Radiation Oncology


Questions discussed in this category

Adverse features include increased nuclear size, nuclear atypia, and mitotic activity up to 10/50 HPF.

i.e. doxorubicin, ifosfamide + RT. Do you worry about decreased locoregional control or increased toxicities with the use of G-CSF in combination with...

If there were negative margins, what other factors would you consider to add adjuvant RT? Size of the tumor or depth of invasion?  

Recurrence is in the radiation field right at the border of graft and scalp, and started to surface at about 20-24 Gy. It is visibly enlarging over se...

68 y.o. Male underwent inguinal orchiectomy and spermatic cord resection of a 5 cm malignant fibrous histiocytoma of the spermatic cord. Margins of re...

Would certain patient/disease characteristics make you choose RT therapy over chemotherapy or other locally ablative therapies? What dose/fraction wou...

Did the publication earlier this year by Gundle et al. JCO 2018 (http://ascopubs.org/doi/pdf/10.1200/JCO.2017.74.6941) alter your concept of close mar...

What margins (if any) do you consider appropriate to not require adj RT? And would you ever consider neoadj RT?

Specifically the groin region? Or are there techniques or a change in the management style of radiation at these sites you would employ to minimize to...

If so, how do you choose your region of treatment? Dose? And elective nodal volume?

If margins are clear, would this tumor necessitate adjuvant radiotherapy? Synovial sarcomas often occur in a young patient subset, would this cause yo...

If so, what patients do you select for the boost? And what data do you give to adequately satisfy the insurance review and win approval?

After and extensive en bloc resection, is there further surgery that would be recommended? Is radiation alone sufficient? 

Would you treat these sites to definitive or post-operative doses? If not, is there a dose constraint you use at these sites? Do you use tighter margi...

What things would you take into consideration for the simulation set-up? Specific instructions for treatment planning? If the PTV is confined to only ...

Is breast conserving surgery followed by radiation therapy an option? 

Do you follow pediatric protocols or treat this more like a high grade soft tissue sarcoma? Specifically for paratesticular pleomorphic RMS, do you ad...

What are some guidelines or principles that you use to recommend adjuvant radiation after complete resections of sarcoma? 

For example, in the setting of a lack of pre-operative imaging, what CTV margin(s) would you utilize for the initial and boost phases of treatment?

How does grade, margin status, and previous radiation dose factor into the recommendation? 

What time delay would make the benefit of adjuvant therapy likely no longer significant?

Do you offer neoadjuvant RT with resection and node dissection vs. definitive radiation?  How extensive does the nodal disease have to be for you...

Is there any role for consolidative RT/CRT to the lung and mediastinum after initial chemo? What dose and fractionation would be most appropriate for ...

If so, how to you address the scar? Do you use bolus? Do you place a 2mm retraction from skin for the target contour?

With the high rates of recurrence postoperatively with angiosarcomas of the scalp, adjuvant radiation is often recommended.  What margins would y...

Most guidelines discuss target delineation and contouring recommendations for extremity sarcomas, which generally suggest larger longitudinal than rad...

For example, a patient with liposarcoma of the lower extremity status post preoperative radiation to 50 Gy who then underwent resection and had focall...

Would the dose change based if there was tumor adherent to bowel versus abdominal wall or muscle?

Would the histological grade or histology affect the dose? Would you consider dose escalating to the center of the tumor if this would not affect orga...

I am treating a resected high grade liposarcoma with positive surgical margins to 66Gy. I would prefer to use IMRT to spare the humerus, but ...

When the disease (in this case, lymphoma) involves almost all of the entire muscle compartment of the distal lower extremity, what is a safe dose? I'm...

And does your dose changes with positive margins? I can't seem to find a good answer in the literature.

Papers discussed in this category

Int J Radiat Oncol Biol Phys, 2012 Jul 15

Cancer, 1986-09-01

Cancer, 2010-03-15

Int J Radiat Oncol Biol Phys, 2015 Jul 1

Lancet, 2002-06-29

Lancet Oncol., 2016-07-01

Cancer, 2006 Jul 15

J Radiat Oncol, 2016

Int J Radiat Oncol Biol Phys, 2007 Apr 1

J Bone Joint Surg Am, 2009 Mar 1

J. Clin. Oncol., 1992-01-01

Int J Radiat Oncol Biol Phys, 2012 Nov 1

Cancer, 2003 Apr 15

Int J Radiat Oncol Biol Phys, 2002 Mar 1

J Surg Oncol,

Breast Cancer Res. Treat.,

J. Clin. Oncol.,

Int. J. Radiat. Oncol. Biol. Phys.,

Int. J. Radiat. Oncol. Biol. Phys.,

Radiother Oncol,

Eur. J. Cancer, 2014 Apr 11

Radiat Oncol, 2017 Jan 26

Pract Radiat Oncol, 2015 Nov 17

Int. J. Radiat. Oncol. Biol. Phys.,

J Natl Med Assoc,

Ann Palliat Med,

Int. J. Radiat. Oncol. Biol. Phys.,

Int. J. Radiat. Oncol. Biol. Phys.,

J Clin Oncol, 2003 Apr 15

Cancer, 2011 Jun 15

J. Clin. Oncol.,

Lancet Oncol.,

J Clin Oncol, 2018 Jan 18

Ann. Surg. Oncol., 2018 Oct 01

Clin. Orthop. Relat. Res.,

Int. J. Radiat. Oncol. Biol. Phys., 2015 Apr 17

Am J Clin Oncol, 2016 Dec

Int J Clin Exp Med, 2015 Sep 15

Pathol. Int.,


Radiother Oncol,

Cancer, 2010 Oct 1

Eur J Cancer, 2012 Oct 20

Am J Clin Oncol, 2019 Jan

Ann Surg, 2007 Oct

Ann Surg, 2012 Feb

J Thorac Oncol,

Br. J. Dermatol., 2014 Nov 10

J Am Acad Dermatol, 2018 Nov

Am. J. Surg. Pathol.,


Am. J. Surg. Pathol.,

Ann Diagn Pathol,