1.Before treatment, a CT scan is often performed to identify the tumor and surrounding normal structures.

The patient is then sent for a simulation so that molds can be created to be used during treatment. The patient receives small skin marks to guide the placement of treatment fields. The response of a tumour to radiotherapy is also related to its size. For complex reasons, very large tumours respond less well to radiation than smaller tumours or microscopic disease. Various strategies are used to overcome this effect. The most common technique is surgical resection prior to radiotherapy. This is most commonly seen in the treatment of breast cancer with wide local excision or mastectomy followed by adjuvant radiotherapy. Another method is to shrink the tumour with neoadjuvant chemotherapy prior to radical radiotherapy. A third technique is to enhance the radiosensitivity of the cancer by giving certain drugs during a course of radiotherapy. Examples of radiosensiting drugs include: Cisplatin, Nimorazole, and Cetuximab. 2. Multiple myeloma is a haematological malignancy characterized by the occurrence of plasma cell tumours within the bone marrow. In advanced multiple myeloma, metastatic deposits outside the bone marrow (extramedullary) are rare. Reported extramedullary sites include the upper respiratory tract and lymph nodes. Parenchymal pulmonary plasmacytoma is exceptionally rare. We describe such a case in a 51-year-old male, who underwent allogenic marrow transplantation. 6 months post-transplantation developing nodal and hilar pulmonary multiple myeloma, the radiological appearances mimicking lymphoma.. The type of radiation therapy most often used to treat multiple myeloma or solitary plasmacytoma is called external beam radiation therapy. 3. operasi pengangkatan kankernya saja sampai daerah bebas tumor disertai pembersihan kelenjar ketiak, dengan mempertahankan payudara tetap utuh, kemudian dilanjutkan dengan radioterapi Conserving Treatment (BCT). 4. a. and require a significantly higher dose of radiation (60-70Gy) to achieve a radical cure. b. The response of a tumour to radiotherapy is also related to its size. For complex reasons, very large tumours respond less well to radiation than smaller tumours or microscopic disease. Various strategies are used to overcome this effect. The most common technique is surgical resection prior to radiotherapy. This is most commonly seen in the treatment of breast cancer with wide local excision or mastectomy followed by adjuvant radiotherapy. Another method is to shrink the tumour with neoadjuvant chemotherapy prior to radical radiotherapy. A third technique is to enhance the radiosensitivity of the cancer by giving certain drugs during a course of radiotherapy. Examples of radiosensiting drugs include: Cisplatin, Nimorazole, and Cetuximab. 5. Prinsip kerja radioterapi adalah memanfaatkan energi dari sinar pengion tersebut sedemikian rupa
sehingga dapat diarahkan tepat mengenai tumor dan merusak kode genetik sel tumor. Energi tersebut akan merusak komponen genetik yang disebut DNA (Deoxyribose Nucleic Acid). Kerusakan DNA akan menyebabkan sel tumor menjadi mandul atau mati. Dengan demikian, sel tumor tidak akan berkembang lagi dan pasien memiliki harapan tinggi untuk sembuh. Namun, disebabkan letak tumor yang terkadang berdekatan dengan jaringan atau organ sehat, maka dapat pula timbul efek samping. Oleh sebab itu, tim Onkologi Radiasi di suatu pusat radioterapi telah dibekali ilmu dan ketrampilan

khusus dalam merawat pasien-pasien yang menjalani radiasi, sehingga efek samping tersebut dapat ditekan hingga seminimal mungkin. 6. kanker serviks, payudara, otak, prostat, prostat, paru paru hati kulit osteosarcoma kanker ovarium