Radiation Oncology

Cervical Cancer   

Questions discussed in this category


Recurrence was 2cm and PET confirmed local. Excision with positive margins. Current plan for salvage whole pelvic RT and vaginal cuff brachytherapy +/...

In  patient with PD SCCA 15mm transverse;  5/20mm invasion; LVSI focally present; margins negative;  0/15 Left pelvic and 0/14 right pe...

What dose and technique do you use and how do you integrate the subsequent definitive treatment plan?

The recently released STARS phase 3 RCT found improved DFS, decreased distant recurrence, with reduced toxicities for chemotherapy (cisplatin + taxol)...

SIBs of 55-57.5 Gy in 25 fractions are frequently mentioned with bowel volume constraints at this dose, but assuming there is no bowel nearby (e.g., b...

Patient with stage IIB cervical cancer treated 8 years ago, now with large (>10cm), isolated, symptomatic recurrence involving the left SCL and med...

Small bowel is usually the dose limiting OAR while planning cervical HDR brachytherapy. Having the bladder empty during treatment planning and deliver...

Would you consider additional EBRT or vaginal cuff HDR in a patient with previous tx with EBRT (45Gy) + HDR (30Gy) for a R1 resection with a radial ma...

This has been a common practice in the community. Is there a benefit for certain patients?

Patient being treated for cervical cancer noted to have a < 1 cm posterior vaginal fornix defect with a small focus epiploclia herniating into the ...

Would there be a substanital increase in the risk of toxicity using such a scheme?  We frequently have patients who have to travel long distance...

Could you discuss how you decide between IMRT or SBRT boost for a patient who is not able to receive intracavitary or interstitial HDR or LDR brachyth...

What chemotherapy and sequencing with radiation therapy would you recommend? IS surgery a component of the treatment?

Do you use a trimmed 10 mm expansion on HR-CTV? Do you also include the entire initial extent of disease? How much does your IR-CTV coverage affect yo...

A literature search indicates that most port site recurrences are managed fairly aggressively with chemoRT or RT doses 45-66 Gy. This is understandabl...

Sequentially or do you integrate the cuff brachy with the EBRT and if so what schedule, BIW, weekly, etc?

For example, a patient with cervical or anal SCC who has missed many treatments due to side effects, low blood counts, hospitalizations, or non-compli...

Do you recommend upfront diversion? Are there unique planning considerations such as the inability to use bladder filling? How do you boost? What are ...

What are your specific protocols for monitoring and for dosing narcotics and sedatives?

Close but negative radial margins? LVSI?  What fractionation/dose do you use for your vaginal cuff boost if used? 

In the setting of a negative lymph node sampling, would you treat a full pelvis or mini-pelvis to compensate for lack of the appropriate surgery? Is a...

In patients who don't meet traditional criteria for adjuvant chemoradiation from Peters (GOG 109) and < 2 high risk factors from Rotman (GOG 92) fo...

What exactly do you contour and what is your dose constraint to that volume?

Does using something like a vienna applicator allow you to avoid dose escalation with more external beam? How do you recommend doing a classic pa...

Some classic references recommend the coverage of the entirety of the sacrum but the volume delineation guidelines for both seem to only cover the mos...

Do you try to keep Hb> 10 or 12? Or somewhere in between? 

The most recent ABS guidelines don't discuss a dose constraint for the small bowel.

Do you treat PAs if pelvic nodes are positive? If common iliacs are involved? Only if there are positive PA nodes?


Papers discussed in this category


International journal of radiation oncology, biology, physics, 2011-02-01

Int J Radiat Oncol Biol Phys, 2013 Jul 9

Int. J. Radiat. Oncol. Biol. Phys., 2014-05-01

Cancer Nurs, 2017-04-21

Cochrane Database Syst Rev, 2010 Sep 08

International journal of radiation oncology, biology, physics, 2019-05-01

Cochrane Database Syst Rev, 2012 May 16

Int. J. Gynecol. Cancer,

Seminars in radiation oncology, 2019-04

International journal of radiation oncology, biology, physics, 2006-08-01

Gynecologic oncology, 2005-11

J. Clin. Oncol., 2011 Mar 28

BMC Cancer, 2017 Apr 28

Clin Transl Radiat Oncol, 2018 Jan 11

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2019-01

International journal of radiation oncology, biology, physics, 1991-07

Cancer,

N. Engl. J. Med.,

J Gynecol Oncol,

International journal of radiation oncology, biology, physics, 2008-11-15

Int. J. Radiat. Oncol. Biol. Phys., 2012 Aug 14

Practical radiation oncology, 2017

Practical radiation oncology, 2018

The New England journal of medicine, 1999-04-15

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2000-04

Ann Oncol, 2012 Feb 21

JAMA Oncol,

Int J Gynecol Cancer, 2019 Jan 04