibitors

Olaparib, niraparib, and rucaparib exploit synthetic lethality in BRCA-mutated tumors by blocking DNA single-strand repair. They are used as maintenance in ovarian and breast cancer.

EMA-CO

Etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine regimen for high-risk gestational trophoblastic disease. Beta-hCG monitors response to treatment.

Point A

Reference point for intracavitary brachytherapy dose prescription in cervical cancer. It lies 2 cm lateral to the cervical canal and 2 cm superior to the external cervical os.

R-CHOP

Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone. It is the standard first-line regimen for diffuse large B-cell lymphoma and other CD20-positive B-cell lymphomas.

CRAB criteria

Calcium elevation, renal insufficiency, anemia, and bone lesions: features defining symptomatic multiple myeloma requiring treatment. Additional markers include marrow plasma cells and involved/uninvolved light chain ratio.

Graft-versus-host disease

Donor T cells attack recipient tissues after allogeneic stem cell transplantation, affecting skin, liver, and gastrointestinal tract. Treated with corticosteroids and immunosuppression.

Stupp regimen

Radiotherapy 60 Gy in 30 fractions with concurrent and adjuvant temozolomide for glioblastoma. It is the standard of care after maximal safe resection.

MGMT promoter methylation

Epigenetic silencing of the DNA repair gene MGMT in glioblastoma. It predicts greater benefit from temozolomide and is associated with improved survival.

1p/19q codeletion

Chromosomal deletion found in oligodendrogliomas and associated with IDH mutation. It defines a favorable glioma subgroup that responds to chemotherapy and radiotherapy.

Wilms tumor

Most common pediatric renal cancer, presenting with an abdominal mass. Treatment combines nephrectomy with chemotherapy and, for advanced stages, radiotherapy.

MYCN amplification

Genetic feature of high-risk neuroblastoma associated with poor prognosis. It guides intensive treatment including chemotherapy, stem cell transplant, and isotretinoin.

Febrile neutropenia

Fever of 38.3°C or higher once, or 38.0°C sustained for an hour, with absolute neutrophil count under 500/µL. Empiric antipseudomonal antibiotics must start within 60 minutes.

Spinal cord compression

Tumor compression of the spinal cord causing back pain, weakness, and sphincter dysfunction. Urgent MRI, dexamethasone, and surgery or radiotherapy are required to preserve function.

Hypercalcemia of malignancy

Elevated calcium from tumor secretion of PTHrP or bone destruction, common in lung, breast, and myeloma. Treated with saline, calcitonin, and bisphosphonates or denosumab.